Specialist article: Face
Nasolabial fold and upper lip linesWhat the mouth muscles have to do with them
The fold between nose and corner of the mouth is getting deeper, and fine lines are appearing above the upper lip? Here you will learn how the nasolabial fold and pleat lines develop, what fillers, Botox and laser can do, and why, in our view, mouth closure, tongue reference position and swallowing pattern also play a part.
Does this sound familiar?
The lines around your mouth are getting deeper, and you wonder why?
What applies to you?
Tap whatever applies to you.
If several points apply, it is worth looking at the muscles beneath the skin. Skin, fat and bone age; there is no way around that. How the muscles around the mouth work, on the other hand, is a pattern, and patterns can be trained.
Lines during trainingFillers, Botox, laserThe key points at a glance
- The nasolabial fold is the border between cheek and upper lip, and everyone has it. Over the years, the tissue of the cheek sinks a little and the fold becomes deeper.
- Pleat lines above the upper lip have one component in the skin and one from movement, for example from pressing the lips when swallowing, many hundreds to a thousand times a day.
- Fillers, Botox and laser act on volume, muscle or skin and have their own risks; Botox paralyses the very muscle that a relaxed lip closure needs. In our view, the training starts beneath this, with lip closure, tongue reference position and swallowing pattern. We do not promise a particular appearance.
Video
Facial muscles, tension and pleat lines: what function has to do with them
Das Video lädt erst nach dem Klick. Dann werden Daten an YouTube (Google) übertragen.
Anatomy
Nasolabial fold: a boundary, not a flaw
The nasolabial fold runs diagonally down from the side of the nose to the corner of the mouth. When laughing, you can see it in everyone, even in childhood.
The name reveals its location. Nasolabial means “between nose and lip”. Here, two differently structured tissues meet. At the side lies the cheek with its fat pad, towards the middle the upper lip, whose foundation is formed by the ring muscle of the mouth. Where the two meet, the skin forms a furrow.
from body donors were examined by surgeons in Dallas using injected dye. The fat at the nasolabial fold forms its own clearly defined compartment1
from body donors were compared by CT in Kiel. In the older group, the fat compartments of the midface lay lower, and their volume had shifted downwards2
A study from Milwaukee shows how closely the fold is connected to the muscles. In the upper lip, the SMAS merges into the superficial part of the ring muscle of the mouth. Pulling on this layer to the side of the fold deepened it, while pulling on the fat layer above it smoothed it3. The nasolabial fold therefore depends on the tension of the tissues beneath the skin.
Upper lip
Upper lip lines: pleat lines and “smoker’s lines”
Fine vertical lines above the upper lip are called pleat lines, after the fabric with its pressed lengthwise pleats. Colloquially, they are often called smoker’s lines.
The skin of the upper lip lies directly on the ring muscle of the mouth. When the ring contracts, for example when pursing the lips, it gathers the skin like a curtain. As long as the skin is elastic, it smooths out again. Over the years this recoil diminishes, and lines of movement become lines that remain even at rest.
from deceased people under 40 and over 80 years of age were compared by a research group in Freiburg. In old age, the skin was thinner, its elastic fibres had broken down, and the ring muscle of the mouth showed signs of muscle wasting4
were measured by the same group using MRI. The upper lip of the older women was longer and thinner, but its total volume was not smaller5
So the lip becomes longer and flatter, and the muscle within it weaker. Whether training slows this down has not been studied. In our view, there is much to be said for letting a muscle keep its daily task. Whatever is integrated into a function is used and keeps its tension. Whatever is not used becomes slack.
The fixed component
Skin, collagen and elastic fibres age, and sun and smoking accelerate this. These lines remain etched into the skin.
The moving component
Every pursing and pressing of the lips folds the skin anew. How often this happens helps determine how clearly the lines stand out.
The lines are not called smoker’s lines without reason. In Ohio, 79 pairs of identical twins were compared, one of whom smoked or had smoked for considerably longer. Assessors who did not know who smoked rated the smokers worse for upper lip lines, the nasolabial fold, and the cheeks and lower eyelids6.
A pleat line is also a movement pattern.There is little you can change about the age of your skin, but you can change the pattern with which your lips work.
Swallowing pattern
Lip pressing when swallowing: the unnoticed training
When it comes to lines around the mouth, many people think of laughing or talking. In our view, a sequence that hardly anyone notices plays a bigger role.
You swallow many hundreds to a thousand times a day, even at night. In the physiological, i.e. naturally intended, sequence, the tongue carries the swallow. Its tip rests on the small ridge behind the upper front teeth, the back of the tongue settles against the palate, and the back teeth touch briefly. The lips only rest loosely together; more under Swallowing and swallowing disorders.
If, on the other hand, the tongue lies low, the swallow lacks support from within. The mouth is sealed from the outside. The lips press, the chin muscle raises the lower lip, and the corners of the mouth contract.
It is precisely this movement that gathers the skin above the upper lip, anew with every swallow. How the chin muscle steps in is described in the article on lip training.
Place a finger lightly on your chin and swallow some saliva once. What do you feel?
Tongue reference position
The tongue: support from within
How the midface looks is not decided only at its surface. From the inside, the tongue lies beneath the palate and helps support it.
In the tongue reference position, the tip of the tongue rests on the small ridge behind the upper front teeth, and the back of the tongue nestles against the palate. Strictly speaking, there is no fixed “tongue resting posture”, because the tongue moves constantly and returns to this form. More on this in the article on the correct tongue resting posture.
If your lips rest loosely together and you breathe through your nose, a slight negative pressure develops in the mouth. It holds the tongue against the palate without it having to press. The lips then only need to seal.
The inside supports. The outside follows.If the tongue supports from within, the lips need little tension. If this support is missing, the lips, cheeks and chin take over the work from the outside, and the skin shows it.
The tongue also helps shape the bone. According to the functional matrix hypothesis of the anatomist Melvin Moss, muscles and soft tissues shape the bones they lie against through their daily work7. The tongue shapes the palate from below, the lips shape the rows of teeth from outside. In our view, the tongue reference position and mouth closure therefore also matter for the shape of the midface, especially during growth.
The triad
Mouth breathing and head balance: tension in the midface
In our view, how a face looks over the years does not depend on a single line, but on the interplay of breathing, swallowing and head balance.
A basic function deviates
The mouth is often open, the tongue lies low, or the head moves forwards. This often begins in childhood.
The lips take over
Because support from within is missing, the lips and chin seal the mouth from the outside. The nervous system stores this solution as a pattern.
The tension shifts
The ring muscle of the mouth presses briefly and forcefully instead of sealing loosely. The cheeks and midface lack the pull from within, and in our view a head tilted forwards pulls them further downwards.
The skin shows it
In our view, the nasolabial fold deepens more easily, and the lines from pressing appear above the upper lip. The ageing of the skin adds to this.
In our view, this chain usually begins with the basic functions, long before a line becomes noticeable. How mouth breathing helps shape the face during growth is described in the article on mouth breathing, and the consequences for the chin line in the article on receding chin and double chin.
In training, the head is therefore upright and your gaze is straight ahead. The lips enclose the FaceFormer, the tongue rests against the palate, and you breathe through your nose. In this way breathing, swallowing and head balance are practised together.
Putting treatments into context
Fillers, Botox, laser: what they can do
There are effective medical treatments for the nasolabial fold and upper lip lines. It is worth knowing what they act on and what risks they carry.
Fillers
Hyaluronic acid fills in volume in or beneath the line. The body breaks it down over time, which is why follow-up treatment is needed.
Botox
Botulinum toxin inhibits transmission from the nerve to the muscle. On the upper lip, it slows down the ring muscle of the mouth.
Laser and peeling
They remove or heat the upper layers of the skin, thereby stimulating regeneration.
with a pronounced nasolabial fold received hyaluronic acid on one half of the face and collagen on the other in a US study. After six months, the correction with hyaluronic acid lasted better8
was how long the effect of a low dose of Botox against lines around the mouth lasted in 60 women, and 20 weeks with the higher dose9
These procedures work and have their place. They address volume, muscle or skin as long as the effect lasts. They do not change the pattern with which you swallow, breathe and close your lips. On sun protection, see Facial training and active cosmetics.
Fillers and Botox are medical procedures with their own risks. Fillers break down and are topped up; Botox paralyses the orbicularis oris muscle, which a relaxed lip closure needs, and thus intervenes in a functional system whose consequences are rarely considered. Very rarely, filler material enters a blood vessel, which can lead to loss of vision10.
Fillers and Botox smooth the surface. Training asks what is pulling on it.One does not rule out the other.
If you have fillers or Botox in your face or are planning a treatment, coordinate the start of training with the treating practice. Botox does not rule out training, but it restricts the interplay of the muscles for as long as it is effective. More under FaceFormer and other treatments.
Training
Upper lip lines during training: broad rather than pursed
Some people notice little lines above the upper lip in the first few weeks while practising with the FaceFormer. This is not a reason to stop, but a pointer to technique.
The lip wedge, the central part of the FaceFormer between the lips, gathers the lips at one point. Lines already present in the skin therefore stand out more clearly at the moment of the exercise, like a relief. That does not yet say anything about everyday life.
In addition, many people take their habitual pattern into the exercise. They purse their lips, and the chin pulls along. The exercise then practises exactly the pressing that accentuates the lines, and the face shows how the swallow has been organised so far.
- Corners of the mouth wide. Draw the corners of your mouth slightly to the side, as in a hint of a smile. The lips enclose the lip wedge broadly, not pursed.
- As much tension as necessary. Pressing does not mean pushing with all your might. The lips hold the wedge just firmly enough that the mouth is sealed and you can swallow.
- Tip of the tongue in its place. Do not consciously push your tongue upwards; the negative pressure during swallowing draws it to the palate.
- Practise in front of a mirror. Check the first sessions until the broad lip position feels familiar.
Letting go is part of the exercise. After swallowing, you release the pressure, the lips enclose the lip wedge without force, and the teeth do not touch. The pause lasts a few seconds at first and becomes longer as your training progresses.
In our view, what counts is less the moment of the exercise than how often the skin is gathered in everyday life. If the swallow succeeds from within, a great deal of daily pressing falls away.
Training
Training the mouth muscles: in sequence, not in isolation
Individual lip exercises train strength. For the nasolabial fold and upper lip, what counts in our view is how the muscles work together in everyday life.
In our view, how deep the nasolabial fold becomes also depends on how the lips, cheeks and tongue work in everyday life. If you follow this logic, a training that brings relaxed lip closure and the tongue reference position back into the pattern can create the conditions for the muscles to support the soft tissues differently. Some users report a softer face after months; this cannot be promised.
In FaceFormer training, the lips, tongue, swallowing, nasal breathing and head balance therefore work together in one exercise, as in everyday life. The exercise instructions list cosmetics among the areas of application of the pull exercises. The aim is a pattern that runs without thinking, so that the muscles also work correctly between the exercises.
You start with the basic exercise, and from about week 3 the pull exercise is added. The direction of pull determines which muscle strands of the lips, cheeks and floor of the mouth are challenged most. The video shows the downward pull, a variant that is best agreed with a practice, for example if little lines keep forming despite broad lips.
The free FaceFormer app guides you through the basic exercises; all the modules are on the exercise pages. You start with the FaceFormer ZERO made of softer material, and after a few weeks you use the ONE, which is the same size, during the day. The exercise manual reckons on six to twelve months until new sequences run by themselves.
Everyday life
Your mouth in everyday life
Lips relaxed, tongue up
The lips rest together without pressing, the tip of the tongue is in its place, and the teeth do not touch.
Check your swallowing in the mirror
If the upper lip and chin stay still when you swallow, the tongue is carrying the swallow.
Purse less
Straws and drinking bottles with a mouthpiece make the lips purse. When drinking from a glass, keep your lips loosely in contact.
Don’t smoke
Smoking makes facial skin age faster.
Sun protection for the upper lip
The thin skin above the lip gets a lot of sun.
Head over the body
Set up your screen and phone so that your head is balanced. The head balance rotation practises exactly that.
Questions
Frequently asked
What is the nasolabial fold?
The furrow that runs diagonally from the side of the nose to the corner of the mouth. It marks the border between cheek and upper lip and is present in everyone; you can see it clearly when laughing. Over the years, the fat pad of the cheek sinks a little, the skin loses elasticity, and the fold remains visible even at rest.
Where do upper lip lines come from?
Vertical lines above the upper lip, also called pleat lines, have two components. One lies in the skin, which becomes thinner and less elastic with age, sun and smoking. The other arises from movement, because every pursing and pressing of the lips gathers the skin. In our view, the swallowing pattern plays a major role here, because it is repeated many hundreds to a thousand times a day.
Why are they called smoker’s lines?
Because they are often more pronounced in people who smoke. When drawing on a cigarette, the lips purse, and smoking makes the skin age faster. In a twin study, the smoking siblings fared worse for upper lip lines and the nasolabial fold. However, the lines also occur in people who have never smoked.
Can the nasolabial fold be smoothed out through training?
This cannot be promised. The fold is an anatomical boundary, and skin, fat and bone age independently of training. The training addresses the tension of the muscles around the mouth, that is, lip closure, tongue reference position and swallowing pattern in interplay with head balance. In our view, it can thus create the conditions for the muscles to support the soft tissues differently. There are no studies on the effect of FaceFormer training on the nasolabial fold.
Wrinkles form on my upper lip during training. Am I doing something wrong?
Usually, the lips are pursed together in the process, and the chin often helps. Draw the corners of your mouth slightly to the side, as if you were smiling, hold the lip wedge with broad lips and take out some of the force. Practise the first sessions in front of a mirror. You do not need to stop because of this; the little lines show that the lips are still sealing the mouth from the outside. That is exactly where the training comes in.
Does Botox help with upper lip lines?
Botox slows down the ring muscle of the mouth so that it gathers the skin less. In one study, the effect lasted 16 to 20 weeks depending on the dose. Because the same muscle closes the lips, lip closure can also be restricted during this time. You decide on the treatment with your practice. The training pursues a different goal; it practises how the muscles work in everyday life.
What role does the tongue play in the nasolabial fold?
In our view, a bigger one than you might think. In the tongue reference position, the tongue rests against the palate and supports the oral cavity from within, and the lips then need little tension. If the tongue lies low, the lips and chin have to seal from the outside, and the midface lacks support from within.
More articles from the knowledge section
Where to go next
Sources
- Rohrich RJ, Pessa JE (2007). The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plastic and Reconstructive Surgery 119(7):2219-2227. PMID 17519724. Source
- Gierloff M, Stöhring C, Buder T, Gassling V, Açil Y, Wiltfang J (2012). Aging changes of the midfacial fat compartments: a computed tomographic study. Plastic and Reconstructive Surgery 129(1):263-273. PMID 21915077. Source
- Yousif NJ, Gosain A, Matloub HS, Sanger JR, Madiedo G, Larson DL (1994). The nasolabial fold: an anatomic and histologic reappraisal. Plastic and Reconstructive Surgery 93(1):60-69. PMID 8278485. Source
- Penna V, Stark GB, Eisenhardt SU, Bannasch H, Iblher N (2009). The aging lip: a comparative histological analysis of age-related changes in the upper lip complex. Plastic and Reconstructive Surgery 124(2):624-628. PMID 19644283. Source
- Iblher N, Stark GB, Penna V (2012). The aging perioral region: do we really know what is happening? Journal of Nutrition, Health and Aging 16(6):581-585. PMID 22660001. Source
- Okada HC, Alleyne B, Varghai K, Kinder K, Guyuron B (2013). Facial changes caused by smoking: a comparison between smoking and nonsmoking identical twins. Plastic and Reconstructive Surgery 132(5):1085-1092. PMID 23924651. Source
- Moss ML, Salentijn L (1969). The primary role of functional matrices in facial growth. American Journal of Orthodontics 55(6):566-577. PMID 5253955. Source
- Narins RS, Brandt F, Leyden J, Lorenc ZP, Rubin M, Smith S (2003). A randomized, double-blind, multicenter comparison of the efficacy and tolerability of Restylane versus Zyplast for the correction of nasolabial folds. Dermatologic Surgery 29(6):588-595. PMID 12786700. Source
- Cohen JL, Dayan SH, Cox SE, Yalamanchili R, Tardie G (2012). OnabotulinumtoxinA dose-ranging study for hyperdynamic perioral lines. Dermatologic Surgery 38(9):1497-1505. PMID 22621180. Source
- Xiao H, Kou W, Yang Y, Dai E, Zhang X, Wen Y, Peng J, Fei P, Zhao P (2024). Administration Method and Potential Efficacy of Hyaluronidase for Hyaluronic Acid Filler-Related Vision Loss: A Systematic Review. Aesthetic Plastic Surgery 48(4):709-718. PMID 36574028. Source
Get started
Ready for the training?
The free FaceFormer app guides you through the basic exercises, counts along and reminds you of your sessions. If you wish, a practice from the practitioner directory can support you.
FaceFormer ZERO + ONE
Both material hardnesses for getting started, day and night. The set for adults.
FaceFormer ZERO
The softer FaceFormer for getting started, for children and for the night.
FaceFormer ZERO Children’s Set
ZERO with hygiene box, plush bag and success book with stamp.
FaceFormer training aims to restore the physiological setting of the basic functions of breathing, swallowing and head balance, with lip closure and the tongue reference position, thereby creating the conditions under which symptoms can improve. It does not replace a medical assessment. You can find practitioners near you in the practitioner directory.
