What to do about laughter lines?

Although laughter lines should be seen as a sign of each person’s personality and not as something negative, there are still numerous ways to eliminate the small, annoying wrinkles. One of the most important possibilities is certainly the artificial hyaluronic acid, which can now be produced in the laboratory and which is very similar to the body’s own hyaluronic acid. This hyaluronic acid causes the skin to appear plumper, more radiant and youthful due to its moisture-binding and moisturizing properties.

As an alternative to injections, it can also be used in capsules, anti-aging creams or as a gel (e.g. eye gel). However, since the skin can only absorb a small amount of hyaluronic acid, the effect is smaller and shorter compared to injections. In wrinkle treatment, hyaluronic acid is injected directly into the deep skin layers below the laughter line using a micro-injection.

By replenishing the hyaluronic acid depot there, new fluid is mobilized under the wrinkle. This ultimately leads to the lifting of the laughter line and makes it optically disappear. This effect is immediately visible and lasts up to 6 months after 2-3 sessions.

Afterwards a new injection would be necessary. This type of wrinkle treatment is particularly popular because of its rapid effect and the low side effects, which can manifest themselves in bruises or slight swelling. Recently, many women also resort to a combination of Botox and hyaluronic acid to remove deep laughter lines in particular.

Here, Botox (or Botulinum toxin) blocks the activity of muscles, which causes the face to relax and prevents the generation of new wrinkles. Hyaluronic acid is then injected, which fills in the wrinkles deep down. The combination of both together leads to an even better and even longer lasting effect.

However, hyaluronic acid can not only be used to fight wrinkles. Nowadays, it is also used to spray on lips, nose, buttocks or breasts; in some cases even to model nipples. An alternative or combination of hyaluronic acid and botulinum toxin, also known as Botox, mentioned above, is also available.

Botox is originally a nerve toxin, which is nowadays used in many ways in cosmetic medicine. Its main fields of application are wrinkle treatment and the prevention of excessive sweating. As a nerve toxin, Botox prevents the transmission of excitation between nerve cell and muscle.

This, in turn, causes the muscle to lose its signal for tension (called contraction). The result is smooth, relaxed skin.Similar to a hyaluronic acid injection, Botox treatment involves injecting the drug into the nerve endings of the desired muscle using a very small and fine needle. It is particularly important to have this application performed by an experienced and well-trained physician, as otherwise unloved complications such as asymmetries, a drooping upper eyelid or a drooping eyebrow are possible.

Through correct handling, Botox can not only combat wrinkles but also create the effect of large, more alert looking eyes. By injecting the Botox into the muscle, the eyebrow is slightly pulled upwards due to the loss of muscle. An application with Botox lasts on average 3-6 months, but always depends on the applied dose and the treatment area.

This means that the more nerve endings are treated with botulinum toxin, the longer the nerve endings take to regenerate and the longer the desired wrinkle-free effect. However, excessive doses of Botox should be avoided, as these would produce the familiar “mask face” without mimic impulses, which has considerable aesthetic disadvantages. Possible complications of a Botox treatment can – if used incorrectly – include drooping eyelids or eyebrows, impaired eyelid closure, swelling, redness or haematomas.

Since the facial muscles must first be deactivated during a Botox treatment, an onset of action of 48-72h must be expected. However, the maximum treatment success is seen after 10 days at the latest. One surgical option to remove annoying laughter lines in the long term would be the so-called face-lift.

It is important to consider the scarring, which is very discreet, but will still be there. For this reason, this type of wrinkle treatment is more recommended to women of advanced age. There are many different face-lifting techniques, in which excess skin is removed and the underlying connective tissue layer is lifted.

The effect is always a rejuvenated, firmer and not mask-like appearance. Suitable techniques for laugh wrinkles include the classic, double-layer total facelift, an upper facelift, in which a lift is performed around the forehead, eyebrows and temples, or the temple lift, in which a lift is mainly performed around the temple and eyebrow region. A lower facelift is also suitable for laugh lines around the mouth.

Since very deep laughter lines cannot always be removed by surgery alone, a combination therapy of surgery and hyaluronic acid or Botox is also recommended here. Although complications have become rare due to modern surgical and anaesthetic methods, there are, as with any other operation, numerous complications such as circulatory problems, bleeding, wound healing problems or even nerve injuries, which would have serious consequences, especially in the face. Every single possible complication is discussed in detail in a medical consultation.