Do Lines Disappear Naturally? Boundaries between smile line care and treatment

As we age, many of us worry about "laugh lines. Since they greatly affect the impression one gives of one's appearance, there is no end to the number of people who suffer from them as a symbol of an aging face.

The Internet has introduced countless measures such as moisturizing creams, massages, and facial training, but can these be enough to make lines disappear naturally? Relying on self-induced measures without understanding the medically known factors, such as changes in facial expression, skeletal structure, and structural changes in the dermis, may actually have the opposite effect.

Here, we explain everything from the mechanisms that cause lines to the latest cosmetic medical approaches, based on the views and evidence of medical specialists, and offer guidelines for identifying the best measures for oneself while clarifying the boundaries between self-care and medical treatment.

 

Why do "laugh lines" form in the first place? Medical Causes and Mechanisms

Many of us have been surprised to suddenly find deeply etched lines on our faces in the mirror. They may seem to appear suddenly as a "sign of age," but in fact, behind the lines are structural changes that are slowly progressing deep within the skin.

The first thing to know is that lines are not just wrinkles. In addition to changes in the skin itself, they are "grooves" caused by changes in the three-dimensional structure of the entire face, including fat, muscle, and even the skeleton.

This section describes the major medically understood causes of lines, both in terms of structural and lifestyle factors.

Structural factors｜Changes in skin, fat, muscle, and bone

With aging, collagen and elastin, which maintain the skin's "elasticity," decrease, causing the skin to lose its firmness. As a result, the skin cannot resist gravity and tends to droop, resulting in the appearance of lines.

In addition, the fat beneath the skin also changes with age. When the fat in the cheeks (buccal fat body) droops due to gravity, its own weight creates shadows around the mouth, which are visualized as linear furrows. In fact, a Shiseido study reported that drooping cheek fat is a major factor in the formation of laugh lines.

Changes also occur on the muscular side. As the facial muscles around the mouth weaken, the muscles lose their ability to support the skin, spurring the formation of lines. In addition, after the 40s, facial bone resorption (bone atrophy) also progresses, and the skeletal structure that supports the skin itself becomes thinner, causing the furrows to become deeper.

primary factor	affect	remarks
Decrease in collagen and elastin	Decreased skin elasticity and firmness	Aging deteriorates fibers in the dermis
Fat drooping and migration	The volume of the cheeks falls to the mouth.	Due to gravity and loosening of supporting tissues
Muscle wasting	Decreased support	Decreased activity of facial muscles (e.g., orbicularis oris muscle)
bone atrophy	Shrinkage of the base and excess skin	Particularly noticeable after 40s

Factors other than age｜Expression habits and lifestyle also play a role.

Aging is not the only cause. Even in younger generations, lifestyle and daily habits can be factors that promote lines.

For example, chewing habits such as chewing only on one side, looking down at the phone for long periods of time, and sleeping positions such as lying on one's side or on one's stomach can also place excessive stress on certain areas of the face through muscle balance and skin pressure. In many cases, these habits can lead to the appearance of lines that differ from side to side.

Oxidative stress from smoking and ultraviolet rays can also easily destroy collagen in the skin, hastening the loss of firmness. The deterioration of the skin's barrier function due to dryness also coarsens the skin's surface texture and makes wrinkles more noticeable.

 

Is it true that if you lose weight, your lines will disappear? In fact, there are cases where it can have the opposite effect!

In the previous chapter, we explained that structural changes in skin, fat, muscle, and bone, as well as daily factors such as facial expression habits and lifestyle, are involved as causes of the formation of lines. As part of these factors, many people have the idea that "I have too much fat on my face, so if I lose weight, won't that reduce my wrinkles?" Many people have the idea that "I have too much fat on my face, so if I lose weight, my wrinkles will decrease.

However, in conclusion, we need to be careful with that concept. Especially in people in their 40s and beyond, "losing weight does not necessarily mean getting younger," and in fact, there is a risk that it could have the opposite effect.

Beware of being too skinny! Does face skinny make you look older?

With aging, changes occur not only in the skin and muscles, but also in the subcutaneous fat and skeletal structure. Especially around the cheeks, fat and subcutaneous tissue are known to atrophy and the entire face loses its support.

Further excessive weight loss here could have the following effects

• Decreased amount of fat in cheeks → Excess skin, drooping
• Skeletal support weakens → "shadows" of the laugh lines deepen
• Atrophy of the facial muscles → Wrinkles and mouth puckering are noticeable.

In other words, in many cases, facial thinning causes an imbalance between skin and fat, and the lines become more prominent rather than less. Ageing skin is particularly difficult to recover from, as its ability to regenerate collagen and elastin is reduced.

Keeping it Healthy! Beauty and youthfulness at the same time!

So, what is the concept of how to reduce "aging" in terms of beauty? The key word is not "slimming" but "toning. Specifically, the following three points are important.

point of view	Examples of contents	explanation
Maintenance of muscle mass	Exercises and massage of facial muscles, masseter muscles, and broad cervical muscles	Keeps cheeks supported and maintains facial lines and mouth taut
Moderate retention of subcutaneous fat	Not too much reduction of the cheek mailer fat and midface fat layer.	Prevents volume loss and sagging
Care to support skin elasticity	Skin care containing vitamin C, niacinamide, retinol, etc.	Supplementation of ingredients to support firmness from the dermal layer is key.

In particular, people in their 40s and beyond often complain of discomfort, saying that even if they lose weight, their face does not look younger or rather tired. In order to maintain youthfulness, it is essential to take an approach that focuses not only on body shape but also on the structural balance of the face.

 

Can I take care of my laugh lines at home? Advantages and Limitations of Self-Care

It is a common feeling among many people to think, "Can't I do something by myself first before undergoing expensive treatments?" In fact, self-care such as moisturizing, massaging, and facial training (so-called "face training") can be expected to have a certain effect on the appearance of lines as prevention or mild care.

At the same time, however, there are many cases in which self care puts an unexpected strain on the skin and muscles, which in turn worsens the condition. In this section, we will clearly outline the benefits and limitations of self-care from a medical perspective, and provide guidelines for correctly understanding what can and cannot be done with home care.

Moisturizing Care｜First Step to Establish Skin Foundation

Behind the appearance of lines is a decrease in the skin's moisture content and a decline in the skin's barrier function. What is effective is the use of skincare products containing moisturizing ingredients such as niacinamide and hyaluronic acid. These ingredients improve the moisture retention function of the stratum corneum, preventing fine lines and wrinkles and maintaining the smoothness of the skin's surface.

However, it only affects the epidermis to the shallow dermis layer. It basically has no power to erase the lines themselves, which have become entrenched as deep furrows. It is realistic to think of moisturizing as "building a foundation to prevent the lines from worsening.

Facial training｜Maintaining facial muscles and promoting blood flow

Facial muscles such as the orbicularis oris muscle and buccal muscles gradually deteriorate if not used. Facial exercises such as vocal exercises to move the mouth widely and tongue rolling exercises are believed to increase the range of motion of the muscles and promote blood flow. Particularly in the modern age, when people have fewer opportunities to move their faces in their masked lives, lack of facial exercise is thought to be a contributing factor to the premature formation of laugh lines.

However, it is recommended to use the method supervised by a doctor or specialist, as doing so blindly may conversely worsen expression wrinkles and left-right differences.

Lymphatic Massage｜For swelling and waste

Massage to promote lymphatic flow around the face is considered effective in temporarily lifting the skin and reducing swelling. In particular, gently flowing the temples, face line, and collarbone area can improve the circulation of blood and lymph, resulting in clearer and firmer skin.

Overdoing it? What self-care can be counterproductive?

The more beauty-conscious people tend to be more enthusiastic about self-care. However, excessive massage, extreme facial training, and the use of self-directed equipment run the risk of being counterproductive.

Particular attention should be paid to damage to the dermis caused by friction and pressure. Proper knowledge and procedures are essential, as overstimulation of the skin may instead destroy collagen and cause sagging of the skin.

Another danger is the misconception that "anything is fine as long as it contains moisturizing ingredients. Using products with ingredients that do not match the skin type or contain excessive additives may disrupt the barrier function and risk causing inflammation.

 

Can lines really disappear medically? Typical types and characteristics of cosmetic medicine

In the previous chapter, we reported that while self-care is effective for "prevention" and "maintenance," there are limitations to "erasing" already engraved lines. So what about in the realm of cosmetic medicine?

In conclusion, there is a good chance that lines will disappear with medical approaches. However, it is important to choose correctly multiple treatments that work on the entire facial structure, not just temporarily filling in the grooves, depending on the purpose of the treatment.

This section describes the main cosmetic medical treatments and easily available cosmetic skin treatments in an easy-to-understand manner, including their characteristics, durability, and suitability.

Hyaluronic Acid｜Naturally plump and beautiful! Its role and effect period

Hyaluronic acid injection is a highly effective treatment in which changes are visible immediately after the procedure. Hyaluronic acid is injected into the dermis and subcutaneous tissue under the skin, physically lifting and smoothing out the indentation of the laugh lines.

In addition to the traditional method of injecting just below the wrinkles, the "aristocrat filler" technique has been attracting attention in recent years. This is a structural approach in which hyaluronic acid is injected at the base of the nasal wings (near the base of the nose) to support the concavity caused by facial bone atrophy and fat loss, thereby fundamentally reducing the appearance of the shadow of the laugh lines.

By forming a strut in this area with hyaluronic acid, the entire cheek is naturally lifted, the laugh lines become shallower, and the midface looks more defined. This is a very effective procedure in terms of improving the appearance of the face.

In addition, the hardness and elasticity (G-value) of hyaluronic acid preparations are selected according to the target area.

Adaptation site	Example of formulation	feature
Shallow wrinkles, thin skin	Jubiderm, Borbella, etc.	Soft and easy to blend with surfaces
Deep lines, structural correction	Jubiderm Voluma, etc.	High density and strong support

The duration is approximately 6 to 18 months, but it varies depending on the individual. Therefore, in actual clinical practice, there are many cases of re-injection after less than 12 months. In particular, structural injections such as noble fillers tend to last longer because of their high visual stability.

Hyaluronic acid may be injected near blood vessels, and knowledge of the proper injection layer and anatomy is essential. It is important to select a safe formulation under the supervision of a trusted physician.

Thread lift｜Lifting technique to physically support sagging skin

Thread lift is a non-surgical lifting treatment that raises sagging mid- to lower-face tissues without incising the skin. The medical threads used are made of a material that is gradually absorbed by the body. The "cogs" (spikes) of the threads inserted under the skin are pulled into the subcutaneous tissue, physically lifting sagging skin and fat in an upward direction.

There are multiple materials and structures of threads used, each with different persistence, irritation, and collagen-producing capacity. Typical materials are as follows

raw materials	feature	Duration
PDO (polydioxanone)	Soft and relatively light pain and downtime during the procedure. Suitable for first-time users and mild sagging.	Approx. 6-12 months
PLLA (polylactic acid)/PCL (polycaprolactone)	Superior strength and elasticity for longer-term lifting. The process of dissolving threads strongly stimulates collagen production and has a high effect on improving skin texture.	Approx. 12-24 months

The threads also come in various shapes, including monofilament, cog, double cog, and 360° rotating cog types, which are used according to the area and direction of lifting. The cogs (spikes) of the threads catch on the subcutaneous supporting tissues and lift the fat and skin that cause sagging, thereby physically improving sagging lines, marionette lines, and facial lines.

In the thread lift, a minute inflammatory reaction occurs as the threads are broken down and absorbed by the body, stimulating fibroblasts and activating the production of collagen and elastin. This has the secondary benefit of improving skin firmness and elasticity and reducing the appearance of pores and fine lines and wrinkles.

HIFU (HIFU)｜Lift-up by cosmetic skin treatment that burns deep tissue

HIFU (High Intensity Focused Ultrasound) is a non-invasive (no scalpel) lifting treatment that applies thermal energy to the deeper layers of the skin (SMAS layer) by focusing high-density ultrasound to a single point. SMAS is a support structure between the skin and the muscles, and is the target layer of the facelift surgery to be pulled up with threads.

The greatest feature of HIFU is that it can reach this SMAS layer without damaging the skin surface, and thus can approach sagging without cutting. The irradiation of HIFU heats the SMAS layer to approximately 60-70°C, causing thermal denaturation. This produces the following step-by-step effects.

• Immediate effect: A mild tightening sensation can be felt immediately after irradiation due to protein contraction caused by heating.
• Medium- to long-term effects: Collagen regeneration is promoted over 2-3 months, improving skin firmness and elasticity

The peak effect usually lasts around 2 months, followed by 3 to 6 months. Many clinics recommend two to three times a year as the treatment interval, and it is positioned as a regular maintenance type of lift treatment.

HIFU is suitable for those who want to start casually and for those who

• Those who are concerned about mild sagging and flabbiness of the skin
• Those who want to start preventive care, not up to cosmetic medicine.
• Those who cannot take downtime

On the other hand, for severe sagging or deep lines, the effect by itself is limited, and combination with hyaluronic acid injections or thread lifts may be recommended.

 

Other effective treatments for laugh lines!

Hyaluronic acid injections, thread lifts, and HIFU, which we have introduced so far, are the main options for improving laugh lines. In addition to these, however, a variety of treatments have been established in recent years that can be utilized for different purposes, and complementary approaches are attracting attention according to each patient's condition and desires.

This section describes the following three procedures, which have been introduced in many beauty clinics, especially in Japan, and support structural improvement, skin texture regeneration, and natural rejuvenation, respectively.

Fat Injection｜Natural rejuvenation through structural volume replacement

Fat injection is a treatment method in which one's own fat taken from the abdomen or thighs is centrifuged, purified, and injected into the necessary area. The most significant feature of this treatment is that it provides a structural approach to the lines by supporting the skin's surface concavity from the inside, resulting in a natural three-dimensional appearance.

• Advantages: long-term durability / natural softness / low risk of rejection due to autologous tissue
• Cautions: downtime at the extraction site / risk of lumps and resorption / treatment prone to differences in technical skill.

However, because the lines have a wide range of motion of the facial muscles and fat is easily absorbed, the retention rate may vary from person to person, and multiple injections may be required.

In recent years, technologies such as "nanofat injections" utilizing stem cells and "microfat injections" with better fixation have evolved and are expected to have synergistic effects with skin quality improvement.

Shopping Lift｜Minimally invasive threading treatment that supports the skin on the face

Shopping lift (shopping thread) is a treatment in which a number of ultra-fine absorbable threads (such as PDO) are inserted into the shallow layers of the skin to stimulate fibroblasts and stimulate collagen production.

Unlike lifting threads with cogs (spikes), the purpose is not to physically lift but to plump up the entire skin to reduce the appearance of lines with a "natural firmness".

• Advantages: Low downtime with immediate makeup available / Synergy with skin texture improvement
• Cautions: Lifting effect is limited / Absorption takes 6 months to 1 year / Regular continuation is required

As the name implies, this procedure is regarded as a maintenance cosmetic treatment aimed at improving skin texture, with little downtime so that the patient can go out and shop immediately after the surgery.

It is particularly suited for mild to moderate stages where no significant sagging has yet appeared, and for cases where a synergistic effect is aimed for by combining with other procedures.

Rejuran injection｜Injection therapy that works on the skin's regenerative power itself

Rejuran is a regenerative injection that uses polynucleotides (PN) derived from salmon as its main ingredient. It is a procedure that aims to rebuild the skin itself by activating its self-repair capabilities for skin damaged by aging or UV rays.

In many cases, thinning and loss of skin elasticity in the laugh lines contribute to accentuating the shadows of the lines, and a combination of structural supportive treatment and skin density enhancement can achieve a more natural and lasting rejuvenation.

• Benefits: Activation of the skin's self-regenerating ability / Improvement of firmness, elasticity, and texture
• Note: Not an immediate effect, but a gradual change / mild swelling and bulging may occur.

Improvements have also been made in formulations, allowing selection according to the target site and concentration, such as PN-H (high concentration), Rejuran Eye, and Rejuran Heal.

In Japan, it is often performed as a programmed treatment based on three to four sessions at a monthly pace, and is a highly versatile treatment for fine wrinkles and sagging around the eyes and mouth.

 

summary

Lines are a phenomenon that appears not simply because of age, but also because of a combination of multiple factors, including loss of skin elasticity, fat drooping, bone atrophy, and lifestyle. Self-care such as moisturizing and massage are effective as daily care, but it is also true that there is a limit to "completely erasing" deeply engraved wrinkles.

Cosmetic treatments such as hyaluronic acid injections, thread lifts, and HIFU can provide a natural form of rejuvenation if chosen correctly. The key is to choose a solution based on the depth of the lines, skin condition, and lifestyle.

And, the first step toward ideal aging care is not to be swayed by misinformation, but to seek counseling at a reliable medical institution. How will you face your face and how will you envision your future expression? The choice you make will lead to lasting beauty.

At Aladdin Aesthetic Clinic, based on our many years of experience in cosmetic medicine and cosmetic dermatology and the knowledge of our doctoral degree, we provide counseling that aims to be "only one", offering the best treatment for each person we meet. We offer only the necessary treatments without any unnecessary information or suggestions.

Feel free to use our official LINE account for 24-hour counseling and reservations. Please feel free to contact us for free counseling for the first time or if you have any concerns.