Dynamic smile lines, options? (photos)

A medium TCA peel and Fractora RF can really tighten up the skin so that those dynamic creases improve a lot and it helps keep you young looking. Fillers would only look wierd.

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

Dynamic changes are more difficult to improve.  However, for smile lines I have a couple recommendations.  A facelift or laser resurfacing is one of your best options.  This basically tightens the overlying skin so that when smiling there is less "bunching" of the skin.  When younger, the elasticity of the skin retracts, making the smile lines less noticeable.  As we age, skin acts more like a sheet than a rubber bank so it crinkles.  If surgery isn't something you wish to undergo, I recommend Sculptra.  This product is slightly firmer than other fillers once it has incorporated, and I find resists the deformation of smile lines better than other fillers.  Softer fillers just tend to be pushed out of the way by the act of smiling.  Hope this helps.