What’s In a Smile?

The purpose of our three primary types of smiles.

There are three primary types of smiles: the affiliative smile, the enjoyment
smile, and the dominance smile.

The affiliative smile involves a simultaneous raising of the corners of the
mouth with the formation of crow’s feet around the eyes.  The enjoyment smile
is very close in appearance to the affiliative smile, but the trigger for this type
of smile is usually spontaneous rather than voluntary. The dominance smiles
(i.e, scheming, critical, proud) have a less friendly appearance as they
typically do not involve the activation of the crow’s feet, rendering a much
colder effect.  There are various circumstances that can affect the expression
and understanding of these different smile types, including cultural norms,
medical illness or injury, and elective cosmetic interventions.

Studies have shown that countries with more immigration smile more.  It
makes sense that nonverbal communication would be of greater importance
when a common verbal language cannot be relied upon.  This affiliative smile
is particularly useful for those who do not already have a strong social
network and/or community. When people express this type of smile, they are
perceived as more approachable, more genuine, and more trustworthy.
Polls taken of people from 32 countries found that emotional expressiveness
was correlated with diversity. In the less culturally diverse countries, smiling
individuals were rated as less honest.  This may be due to the fact that in
more homogeneous nations, smiling is more often used to show superiority
and exert power (i.e., dominance smiles) than as a means of making a
connection.

As facial plastic surgeons, we see many people with smiles that have been
affected by tissue damage and/or nerve injury.  For these patients, the simple
act of smiling can be very elusive and even painful. Studies have shown that
patients with an impaired smile are perceived as less likeable and less
trustworthy, which translates into a significant disadvantage in social
situations.  Not only are these individuals being judged less favorably, but they
are also much less likely to get a smile in return, which can have a significant
impact on mental health and happiness. In order to help treat these patients,
we need to help restore their ability to effectively smile to the greatest possible
degree.  Much effort has been placed into determining successful smile
characteristics and to developing advanced surgical techniques to replicate
these qualities.

While elective cosmetic interventions are inherently undertaken to improve
appearance, there can be unintended effects with detrimental effects on the
smile.  About 1-2% of patients undergoing facelift will have permanent
weakness of a branch of the facial nerve, which can significantly impact
smiling. Immobility in various facial movements can also occur after
neurotoxin injections (i.e., Botox, Dysport, Xeomin).

These injections are done to reduce the appearance of wrinkles by relaxing
the underlying facial muscles, with one of the most common targets for these
treatments being the crow’s feet. While a degree of relaxation in this area
around the eyes is associated with a more rested and youthful look, excessive
weakening of these muscles can result in the inability to express an affiliative
(“friendly”) smile.

Smiling is a powerful gift of communication that can dramatically influence
interpersonal interactions.  While there are a wide range of affable and joyful
smiles, there are also smile types that are less genuine in appearance.  In
some social circumstances and cultures, this may be the result of an
intentional display of dominance. In other cases, the lack of a sociable smile
may be the result of a facial deformity, medical condition, or even as a side-
effect of cosmetic interventions.

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