What is causing fine lines over entirety of cheeks and what can be done? (photo)

Question

I am really hoping someone has some advice on this topic! I am 30 years old and recently had a new baby. I am noticing a lot of fine lines over my entire face, especially when smiling. I understand fine lines in the usual places like eyes, forehead, etc, but I have never seen or heard of lines appearing all over the face. What can be done to the lines all over my cheeks? Also what is the cause of all these lines appearing? They show mostly when I smile but I only have noticed recently. Thx!

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer.

Brian M. Harmych, MD, FACS · Answer

Thank you for sharing you question and photo. The cause is simply the very earliest signs of aging and cumulative sun damage (even though you are young). The simplest, easiest, and least expensive option is improve skin care. Have a dermatologist or esthetician set you up with a gentle cleanser, moisturizer, daily sunscreen, +/- retinol/retinoid. Nonsurgical treatments like neuromodulators (Botox, Dysport, Xeomin, etc) are sometimes used to treat this. However, this is not a preferred option (for this specific concern) in my practice. HA fillers aren't great at dynamic (caused by muscle contraction and movement) lines and wrinkles. Although, there may be some benefit once these lines become deeper over time. Laser resurfacing (or fractional laser resurfacing) can improve skin tone and texture by inducing new collagen. However, any laser treatment would have more downtime, expense and risks associated. Bottom line: you have several good options to improve these early signs of facial aging. An in person consultation with a board certified specialized would be informative as the next step.

Vibha Gambhir, MD · Answer

Thank you for your question. Over time, especially after 30, we lose collagen. To help fine lines and wrinkles I recommend radio frequency such as thermage and/or PRP to help build collagen and help slow down the aging process. For more intense results a CO2 laser can be done, but requires more down time.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! After pregnancy, there can definitely be changes in the texture and quality of the skin - fine lines included. As for the fine lines, chemical peels such as glycolic acid or TCA can resurface the skin with excellent results. At times, I'll recommend Morpheus8 RF microneedling which can help to "tone" the underlying collagen, thus rejuvenating the skin. Topical skin care as well such as Hydrafacials and use of tretinoin can be very useful as well. I would recommend consulting with a facial plastic surgeon who also has a med spa with a variety of treatments. Hope this helps you!

What is causing fine lines over entirety of cheeks and what can be done? (photo)

Answers (5)

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