Why is the “Joker Smile” dangerous? – Rubryka

What’s the problem?

Another dangerous trend is spreading on social media: this time, teenagers are cutting the corners of their mouths to widen their smiles.

The “Joker smile” is the latest teen “fashion” on TikTok. Most teens imitate it with makeup, filters, or video editing tools to increase their views and likes. However, some have taken it further, wanting a permanently wide smile, and actually cutting their lip corners.

In one video, the girl who did this says she can no longer physically open her mouth, and it hurts a lot. The visual result wasn’t what she expected either: instead of a cute, wider smile, the corners of her lips drooped downward.

Doctors warn that such experiments carry real health risks, and psychologists draw parallels with the “Blue Whale” wave of self-harm, when kids didn’t fully understand the consequences of their actions.

What’s the solution?

Where did it come from? Why would kids even agree to such experiments with their bodies? And what should parents do to keep teens from copying dangerous trends? We asked a psychologist and plastic surgeons.

How does it work?

Plastic surgeon Maryna Yurchenko. Photo courtesy of the expert

Plastic surgeon Maryna Yurchenko, an expert in facial and eye aesthetics, explains that the trend for the so-called “Joker Smile” is an attempt to achieve a friendly or happy look, where the lip corners are lifted even when the face is at rest. On social media, teens portray it as a simple “aesthetic trick,” but in reality, it’s a real surgical procedure.

“Yes, it does exist in plastic surgery,” she says, “but not in the way they show it on TikTok. It’s called a lip corner lift, an operation used when someone has drooping lip corners, asymmetry, or age-related changes. In these cases, small micro-incisions near the lips allow us to lift the tissues, restore balance, and get rid of the ‘sad’ facial expression.”

Sometimes doctors combine the surgery with Botox or fillers, which gives a gentle lifting effect without overstraining the muscles. But, she stresses, this has nothing in common with the self-inflicted experiments now spreading online.

In professional practice, lip-corner correction is done only when there’s a medical or aesthetic indication, and the goal is naturalness — not an artificial “permanent smile.”

When it makes sense:

• drooping lip corners (age-related changes, sagging, muscle weakness);
• asymmetry (one corner lower than the other), to make the smile more balanced;
• combined with other rejuvenation procedures;
• only when the tissues are healthy and strong enough for correction.

Plastic surgeon and burn specialist Dmytrii Homola supports this:

“In TikTok and Instagram, this procedure has been twisted into something completely senseless medically and aesthetically. Someone romanticized this aesthetic horror and called it a ‘Joker Smile,’ but as a doctor, I see danger, not creativity.”

Illustrative photo: from open sources

Lips are one of the most delicate areas of the face. They’re full of nerves and blood vessels, and the mouth is full of bacteria. Maryna Yurchenko says the results of these DIY experiments can be terrifying:

• Asymmetry: one corner heals differently from the other, causing a crooked smile;
• Impaired articulation and facial movement: difficulty moving the lips, speaking, or smiling;
• Tissue retraction: the skin “tightens” toward the incision, deforming the lip corners;
• Nerve damage: loss of sensation or impaired muscle function;
• Prolonged bleeding;
• In severe cases, tissue necrosis or sepsis (blood poisoning);
• And even when it seems like “it worked,” without proper technique and tissue support, the lip corners can sink again.

“None of this is an exaggeration. I’ve had patients come in after attempting to do things to their own faces. Even a tiny cut in this area can be dangerous,” says Homola.

Plastic surgeons stress that aesthetic medicine isn’t about chasing trends or trying to become someone else. It’s about health, harmony, and self-confidence, but only when everything is done consciously and with respect for your body, under the care of a specialist.

“I remember myself as a teenager, when it seemed like my appearance determined everything, and I wanted to try anything just to be liked. But the so-called Joker Smile is not a life hack. It’s not makeup — it’s a surgical cut in an area full of nerves and blood vessels. If you want to change something about yourself, that’s okay. But don’t let trends decide what your face should look like,” Yurchenko addresses teens.

Plastic surgeon Dmytrii Homola. Photo courtesy of the expert

Homola adds a message for parents:

“If you see that your child is getting involved in these ‘trends,’ don’t push them away. Talk. Explain that their face is already unique, and no TikTok hype is worth a scar.”

First, stay calm. Don’t yell, blame, or shame the child. This isn’t just “stupidity” — it’s a sign they’re hurting inside or were influenced by others. Next, take the child to a doctor. Ideally, to a plastic or maxillofacial surgeon.

“Don’t panic, but act fast. Treat this as a potential surgical injury. It’s important not to wait until the scars set, because early correction — choosing the right stitches, closing the wound, treating infection — can greatly reduce the consequences,” says Yurchenko.

A doctor will assess the depth of the cut, determine whether muscles, nerves, or vessels are affected, examine the wound edges, and check for signs of infection. They will clean the wound and, if needed, perform cosmetic suturing or plan later correction.

“Don’t postpone seeing a specialist, even if it looks like it’s healing. Lips aren’t something you can gamble with. And absolutely involve a psychologist. In my opinion, this usually isn’t about wanting to be prettier, but about anxiety, insecurity, or a need for recognition,” says Homola.

Psychologist Oleksandra Kozlovska. Photo courtesy of the expert

Psychologist Oleksandra Kozlovska explains that during adolescence, children undergo a significant neurobiological restructuring. Hormonal changes affect the entire body. The brain’s reward system, which seeks novelty and pleasure, works more intensely than the risk-control center in the prefrontal cortex. That’s why the desire for approval, likes, and peer attention can be stronger than the fear of pain or danger.

Dopamine plays a role, too. Every new like, follower, or positive comment creates a brief dopamine spike, reinforcing a reward loop. A teen starts craving that feeling again — even if getting it involves risk or pain.

She notes that teens don’t perceive risk in the same way adults do. Belonging to a group, feeling “one of them” or “special,” is crucial. That’s why they copy behavior, even if it’s unsafe.   

“The Joker Smile is self-harm, even if it’s ‘for beauty,’ ‘aesthetic,’ or ‘an experiment.’ In psychology, this is classified as non-suicidal self-injury. When someone intentionally harms themselves not to die, but to cope with emotional tension or to feel control over their body,” Kozlovska says.

Worldwide, about 17% of adolescents have intentionally harmed themselves at some point. The average age when kids start experimenting with self-harm is 12. However, experts believe they likely first encountered the idea earlier, at the ages of 10 or 11.

Several years ago, a study found more than 1.2 million Instagram posts containing one of five popular self-harm hashtags. Today, when you follow these hashtags, the Ukrainian segment of Instagram suggests psychological help, but parents still need to pay attention, especially now, when social media often replaces honest communication.

“Children’s and teens’ brains aren’t fully developed in the part responsible for long-term planning and risk assessment. So it’s hard for them to imagine future consequences — scars, infections, medical complications. What matters to them is the ‘now’: being accepted, noticed, interesting. Showing others, ‘Look how cool I am,'” she says.

Even if the “Joker Smile” is only makeup or imitation, it normalizes the idea of harming the body. It makes it look trendy and aesthetic, and that’s a problem. Such trends lower sensitivity to real harm and can open the door to other forms of self-injury. 

Does it really work?

According to the psychologist, risk groups include:

• kids with low self-esteem,
• those experiencing bullying or social isolation,
• teens with traumatic experiences (violence, loss).

Parents need to be aware of and attentive to emotional and behavioral changes. Adolescence is a time of intense self-searching, when inner experiences often take forms adults don’t understand. But this is precisely when a child needs support the most, even if they seem distant.

Illustrative photo: iStockphoto 

Warning signs:

• withdrawal;
• low self-esteem, phrases like “Everyone’s pretty except me,” “I want to feel something”;
• long sleeves in hot weather or always at home (to hide cuts);
• sleep disruptions, scrolling social media late at night.

Kozlovska recommends:

• Explain that this isn’t normal. It’s not about beauty or courage — it’s emotional manipulation: “Your value isn’t in your looks or in reactions on a feed. It’s in the fact that you live, feel, and can change the world for real.”
• Talk with your child about their feelings. Create little “islands” of time together — to talk, share secrets, connect. Become the kind of friend they can trust with their emotions.
• Teach them how social media algorithms work, and why trends shouldn’t be taken as norms.
• Set rules for digital safety: establish breaks from social media, block dangerous hashtags, and avoid pages with harmful content.

“Don’t yell or judge your child for curiosity or for any signs of self-harm. First, give them a sense of safety. Say: ‘I see you’re hurting. I care. I want to know what happened and help you,'” Kozlovska says.

Remember: a child needs time and space to open up. Don’t pressure them or say things like, “If everyone jumped out the window, would you?” or “You have a mind of your own, don’t you?” That only makes things worse. If the child won’t talk to you, involve a psychologist — kids often open up more easily to another adult than to parents.

And most importantly, build trust with your child from a young age — not only when you notice a problem, but long before that.