Under eye and smile lines - Which treatment is best for a youthful look? (photos)

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

This problem is quite common. The use of a cohesive, resilient HA filler fanned through the region at an approximately 45-90 degree angles to the lines, typically and signiificantly reduces the appearance of these lines. Make sure to consult with a board certified cosmetic dermatologist and ask to see his/her personal B&As before agreeing to proceed. Best of luck.

What you have are wrinkles caused by the underlying muscles on skin with decreased thickness and elasticity. Daily use of tretinoin (Retin-A) and Obagi’s ELASTIderm to thicken the skin and add elasticity is the best treatment. If you wish to speed improvement, then you can stiffen the skin by threading filler at 90 degrees to the lines in the bottom of the dermis. Most injectors will not be familiar with this technique. The other things you mentioned will not help.