Smile Lines and the Jennifer Aniston Myth: Why Treating the Line Is the Wrong Fix

Scroll through the comments under any photo of a famous woman in her fifties and you will find the same predictable pile-on. Someone points at her smile lines. Someone else declares she has "let herself go" or, just as often, that she has "had too much done". Jennifer Aniston gets this treatment constantly. And, as I would put it plainly, the people doing the pointing have got it completely wrong.

The woman looks gorgeous. She looks age appropriate. She is ageing beautifully. Her smile lines are not a flaw to be scrubbed out, they are a normal feature of a human face that moves and expresses and smiles. The people who genuinely look strange are not the ones with visible smile lines. They are the ones who have had those lines aggressively overfilled, whose faces have gone flat and puffy and, in my words, end up looking almost alien.

That gap between what people think they should treat and what actually needs treating is the whole point of this piece. Because chasing the line is one of the most common mistakes in aesthetics, and it produces exactly the result nobody wants.

What smile lines actually are

Smile lines, known clinically as the nasolabial folds, run from the sides of the nose down towards the corners of the mouth. Here is the part most people miss: they are not really wrinkles in the way crow's feet or forehead lines are. They are a structural feature of the face, a natural boundary between the cheek and the upper lip area. Everyone has them, at every age. On a smiling toddler they are a pair of sweet little brackets around a grin. They are meant to be there.

What changes with time is not that a line suddenly appears where there was none. It is that the fold becomes deeper and more shadowed. And the reason for that has almost nothing to do with the line itself.

As we age, the face loses volume and support in the midface, the area over the cheekbone and beneath the eye. The fat pads that once sat high and full begin to descend and deflate. Bone remodels and recedes slightly. Skin loses collagen and elasticity, so it holds less firmly to the structures beneath it. All of that soft tissue drifts downward under gravity, and it tends to gather and rest along the nasolabial fold. So the fold deepens not because the line got worse, but because everything above it slid down and pooled on top of it.

Think of a curtain. If the rail sags in the middle, the fabric bunches at the bottom. You do not fix the bunching by cutting the fabric at the bottom. You fix the rail. The smile line is the bunching. The midface is the rail.

Why overfilling the line backfires

When a patient asks to have their smile lines "filled in", the instinctive but wrong response is to inject product directly into the fold to plump it up level with the surrounding skin. In the short term the line may look shallower. But you have now added weight and volume to the very place where tissue was already collecting. You have made the lower face heavier without addressing why the fold got deep in the first place.

The result is a face that reads as overdone. The area between the nose and mouth looks full, slightly swollen, and oddly disconnected from the rest of the face. Because that is exactly what it is. The cheek is still deflated, the support is still missing, but now there is a dense band of filler sitting in the crease. In an animated face, that region does not move naturally. It sits there, static and puffy. This is the look I describe so bluntly, the smile lines have disappeared but the rest of the face still does not look good, and the overall effect is worse than doing nothing at all.

Worse still, overfilling tends to compound over time. A little more product each visit, chasing a line that keeps reappearing because the real cause was never treated, and eventually the proportions of the whole lower face are distorted. This is precisely the pattern behind the harshest online criticism of certain celebrities and influencers. Not too little treatment. Too much of the wrong treatment, aimed at the wrong target.

Treat the structure, not the crease

The approach that actually works is almost counterintuitive to a patient focused on the line. Instead of injecting the fold, a skilled doctor restores volume and support higher up, on and around the cheekbone where it has been lost. When the midface is gently re-supported, the descended tissue is lifted back towards where it belongs. The nasolabial fold softens as a consequence, because the weight that was dragging on it has been redistributed.

This is why two people can both complain about deep smile lines and end up having completely different treatments. One might need cheek support to lift the midface. Another, with genuine skin laxity, might benefit more from treatments that stimulate collagen and tighten the skin envelope. A younger patient with early shadowing might need very little, perhaps just a small, precise touch. The line is the symptom. My job is to diagnose the cause behind it.

A whole-face assessment

At Wellface my starting point is never a single line. It is the face as a whole, at rest and in movement, in proportion and in balance. I talk about treating the face globally, so that it looks lifted, refreshed and, crucially, still like the patient. A good consultation looks at how the cheeks, the jawline, the skin quality and the folds all relate to one another. Very often the smile line the patient came in worried about is not where the treatment happens at all.

Pro-ageing, not anti-ageing

There is a meaningful shift in language here, and it matters. Pro-ageing does not mean fighting every line as if it were the enemy. It means helping a face age well, keeping its structure supported and its skin healthy so that it looks like a rested, well version of its actual age. Smile lines are part of a face that has lived and laughed. The aim is not to erase them into oblivion. It is to keep the whole face looking harmonious, so that a natural fold reads as character rather than tiredness.

The treatments that genuinely help smile lines

Because the real issue is usually structural, the most effective options address volume, support and skin quality rather than blasting the crease with product.

Dermal fillers, when placed thoughtfully in the midface and along the cheekbone, restore lost support and lift the tissue that has descended. Used this way, filler works with the anatomy rather than against it. Only occasionally, and in very small, careful amounts, does a fold itself warrant any direct product, and even then it is about softening a shadow rather than filling a line flat.

Skin-quality treatments play a big part too, especially where laxity is driving the problem. Collagen-stimulating options such as Profhilo, polynucleotides and skin boosters improve the firmness, hydration and bounce of the skin, so it holds itself better and the fold looks less like a fixed crease. For patients with more significant laxity, energy-based treatments such as Morpheus8 combine microneedling with radiofrequency to tighten and remodel the deeper layers over the following months. And where fine lines and texture are part of the picture, resurfacing with lasers can smooth and refresh the surface.

The right combination depends entirely on the individual. That is the reason no honest doctor can quote you a treatment for smile lines from a photo alone.

Common questions about smile lines

Are smile lines a sign I have aged badly?

Not at all. Smile lines are a normal anatomical feature that everyone has, at every age. They simply become more shadowed over time as the midface loses support. A visible smile line on a well-rested, healthy face is a completely natural part of how faces look, and treating them into oblivion tends to look far stranger than leaving them be.

Should I just get my smile lines filled?

Usually no, at least not directly. Injecting straight into the fold is the classic mistake that leads to a heavy, overfilled lower face. In most cases the smile line softens best when the cheek and midface are re-supported, which lifts the descended tissue that was deepening the fold. A proper assessment will tell you what your face actually needs.

Will treatment make my smile lines disappear completely?

That is not the goal, and it is not desirable. The aim is a face that looks lifted, balanced and naturally youthful, where the fold is softened rather than erased. A face with no smile lines at all, on someone who is no longer twenty-five, tends to look artificial. Subtlety is the whole point.

How long do the results last?

It depends on the treatment. Structural filler in the midface can last well over a year, while collagen-stimulating and skin-tightening treatments build gradually and are usually maintained with occasional top-ups. I will explain the expected timeline for whatever plan suits your face.

Is there any downtime?

Most of these treatments involve little disruption to daily life. There may be some minor swelling, tenderness or occasional small bruising after injectables, which settles over a few days. Energy-based and resurfacing treatments can involve a short recovery period. This is all covered in your consultation so you know exactly what to expect.

Come and be assessed properly

If you have been eyeing your smile lines in the mirror and wondering whether they need filling, the most useful thing you can do is have them looked at by a doctor who will assess your whole face rather than reach for a syringe. The answer is often not what people expect, and it is very often gentler than they feared.

Wellface is a doctor-led clinic with branches in Cobham, Esher and Wimbledon, and I take a considered, pro-ageing approach to every face I treat. Book a consultation with me and let me show you what treating the structure, rather than chasing the line, can really do.