26, female - How can I remove these permanent lines in my cheeks? (Photo)

Question

Im 26, F and have permanent creases/lines in my cheeks that appear with makeup and without. Will microneedling reduce their apperance? Or skin boosters? Thanks!

Behnoush Zarrini, MD · Answer

Thank you for your question and providing your photo, and at 26, it is completely normal to experience early signs of skin crease changes, often due to high expression or early collagen reduction. As a board-certified physician specializing in facial sculpting at Beverly Wilshire Aesthetics, I recommend a proactive approach to address these permanent lines before they deepen. Both treatments you mentioned are excellent, but I would suggest a combined approach using Morpheus8 RF Microneedling to remodel the dermal tissue and tighten the skin, combined with skin boosters or a very soft hyaluronic acid filler to provide hydrating support to that area without altering your natural expression, creating a smooth, youthful result.

Carl Truesdale, MD · Answer

At your age, 'permanent lines' running through the cheek typically come from one of three things, and the right answer depends on which is driving it.
First possibility: animation lines etched into the skin from repeated facial expression. This is similar to crow's feet from smiling, but in the cheek area. Treatment: small doses of Botox to the responsible underlying muscle (often the lateral orbicularis oculi or zygomaticus) plus skin treatments like microneedling or fractional laser to soften the etched lines themselves.
Second possibility: underlying volume loss creating a fold or hollow that reads as a line. Less common at 26 but possible after weight loss or in patients with naturally thin midface tissue. Treatment: targeted filler to the lateral cheek or deep medial cheek to restore the convex curve that the line is the absence of.
Third possibility: skin laxity or texture changes from sun damage. Treatment: skin-focused regimen (retinoids, sunscreen, vitamin C) plus in-office treatments like Hydrafacial, microneedling with PRP, or chemical peels.
What I'd avoid at 26:
Aggressive facelift or surgical lifting. The tissue hasn't descended, so a lift would create tension without solving the actual issue.
Permanent fillers (Bellafill, Artefil, silicone). These integrate with tissue and are very difficult to remove if you change your mind in your 30s and 40s.
Best move is a consultation with a facial plastic surgeon (or dermatologist who does cosmetic work) who can examine the lines in person and determine what's actually creating them. Static lines (visible at rest) are different from dynamic lines (only visible with movement), and the treatment is different.
Bring clean photos in good lighting from front, three quarter, and side angles. Document the lines at rest, smiling, and talking. This helps the consult diagnose correctly.

Anna Chacon, MD, FAAD · Answer

At 26, what you’re describing is actually very common, and it usually falls into one of a few categories rather than true “permanent wrinkles” in the aging sense.

Cheek lines can appear from:

Natural facial anatomy (smile lines or “dynamic folding zones”)
Skin dehydration or reduced elasticity
Early collagen changes
Or sometimes subtle volume distribution in the midface

The fact that you notice them both with and without makeup suggests there may be a structural component, not just surface texture.

Will microneedling help?

Microneedling can help, but in a modest and gradual way.

It works by stimulating collagen remodeling, which may:

Improve skin texture
Slightly soften fine creasing over time
Help makeup sit more smoothly

However, it does not fully erase deeper or anatomically formed cheek folds. It’s more of a “skin quality improvement” treatment rather than a line-removal treatment.

What about skin boosters?

Skin boosters (like hyaluronic acid microinjections) can be very helpful in younger patients like you.

They work by:

Improving hydration from within the skin
Giving a subtle plumping effect
Softening the look of etched or dehydrated lines

In many cases, this is actually more effective than microneedling alone for visible cheek creasing, especially if dryness or early volume changes are contributing factors.

The key point:

Cheek lines in your age group are often not something to “erase,” but rather something to soften and blend so they’re less noticeable in expression and makeup.

Depending on your facial anatomy, sometimes the best results come from a combination approach:

Skin boosters for hydration and subtle volume support
Light collagen stimulation treatments (like microneedling or RF microneedling)
And occasionally very conservative filler if true structural support is needed

The goal at your age is usually refinement, not correction — keeping the face natural while reducing the visibility of those folds in everyday lighting and makeup.

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.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. 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

Nelson Lee Novick, MD · Answer

A low viscosity, cohesive, malleable HA filler can be used to directly elevate and smooth the creases.
If the creases result in part from volume deficit in the cheeks above, this can be easily addressed with the use of an appropriately robust HA volumizing filler to restore a feminine Ogee Curve while at the same time providing sufficient lift to improve the creases below. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler injector expert and best of luck.

Paul Flashner, MD · Answer

Hi! Microneedling and skin boosters can help a bit with hydration and texture, but for deeper cheek lines, Morpheus8 is a great option. It works deeper in the skin to boost collagen and smooth out creases more effectively.

Happy to chat more or book you in for a consultation

Happy to chat more or book you in for a consultation

Skin Social · Answer

Based on the photo, these appear to be mild early cheek creases with some textural skin thinning rather than a significant volume-loss issue. At 26, this is very commonly treated with collagen-stimulating approaches rather than traditional filler.
Microneedling could absolutely help improve the appearance over time, especially when performed as a series, since it promotes collagen remodeling and can soften superficial creasing and texture irregularities. I would recommend starting with a series of 3 microneedling sessions, spaced 4-6 weeks apart and then reassess. 
I would also consider biostimulatory treatments such as Sculptra or hyperdilute Radiesse, as these tend to improve overall dermal support and skin quality gradually and naturally. In my experience, they are often more effective for this type of concern than skin boosters alone.
I would be somewhat cautious with standard filler in this area at 26, since heavier volumization can sometimes accentuate dynamic cheek creases rather than improve them. A more regenerative, collagen-focused treatment plan usually provides the most natural long-term outcome for patients with similar concerns.
For you, I would recommend starting with microneedling & Sculptra!

26, female - How can I remove these permanent lines in my cheeks? (Photo)

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