Age 39. What can lift my smile lines away, tighten skin and make me look younger? (photos)

In our practice, we perform a non-surgical face lift / skin resurfacing treatment using Renuvion Helium Plasma Radiofrequency. ​To get the most improvement with skin tightening, we combine Renuvion (formerly J-Plasma) with lasers (Fraxel, Clear + Brilliant, CO2), microneedling/PRP, Ultherapy and InMode FaceTite. I suggest getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer​​​​

Hi @srichards822! I would recommend Morpheus 8 and dermal fillers at the nasolabial folds. I typically injection Restylane Defyne or Refyne. Morpheus8 is a non-surgical advanced radiofrequency microneedling treatment. Morpheus8 treatment stimulates collagen production to tighten and smooth wrinkles on the face.

The so-called "parallel laugh lines" seen in the photo with smiling would not be expected to be helped by Voluma, which is a robust HA filler intended for treating volume deficit in areas, such as the cheeks. Nor would traditionally injected Botox be expected to be of much value here, either. So no surprises in this story. Parallel laugh lines, which usually look like crinkling of the skin at rest, and especially what is observed quite prominently and clearly in the photo provided here with smiling, require instead treatment with a cohesive, low viscosity HA filler fanned below and about 90 degrees to the lines to act as a kind of buttress against the accordion-like folding with smiling. For further benefit, if so desired, Botox may be injected in a grid-like Mesotox technique throughout the region (and not injected in traditional locations or in traditional techniques or concentrations). You would be wise to consult with an experienced, board certified cosmetic dermatologist injector.

You'll likely have the best results from a combination of treatments. Morpheus8 uses RF technology with microneedling to improve overall skin tone and texture. Three treatments are recommended for maximum results. Fillers and Botox can be combined with this treatment. We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.