SMAS facelift with fat transfer - What will improve pronounced creases extending from corners of mouth when I smile? (Photos)

Thank you for your question and photos. Although a full face before and after front and sideview photos would be very helpful, from this limited view, I see two areas of concern. 1, the mandibular cutaneous ligaments were not released, creating these tension lines when you smile and 2, you have a long upper lip which was not addressed with a lip lift (compare your upper lip vertical length with the one when you smile). A SMAS facelift does not address these areas adequately, and these areas stay "old". Fat graft or nanofat which is more stem cells than fat, might help if it is injected deep into the dermis, but will not affect your dynamic lines. You would benefit from a deep plane facelift to lift and reposition the areas of the face the SMAS does not correct. See a board certified plastic surgeon for an in person consultation/evaluation. At almost 1 year out from your surgery, the deep plane facelift can be done. Good luck.

It is very likely that fat grafting would improve this anatomical/functional deformation. You may need to repeat it in 6-8 months since graft take in this area is low, around 15-20%. Good luck.