When I smile, I have small lines in cheeks that have progressively gotten worse. What would you recommend to correct it? (photo)

Hi @cristylynn! I recommend Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting. Best of luck, Dr. Nima!

Thank you for the pictures.  Those lines that you are describing are called laugh lines.   They can be filled in with dermal fillers.  Tanning may have probably resulted in the textural changes you are now seeing in your skin.  I would recommend you see a dermatologist that also does fillers to give you more options on what will better help your skin.  

Great question - I find what works best is C02 or erbium laser resurfacing followed by dermal fillers such as Restylane Refyne/Defyne or Juvederm Vollure. Of course, skin care including SPF, tretinoin, and growth factors is essential for long term maintenance at home.

Thank you for
your question crisylynn. I understand your concern. Fillers are used to
restore lost volume in and enhance the appearance of the face. Fine lines on the cheeks are common concerns. For my patients I recommend combining retinoids with fractional CO2 lasers. Retinoids can irritate the skin and some people start by using less product and using it less frequently for the first few weeks. The skin will slowly adjust and more will be tolerated. Fillers can also be used but I find that laser work better for very fine lines. Please
consult with a doctor for specific recommendations.  Good luck!

these are called laugh or smile lines. there are many ways to address this.  They can be filled in with dermal fillers.  They also can be treated with microneedling, microneedling with RF and or laser treatments.  RetinA is a good option for skin care. You may want to decrease the dose or use a time released preparation.  Good skin care and sun avoidance moving forward will help to repair these lines and delay the onset.

Thanks for sharing your question and photos. The years of UV light exposure and sun damage have probably resulted in the textural changes you are now seeing in your skin. The laugh lines you are describing are relatively common and I usually recommend treatment with one of the newer flexible gel hyaluronic acid based fillers such as Restylane Refyne/Defyne. I also would recommend you consider a good topical skin care regimen which should include an antioxidant (check out SkinCeuticals CE Ferulic or Phloretin CF), broad spectrum SPF 30+ sunblock, hyaluronic acid based moisturizer and a retinol. When it comes to antiaging as opposed to acne, I usually recommend that patients start with an over the counter retinol rather than tretinoin (Retin-A) as retinol is gentler on the skin. If your skin can't handle a retinol, then I would consider a gentler product like the RestorseaPRO Intensive Treatment 10X combined with their Rebalancing Lotion. Gentle lasers likes Clear + Brilliant, microneedling, and chemical peels could also be used to improve the texture of your skin. As you can see, there are many ways to address your cosmetic concerns and so the best thing to do is first see an experienced physician for an in person consultation and to come up with an appropriate treatment plan.