Hyaluronic acid at the sides of the mouth: the complete guide to a natural, refreshed look in 2026

Injecting hyaluronic acid at the sides of the mouth is one of the most sought-after and effective treatments for softening smile lines (the lines running from the nose to the mouth) and marionette lines, which give the face a sad or drooping look. It is important to understand that the aim of modern treatment is not to "iron out" the lines completely, but to restore the volume lost over time in a measured and gentle way, to create a refreshed, natural and harmonious look.

The treatment is quick, tailored to each patient's facial structure, and is carried out at the Dermacare clinic only after a professional assessment appointment to ensure an accurate and safe result.

How does hyaluronic acid restore volume at the sides of the mouth?

Over the years, our skin, especially in dynamic areas such as the sides of the mouth, naturally loses its reserves of hyaluronic acid, collagen and elastin. This process, combined with gravity and repeated facial movements, leads to the formation of two main types of lines:

• Smile lines (nasolabial folds): these are the lines running down from the sides of the nose to the corners of the mouth, which become deeper and more prominent with age.

• Marionette lines: these are the lines running down from the corners of the mouth towards the chin. They tend to "pull" the corners of the mouth downwards and give the face a tired, angry or sad expression, even when you are in an excellent mood.

The modern approach, which we advocate at Dermacare, is not to try to erase the lines completely, which can create an artificial, puffy look. Instead, we focus on the controlled restoration of lost volume, to soften the overall appearance and provide support for the tissues.

Refilling the skin's "moisture reservoirs"

You can think of hyaluronic acid as a natural moisture "sponge". It is an amazing molecule capable of binding up to 1,000 times its own weight in water. When we inject hyaluronic acid gel into areas that have lost volume, we achieve two effects at the same time:

1. An immediate filling effect: the gel itself adds physical volume beneath the skin. It gently "lifts" the hollow that has formed and smooths the line in a way that is visible immediately at the end of the treatment.

2. Improved hydration and elasticity: the molecules attract water from their surroundings and "lock" it into the tissue. This improves the skin's internal hydration, gives it a more vital and refreshed look, and contributes to its elasticity over time.

During the consultation and assessment with us at Dermacare, the medical team does not look only at the line. We examine the whole structure of the face, your facial expressions and the quality of your skin. This is how we select the exact type of filler, with a different level of thickness and flexibility, and the right injection technique for you. The aim is a harmonious result in which the sides of the mouth look smoother and younger, yet still blend in completely naturally with the rest of your features.

Good to know: hyaluronic acid treatment at the sides of the mouth is not a "facelift". It is a targeted, gentle and elegant solution designed to soften the appearance of lines and restore lost volume. The result is a significantly younger and more natural look, with almost no recovery time.

We have prepared a table to summarise the information conveniently.

Summary of hyaluronic acid treatment at the sides of the mouth

Treatment feature	Details
Aim of the treatment	Restoring volume, softening smile lines (nasolabial) and marionette lines.
Product used	Hyaluronic acid gel with a thickness adapted to the area and the skin quality.
Pain level	Minimal. A local anaesthetic cream is usually used.
Treatment duration	About 20-30 minutes (not including anaesthetic time).
Recovery time	Usually no dedicated recovery time is needed; you can return to your routine.
Results	Visible immediately and settle within about two weeks.
Longevity of the result	9-18 months on average, depending on the type of product and the patient's characteristics.
Common side effects	Redness, slight swelling or a small localised bruise that pass within a few days.

The table provides a general picture, but it is important to remember that the experience is personal and every treatment plan is tailored precisely to your facial structure and your goals.

Why do lines form at the sides of the mouth in the first place?

To understand how hyaluronic acid treatment at the sides of the mouth manages to restore a refreshed look, it is important to know about the processes taking place beneath the surface of the skin. The appearance of lines is not just a matter of age, but the result of a combination of internal ageing processes and external factors that affect us.

Over time, the body slows down the production of the three main building blocks that keep skin firm and elastic:

• Collagen: the protein that gives the skin strength and structure.

• Elastin: the protein that allows the skin to return to its place after every smile or expression.

• Natural hyaluronic acid: the molecule responsible for volume, hydration and a vital appearance.

When this "scaffolding" weakens, the skin becomes thinner and less elastic, and loses volume. This is the stage at which static lines begin to appear, lines that are visible on the face even at rest.

Factors that speed up the process

Beyond the natural process, there are several environmental and behavioural factors that make lines deeper more quickly, especially in the challenging Israeli climate.

1. Sun exposure
UV radiation is one of the main causes of premature skin ageing (photoaging). Prolonged sun exposure causes accelerated breakdown of collagen and elastin fibres, which depletes the skin's internal support and contributes directly to the formation of deep lines around the mouth.

2. Genetics
Your genetic make-up plays a significant role in determining how fast your skin ages and your tendency to develop lines in specific areas. If your parents had prominent marionette lines or smile lines, you may have a similar tendency.

3. Smoking and lifestyle
Smoking is a recipe for premature ageing. It constricts the blood vessels, reduces the flow of oxygen to the skin and impairs its ability to renew itself. In addition, the repeated pursing of the lips when inhaling is a significant accelerator of lines around the mouth. A poor diet, stress and lack of sleep also contribute to tired, lacklustre-looking skin.

The role of facial expressions

Facial expressions, such as smiling, laughing and talking, work the muscles around the mouth thousands of times a day. At first they create dynamic expression lines, which appear only when the face is moving. Over the years, as the skin loses its elasticity, it struggles to return to its smooth state. So what started as a temporary smile line becomes a permanent line, etched into the skin even when we are not smiling. If you would like to better understand the differences and how each type is treated, you can read about it in our guide to ways of treating expression lines.

So how does a hyaluronic acid injection solve this?

This is where the most direct and elegant solution to the problem of volume loss comes into the picture. A hyaluronic acid injection works like "refilling the reservoirs": it gives back to the skin what time and the environment have taken away.

The injected gel physically fills the hollow that has formed beneath the line, lifting and smoothing the skin. In addition, hyaluronic acid binds water, raises the level of hydration in the area, improves the skin's elasticity and contributes to a healthier, more refreshed overall appearance. So the treatment does not just "blur" the line, it genuinely improves the quality of the tissue from within.

To achieve a natural result with hyaluronic acid injections at the sides of the mouth, the treatment process is just as important as the quality of the product. At Dermacare we have developed a precise working protocol that gives you complete confidence and a harmonious result, one that does not look "done". We believe that a personal, transparent and meticulous process is the only way to avoid an exaggerated look and achieve an elegant improvement.

It all starts with a personal assessment appointment.

Step 1: professional assessment and personal consultation

This is without doubt the most critical stage of the process. In this appointment, one of the experienced doctors from the Dermacare team will listen to you and understand what bothers you and what you expect from the treatment.

Our professional assessment includes examining several key parameters:

• Facial structure and dynamics: we examine your face not only at rest but also in motion, while you speak or smile. This helps us understand how your face "works" naturally.

• Depth and type of lines: there is a big difference between smile lines (nasolabial) and marionette lines, which indicate sagging. We identify the main cause of their appearance: volume loss, sagging tissue, or a combination of the two.

• Skin quality: we check the elasticity, hydration level and thickness of the skin. This information helps us choose exactly the right type of filler for you.

After the assessment, we sit down for an open conversation about expectations. We explain to you exactly what can be achieved, what the limitations of the treatment are and what the realistic result will look like. Our aim is for you to leave the appointment with a full understanding of the process and complete confidence in it.

Our approach at Dermacare: we do not "fill a line", we "sculpt the area". In practice, this means the injection is not always concentrated only within the line itself. Sometimes, to achieve a gentle and natural lift, we provide support at strategic points in the cheeks or jawline. This approach creates a more refreshed and harmonious look without overloading the mouth area.

Step 2: treatment planning and preparation

Once we have put together a personal treatment plan, we are ready to begin. Before the injection, the area is thoroughly cleansed and disinfected.

A strong anaesthetic cream is then applied for about 20-30 minutes. This step is essential to ensure a comfortable treatment with minimal discomfort. We make sure to give the cream enough time to work so that your experience is as relaxed as possible.

Step 3: precise injection

The injection itself is fairly short, taking about 20-30 minutes. The doctor will use a very fine needle or a cannula (a flexible tube with a rounded tip), depending on the area and the chosen technique. The great advantage of a cannula is that it allows a more even distribution of the product and significantly reduces the risk of bruising.

The product is injected in small, measured amounts, at strategic points and at different depths of the skin. The secret to a natural look is full control over the amount of product, the injection depth and the angle of insertion; this is how a puffy or "overdone" look is avoided. In addition, most of the fillers we use already contain lidocaine (an anaesthetic), which increases comfort during the procedure.

Step 4: shaping and finishing

Immediately after the injection, the doctor gently and carefully massages the treated area. This is critical to "sculpt" the product, make sure it spreads evenly in the tissue and prevent lumps from forming. This is what ensures that the product blends smoothly and harmoniously into the face.

At the end of the treatment, you will receive clear aftercare instructions from us: what to do and what to avoid in the next 24-48 hours. Following the instructions will ensure the best possible result and a quick recovery. If you would like to learn more about other options, you can read about combined treatments for wrinkles with hyaluronic acid in our comprehensive guide.

Who is the treatment suitable for, and who is it less suitable for? Managing expectations before you start

Injecting hyaluronic acid at the sides of the mouth is a highly effective treatment for refreshing the appearance of the face, but like any medical-aesthetic procedure, it is not suitable for everyone. At Dermacare, the first thing we do in the consultation is listen to you, understand what bothers you and make sure that this treatment will really provide the right answer. Personalisation is the key to a result you will love.

When is an injection at the sides of the mouth the right solution?

This treatment is an excellent choice for women and men who want a significant improvement in their appearance, without surgery and without a long recovery time.

The treatment is ideal in the following situations:

• Expression lines that are becoming permanent: when smile lines or marionette lines are visible even when the face is relaxed.

• A feeling of "drooping" or "hollowness": if the area at the sides of the mouth looks slightly sunken, giving the face a tired or sad look.

• A wish to restore vitality to the face: the treatment can soften the expression and create a more vital and refreshed look.

• A desire for a natural look: for anyone who is worried about an "overdone" look and wants an elegant, harmonious result.

In general, the ideal candidates are people who understand that the goal is not to "iron out" the face, but to soften lines, restore lost volume, and achieve a younger, more refreshed look that stays true to the original.

When is the treatment not recommended?

Your safety comes first, so there are situations in which we will not carry out the treatment or will recommend postponing it. Our medical responsibility requires us to be transparent and to act with the utmost care.

We will not inject in cases of:

• Pregnancy and breastfeeding: there is not enough research on the safety of the treatment during these periods, so we avoid performing it.

• Active skin infection: if there is herpes, inflammatory acne or an open wound in the area to be injected, you must wait for it to heal completely.

• Known allergy to hyaluronic acid: this is very rare, but if there is a known sensitivity, the treatment is not permitted.

• Certain autoimmune diseases: these conditions require individual review and approval from the treating doctor before an injection can be considered.

• A tendency to keloids (raised scars)

Realistic expectations: what can the treatment really achieve?

This is perhaps the most important part of the process. Our aim is for you to leave the clinic satisfied, and the way there starts with realistic expectations. A hyaluronic acid injection will provide a visible improvement, soften the lines and give the face a refreshed look, but it will not change who you are.

Our philosophy at Dermacare is simple: to make you look like the best version of yourself, while fully preserving your unique appearance. A good result is one where friends tell you "You've been looking great lately!", not "What have you done to your face?".

Recovery, instructions and managing possible side effects

One of the great advantages of hyaluronic acid injections is the quick return to your routine. Since this is not surgery, most patients can return to normal activity almost immediately. However, to ensure the best possible result and a smooth recovery, it is important to follow a few instructions and to know what to expect in the days after the treatment.

Important instructions for the first 48 hours

At Dermacare, every patient receives a clear, personalised instruction sheet from us. The goal is simple: to minimise side effects and allow the product to settle ideally in the tissue.

These are the important things to remember:

• Avoid strenuous physical activity: intensive exercise increases blood flow and can lead to swelling or bruising in the injection area. It is recommended to take a break from workouts, running or weightlifting for 24-48 hours.

• Avoid sources of heat: saunas, jacuzzis, hot showers and direct sun exposure are not recommended in the first few days. Heat dilates the blood vessels and can worsen redness and swelling.

• Do not apply pressure to or massage the area: this is a critical rule. It is very important not to rub, press or massage the injected areas (unless the doctor has instructed otherwise). Hyaluronic acid is a delicate gel that needs time to settle and integrate into the tissue. External pressure can move the product and affect the symmetry of the result.

• Avoid drinking alcohol in the 24 hours after the treatment.

Common side effects and how to deal with them

It is important to understand that mild reactions in the injection area are a natural and normal part of the process. They reflect the body's response to the procedure, and in the vast majority of cases they pass on their own within a few days.

The most common effects are:

• Redness and slight swelling: the injected area may be slightly red and sensitive to touch. This is an expected reaction that usually passes within a few hours to two days.

• Small bruises (blue marks): sometimes the tip of the needle meets a tiny blood vessel and causes a small localised bruise. These marks are absorbed and disappear within a few days, and in the meantime they can easily be covered with a little make-up (24 hours after the treatment).

A tip from the Dermacare clinic: to ease swelling and discomfort, you can apply cold compresses (ice wrapped in a thin towel) to the area for 10 minutes at a time, several times during the first day. It is important not to put ice directly on the skin, to avoid a cold burn.

If the swelling or redness does not pass after a few days, or if, heaven forbid, unusual effects appear such as severe pain, a sharp change in skin colour or lumps, it is important to contact us at the clinic immediately. Our responsibility is to provide full support until complete recovery.

The experience of the treating doctor and their in-depth knowledge of facial anatomy are the key to minimising risks and dealing quickly with any reaction. Choosing a professional clinic such as Dermacare gives you not only a beautiful aesthetic result, but also peace of mind and safety every step of the way.