I Have Multiple Smile Lines on Each Cheek. What Are These and Can I Fix Them? (photo)

I am mostly happy with my skin, and when my face is at rest, I do not have smile lines. However, when I smile, multiple vertical lines show up on each cheek. I know what smile lines are, and I of course don't mind having them. I don't think it's normal to have so many, though. I have mild acne scarring on each cheek; could this be the cause? At any rate, what can I do to fix the extra lines? Thank you so much for your help.

Doctor Answers 3


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Given that you have fine lines AND acne scarring, I think that one of the fractionated lasers might be the best approach.  Either the Fraxel or Pearl Fractional can be helpful but there are differences in the number of treatments needed and the length of down time.  There really isn't anything that will prevent smile lines from occurring on your cheeks when you smile since the skin is going to have to fold somewhere.

Seattle Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

How To Treat Smile Lines Around the Mouth

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The lines you are describing appear to smile lines around the mouth that are dynamic in nature (meaning seen only when using the muscles and not at rest).  Filler is not appropriate for these lines because, as you said, they are not present at rest.  Botox can help soften these, but it has to be done very cautiously and conservatively as not to weaken any necessary muscles around the mouth. Sometimes chemical peeling or laser can help soften these lines as well. 

Channing R. Barnett, MD
Boca Raton Dermatologist
4.1 out of 5 stars 8 reviews

Mid Cheek Lines - how to help?

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There are actually two fillers that can improve these lines.  One is Sculptra which causes your skin to make more collagen, and it not place directly into the lines, but in a blanket fashion throughout the cheek.  The other is a new very superficial filler which can be placed directly into the lines, it is called Belotero, and can significantly soften the crease on smiling, but not leave a ridge at rest.

Stephen Mandy, MD
Miami Dermatologic Surgeon

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