Say Cheese: The Power of a Smile

There has been a great deal written about the benefits, from happiness to health, of smiling. Studies have shown that forcing ourselves to smile tricks our brain into thinking we are happy. The simple act of smiling spurs a chemical reaction in the brain, releasing dopamine and serotonin. Dopamine increases our feelings of happiness while serotonin is associated with reduced stress. So a forced smile is certainly better than no smile at all.

Research has also been done that demonstrates the power of a genuine smile. This genuine smile is referred to as a Duchenne smile, named after French physician Guillaume Duchenne who studied the physiology of facial expressions in the nineteenth century. In one long-term study,  photos of young women were reviewed and those with a Duchenne smile were significantly more likely to report higher marriage satisfaction and overall well-being up to 30 years later. One could conclude that those who smile regularly and sincerely are more likely to lead happy lives.

Can you tell the difference between a genuine smile and a fake one? Studies have shown that even at young ages children can tell insincerity with facial expressions. When you look at the two images below, the smile on the right portrays two hallmarks of a Duchenne smile: contraction of the zygomatic major, raising the corners of the mouth, and the orbicularis oculi, raising the cheeks and producing crow's feet around the eyes. Since contraction of the orbicularis oculi happens naturally when we smile but cannot easily be faked, the absence of crow’s feet can signal an insincere smile (or the result of being “over frozen”).

For patients undergoing treatment with neuromodulators (Botox, Dysport, Xeomin), preserving the natural smile is essential. Patients who receive too large a dose of a Botox in the crow’s feet may appear to have a fake or insincere smile even when they are genuinely happy. Don’t get me wrong, I think a small amount of neuromodulator for crow’s feet is a wonderful option to soften lines and prevent wrinkles. Also receiving cosmetic treatments can help patients to feel better about their appearance overall, increasing confidence and happiness (resulting in more smiles!). Choosing the right injector will make sure that your emotions continue to show and your face doesn’t appear “frozen.” One of my guiding principles as an injector is to make sure patients achieve natural looking outcomes. Understanding the facial anatomy and ensuring that injections to lessen the appearance of crow’s feet do not eliminate the appearance of that natural, genuine Duchenne smile is very important!