Deep cheek lines when I smile? What could improve this?

Question

When I’m not smiling my cheeks look normal, but when I smile everything gets pushed up and my cheeks stick out and my mouth area gets deep lines around it. My cheeks are not noticeably chubby, it just looks weird when I smile.

Jack G. Bertolino, MD · Answer

Your photo shows you still have good volume. Your nasolabial folds are deep and could use either a volumizing filler like Radiesse or Restylane LYFT. Or you could seek out a provider that does the ALMI procedure using your fat as a micronized fat injection. Hope this helps. JB

Michael A. Zadeh, MD, FACS · Answer

It's hard to give an accurate assessment based on a single picture. You would need a full facial examination while both smiling and not smiling. Based on what you have given us, Fillers may be a good start for you. I would recommend an in-person consultation and evaluation with an experienced physician provider. Best wishes.

Jason Emer, MD · Answer

I recommend fillers for the lines themselves but also lifting around the mouth and cheeks to build underlying anatomical support. In our practice we combine sculptra with other fillers "layered" on top and lasers, rf treatments, J Plasma and peels to get the most conservative natural look. Please see a facial sculpting expert. Best, Dr. Emer

Andrew T. Lyos, MD, FACS · Answer

Hello and thank you for your question and photo.  I would love to see more photos from different angles.  With the photo you have provided, your lower face looks excellent.  I would recommend an in- person consultation with a board certified provider who will discuss your concerns and give their recommendations. You may find that with the correct medical grade skin care line and a few microneedling with PRP treatments as maintenance, you would be pleased with your lower face and smile.  I hope this information helps and best of luck to you!

Nicholas Gentry, MD · Answer

Your smile is beautiful! An exam or at least photos of you at rest and making other expressions would be better. You look young but some volume replacement with fillers can soften the issue you are describing. Most aesthetic clinics will offer free consultations. For physicians, an in person exam and history is invaluable.

Michael S. Mall, MD · Answer

Thank you for the picture and yes there are several options to address your concerns.  You may want to try fillers in multiple areas such as the nasal-labial folds and the cheeks to replace volume loss, as well as the Titan laser to tighten your skin.  You have a beautiful smile so see a physician or nurse injector who is an expert and facial sculpting.Best

Anteneh Roba, MD · Answer

It looks like you may have some volume loss .You would do well with fillers, either hyaluronic based fillers like Juvaderm or restylane or Radiese.

Kendall Peters, MD · Answer

Thank you for your question. These lines are referred to as nasolabial folds and they represent the junction between your cheeks and lip area. I like to inject Restylane Defyne or Refyne into these lines because they help to fill them in but also allow for dynamic movement, meaning they will not result in lumps or bumps during facial animation.

Anandita Gephart, MD · Answer

It's hard to tell when you are smiling, it would be better to review a photo with your face at rest ... however to answer your question...
Nasolabial folds are simple to treat with fillers and get great results .

John Tanqueray, MBBCh · Answer

Its hard to make a clear conclusion from the single photo, but this is a possible explanation for what you are seeing:I suspect you will have lost a little volume in the cheeks, which means the fat pad has slipped downwards, encouraging the lines that are bothering you. What often happens along with this is that your smile becomes wider so you see more teeth than usual, and some shadowing in the corners of your mouth (I wonder if this is what you are seeing when you say it looks "weird").Its very interesting how fillers not only create lift and contour, but also moderate the way the muscles work by adding a bit of resistance into the tissues. I suspect that with suitable filler treatment the lines would lessen and you would feel your smile was more like the one you recognise.I hope this makes sense.