Nasiolabial smile lines - Alternatives to fillers? (photo)

Ordinarily, I would consider the use of an HA filler for the treatment of smile lines. This would usually be a robust HA volumizing filler when cheek volume deficit is at the root of the smile line development or direct injection of a low viscosity, cohesive, malleable HA filler directly along the fold when there is little cheek volume deficit to account for the smile lines.
However, through the years, I have used subcision, without any additional filler at all, to elevate and smooth smile lines.
I would be reluctant to suggest treatments, such as peels or microneedling, which are best reserved for superficial, surface textural irregularities. And I would suggest a healthy dose of buyer beware when being hawked, as you no doubt will be, expensive, supposedly "next big thing" light and energy-based gizmos, such as fraxel lasers or RF devices, as the hard science to support their use lags well behind the heavy marketing hype and social media buzz to hawk them.
You would be wise to consult with a board certified cosmetic dermatologist with extensive experience in performing subcisions. Hope this helps and best of luck.

You may want to look into Morpheus8. This treatment combines RF technology with microneedling to improve overall skin tone and texture. We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day. I've included a video I hope you find helpful.

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon