Watch a close-up selfie video and you will see it: the thin accordion-like pleats that form at the corners of Visit the website the mouth as you grin, and the vertical “barcode” lines that pucker above the upper lip when you purse or sip from a straw. Patients often ask if Botox can soften those specific lines without freezing their smile or changing how they speak. It can, in select situations, but the strategy is different from the way we treat crow’s feet or forehead lines. Here is how experienced injectors approach lips and smile lines, who benefits, who does not, and what to expect if you try it.
What we mean by “lip lines” and “smile lines”
The terms get mixed up in conversation, so it helps to be precise:
- Lip lines, sometimes called smoker’s lines or barcode lines, are the vertical creases radiating from the vermilion border. They are caused by repeated contraction of the orbicularis oris muscle, along with collagen loss, sun exposure, and skin dehydration. These lines appear with pursing and can etch in over time. Smile lines usually refer to two different areas. One is the nasolabial fold, the crease that runs from the nose to the corner of the mouth. The other is the dynamic fan of lines that appear at the outer corners of the eyes, commonly called crow’s feet. In this article, we will focus on smile-related lines around the mouth, then touch on where Botox excels around the eyes and forehead for comparison.
Understanding the anatomy matters because Botox relaxes muscles. It reduces motion-driven creases, not folds formed mostly by volume loss or tissue descent. That difference guides whether Botox is sensible, or whether filler, energy-based devices, or skin-directed treatments would work better.
What Botox does well, and what it cannot do
Botox, and similar botulinum toxin type A products, temporarily quiet muscle activity. We use it for wrinkle reduction therapy across the upper face because those lines mainly come from strong, repetitive muscles. For example, Botox for crow’s feet wrinkles or Botox for forehead line smoothing tends to deliver predictably smoother skin with natural expression when dosed correctly. Patients often describe the effect as Botox for smoothness in facial skin and a more rested look.
Around the mouth, the orbicularis oris acts like a sphincter. It helps you sip, whistle, pronounce certain sounds, and seal the lips. Over-relax it, and you risk difficulty with straws, minor drooling when drinking, or a subtle change in enunciation of “p” and “b” sounds. That is why dosing near the lips is conservative. The aim is not a frozen mouth. It is a micro-relaxation that reduces excessive pursing without compromising function.
Botox also does not fill etched-in grooves. If a line is visible at rest and looks like a tiny scar, that etched quality is due to dermal changes. In that case, Botox may help prevent further deepening by reducing the muscle force, but it will not erase what is already carved in. Skin-targeted options, such as microneedling with or without radiofrequency, fractional laser, or careful use of a light hyaluronic acid filler placed very superficially, often work better for those fixed lines. Seasoned injectors sometimes combine microdoses of Botox with microdroplet filler in the superficial dermis to treat stubborn perioral lines, a technique sometimes called a “lip smoke line blend.” The balance makes the difference.
Where Botox shines around the mouth
Two patterns respond especially well to Botox facial skin treatment in this region.
First, vertical lip lines that appear only with pursing in younger to middle-aged patients. If the lines are mostly dynamic and not deeply etched, 2 to 8 units total, microdosed across the upper and lower lip border, can soften the “barcode” effect. The effect is subtle, but patients report smoother lipstick application and fewer vertical creases when drinking from a bottle or straw.
Second, a gummy smile caused by hyperactive elevator muscles of the upper lip. A tiny dose at the points where the lip lifts can drop the upper lip by a millimeter or two. This can reduce gum show when smiling without altering your overall character. The doses are small and the effect wears off in about 8 to 12 weeks in that specific area, sometimes a little longer.
Injectors sometimes add a touch of tox to the depressor anguli oris muscle when downturned corners form at rest. Relieving the constant pull at the corners can reduce the crease and improve oral commissure position. This is a case where Botox for facial contouring to reduce wrinkles is more about softening the mouth’s posture than about the lines themselves.
Where filler, lasers, or skincare outperform Botox
Nasolabial folds deepen mostly from midface volume loss and skin laxity, not overactive muscle. If the complaint is the fold itself, filler to support the midface and the fold typically helps more than toxin. Energy-based devices and collagen-stimulating treatments can improve skin quality and elasticity in this zone. A practical rule: if the crease is present at rest and does not dramatically change with expression, muscle relaxation alone will not solve it.
Deep, etched perioral lines that are visible even when the mouth is relaxed usually need skin-directed therapy. Fractional non-ablative lasers or light ablative passes can remodel collagen and smooth texture. Microneedling with radiofrequency can help thicker, more resilient skin. For delicate upper lip skin, careful use of very low-viscosity filler in tiny amounts can “iron” individual lines. In experienced hands, a staged plan brings the best results: Botox to reduce the ongoing mechanical stress, then skin remodeling to treat the etched lines, and sometimes minimal filler to polish.
Dose, placement, and the art of not overdoing it
New injectors often underestimate how strong the orbicularis oris is. I prefer to start with microdroplets along the vermilion border, often 0.5 to 1 unit per point, with 4 to 10 points across the upper and lower lip combined, depending on muscle mass and lip size. This comes out to roughly 2 to 8 units total for perioral lines. Patients with larger or more active muscles might tolerate slightly more, but I rarely exceed 10 units in the immediate lip region on a first visit. The goal is a Botox facial rejuvenation for fine lines effect, not a change in speech.
For gummy smile, typical dosing is 2 to 4 units per side, precisely placed where the lip elevators bunch on smiling. Less is more. Overcorrection can flatten your smile. Touch-ups at two weeks help refine the dose if needed.
For downturned corners, 2 to 4 units per side into the depressor anguli oris can help the commissures lift slightly, taking tension off the crease at the corner. Patients often notice that lipstick stops migrating into those tiny radiating lines that form at the corners.
This restrained approach respects function. It also allows adjustments on the second visit, once we see how your muscles respond. Faces are asymmetrical. What works for a friend rarely translates unit-for-unit.
Longevity and expectations
Around the mouth, Botox tends to wear off faster than in the forehead or crow’s feet area. The orbicularis oris is in near-constant motion, which likely speeds turnover at the neuromuscular junction. Expect 6 to 10 weeks of visible softening for tiny perioral doses, sometimes up to 12 weeks. Gummy smile correction can last closer to 8 to 12 weeks. Crow’s feet and forehead line smoothing can run 3 to 4 months on average because those muscles, while active, are not working with every sip or syllable.
This shorter duration is part of the cost-benefit calculation. Some patients maintain a schedule every 8 to 10 weeks for perioral microdoses, then stretch forehead and crow’s feet sessions to every 3 to 4 months. Others choose to use Botox primarily in the upper face, where it delivers Botox wrinkle reduction for upper face predictability, and manage lip lines with skin remodeling plus a touch of filler once or twice a year.
Safety, side effects, and red flags
Expect minor swelling, pinprick redness, and occasional small bruises where the needle entered. Ice and gentle pressure help. Most patients return to normal activity the same day.
Functional side effects depend on dose and exact placement. With perioral Botox for lip and smile lines, the most common temporary change is difficulty forming a tight seal around a straw. Some notice water escaping the corners of the mouth when rinsing after brushing. A few report that whistling feels odd. These effects fade as the toxin wears off. If you rely on precise lip movement for wind instruments or certain sports, discuss that with your injector beforehand.
Avoiding vascular compromise is critical when adding filler to etched lines. While Botox carries low risk of vascular events, fillers require a trained injector who understands perioral anatomy, uses micro-aliquots, and watches for blanching, disproportionate pain, or color changes. If any of those occur, treatment must be stopped and reversed. Choose a clinic that has hyaluronidase on hand and protocols ready.
Where Botox excels by comparison: eyes and forehead
It helps to see why we lean on Botox for crow’s feet removal and forehead smoothing. The orbicularis oculi around the eyes creates lateral lines with smiling. Relaxing the outer fibers with 6 to 12 units per side can give clean results without affecting eyelid closure when placed correctly. Patients often call this Botox for eye wrinkle smoothing or Botox for anti-wrinkle injections around eyes. It is one of the most consistent areas for Botox for wrinkle-free skin.
Similarly, the frontalis creates horizontal lines across the forehead. Proper balance between the forehead and glabella lets you lift the brows without creating a heavy look. Doses vary widely based on brow position and muscle mass, often 8 to 20 units across the forehead and 10 to 25 units between the brows. For deep forehead wrinkles at rest, Botox treatment for deep forehead wrinkles can soften the lines, though strongly etched grooves might still need resurfacing. These upper-face zones demonstrate why Botox facial rejuvenation injections have become a mainstay: strong muscles, dynamic lines, predictable smoothing.
Around the mouth and lower face, expression complexity and functional demands make us more cautious. Botox still has a role, but the margins for error are smaller and adjunct therapies matter more.
A practical path to smoother lip and smile lines
Patients do best with a phased plan. A single-session fix is rare for etched perioral lines. Think in terms of sequence and synergy.
Start by identifying the dominant factor. If pursing exaggerates vertical lines and they disappear at rest, a trial of micro-Botox is sensible. If the lines remain at rest and the skin looks crepey, prioritize skin remodeling. If the corner crease worsens with a downward pull, target the depressor muscles. Many will benefit from a combined approach.
Skin quality basics matter more here than many realize. Upper lip skin is thin, often sun-exposed, and prone to fine creases. Sun protection with a lip-safe SPF, nightly use of a gentle retinoid (or retinaldehyde for sensitive skin), and avoidance of constant straw use can slow recurrence. For daily texture, a light peptide or hyaluronic acid serum can help the area hold moisture, reducing the appearance of fine lines.
When filler enters the plan, keep volumes tiny. I use micro-droplets of a soft, low G’ hyaluronic acid, often totaling 0.3 to 0.6 mL across the upper lip in a session, sometimes less. The aim is to support the dermis just enough to reduce the etched track without puffiness. Overfilling blunts lip shape and can look obvious when you smile, which defeats the purpose.
Patients who smoke or vape see lines return faster. If you are ready to cut back, this is one of the few aesthetic treatments where lifestyle change directly protects your investment.
Costs, visit cadence, and value
Pricing varies by region and clinic. For perioral microdoses, the material cost is low because the units are few. The expertise is what you pay for. Many practices set minimum visit fees, so adding a microdose at the time of your Botox for crow’s feet and forehead wrinkles session is efficient. A common cadence is every 3 to 4 months for the upper face, with every other visit including a perioral touch if needed. Some prefer more frequent perioral sessions at smaller intervals for consistent lip line control.
If we integrate skin-directed treatments, expect 2 to 3 sessions of microneedling RF or fractional laser spaced 4 to 6 weeks apart, then maintenance once or twice a year. That is usually more cost-effective than chasing etched lines with filler alone. Patients who combine modalities typically perceive the most natural result because no single tool is overused.
Real-world scenarios that guide decisions
A 42-year-old with strong pursing when sipping from a bottle, no lines at rest, and a mild gummy smile is an excellent candidate for Botox to reduce facial wrinkles at the lips and elevators. Microdoses settle the dynamic lines, and a small gummy smile correction balances the smile arc. She returns at 10 weeks to maintain.
A 58-year-old with fine, etched vertical lines even when her mouth is at rest, plus a deep nasolabial crease, will not get much from toxin alone. A staged plan brings better results. First, light fractional laser or microneedling RF to remodel collagen. Second, tiny droplets of soft filler into the most stubborn tracks. Third, a conservative perioral Botox session to reduce further mechanical stress. If midface volume is low, support there with filler to ease the fold. This approach targets each problem at its source.
A 35-year-old trumpet player with developing smoker’s lines should avoid perioral Botox, given performance needs. Skin therapy and strategic filler microdroplets are the safer path. This case underscores why personalized planning matters more than any single product.
What about the neck and beyond?
Patients sometimes ask if Botox for neck wrinkle smoothing or neck rejuvenation fits into a smile line plan. Botox can soften vertical neck bands by relaxing the platysma. It can also refine jawline definition gently when used in a “Nefertiti” pattern. For necklace lines, which are horizontal, energy-based devices and skin boosters work better than toxin. If your primary goal is a cohesive lower-face and neck refresh, a combination of neuromodulator for bands, collagen-stimulating treatments for texture, and careful filler for structural support often delivers the most harmonious result.
Around the eyes, Botox to treat under eye wrinkles and Botox for treating under eye puffiness are different issues. Toxin can soften lines just outside the orbital rim. True under eye bags come from fat pads and skin laxity, which require other treatments like lower blepharoplasty, lasers, or skin tightening devices. This distinction helps set realistic expectations and prevents disappointment from overpromising what Botox can do.
Avoiding the “done” look
Good Botox for facial rejuvenation enhancement should look like better skin behavior, not less personality. Four habits help keep outcomes natural:
- Start conservatively, then adjust at the two-week mark based on function and symmetry. Treat the generator, not the symptom. If midface descent deepens the fold, correct that before the fold. Layer treatments over time. Micro-Botox, subtle filler, and skin remodeling each handle part of the problem. Respect your personal style. If your animated smile is a signature, keep doses low near the lip elevators and accept a touch of movement in exchange for character.
These principles matter more around the mouth than perhaps anywhere else on the face. Even small changes can alter how speech feels or how you experience your smile.
How this fits into a broader anti-aging plan
Botox anti-aging skin therapy is one pillar. The others are skin health and structural support. Sunscreen daily, topical retinoids at night, and periodic collagen stimulation preserve gains from toxin. Strategic filler adds support where bone and fat have receded. For some, bio-stimulators and light resurfacing maintain texture. A balanced plan yields a smoother, more youthful appearance treatment result without obvious signs of intervention.
When patients want Botox for facial wrinkle removal across multiple zones, I often map a year. Early sessions focus on establishing upper-face control where results are most predictable: Botox wrinkle injections for forehead and Botox for crow’s feet and forehead line prevention. Once that cadence is stable, we introduce micro-perioral dosing and evaluate. If etched lines persist, we layer in skin therapy. By the end of the first year, patients have a rhythm that they can maintain with fewer surprises.
Bottom line: can Botox help lips and smile lines?
Yes, with the right target and a gentle touch. For dynamic perioral lines, gummy smile, and downward corner pull, Botox facial skin smoothing injections can make a noticeable difference. It is not a cure for etched lines at rest, nor a solution for volume-related folds. Think of it as a way to reduce the ongoing mechanical stress that causes lines to deepen, often combined with skin remodeling and minimal filler for the best finish.
If you decide to proceed, look for an injector who does this work weekly, who is comfortable saying no to toxin in certain patterns, and who can offer alternatives. Ask to start conservatively. Plan for slightly shorter duration than in the upper face, and budget accordingly. Most important, be clear about your priorities. Smoother lipstick application, fewer vertical creases when sipping, less gum show, and softer corner drag are all realistic goals. A frozen smile is not on that list.
With careful dosing and a thoughtful plan, Botox for lip and smile lines can be a quiet upgrade that keeps your expressions true while softening the wear and tear that time and movement leave behind.