How can I remove upper cheek lines when smiling? (Photo)

Question

when I smile i have upper cheek lines - these only appear when I smile. i have asked to have filler there but the nurse said this will not help. Any recommendations on how to remove these lines as when Im smiling i look older

Jonathan Kulbersh, MD · Answer

Hello and thank you for your question. The nurse you spoke with is correct; fillers are not the appropriate treatment for dynamic wrinkles (caused by expression). Fortunately, you have plenty of other options. Neuromodulators like Botox and Dysport can help soften the crow’s feet next to your eyes. You can also combine this treatment with laser resurfacing or RF microneedling to tighten and firm your skin. I recommend scheduling a consultation with a board-certified facial plastic surgeon for a customized treatment plan.

Jason Emer, MD · Answer

you can do botox to help some movement lines, but lasers and plasma pen are going to help you most. you will never get rid of these completely this is texture and tone of the skin, which needs collagen production and long term skin tightening/resurfacing.

at home peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, see link) should be started now to prevent further aging.

For facial rejuvenation,  I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

Junaid Syed, MD · Answer

There are number of treatments that can be applied to take care of these lines. Basically your skin needs more elasticity/collagen for firmness in this area. 1. Small PDO threads for collagen2. PRP/PRF Facial3. Injectable serums4. Fractora(Microneedling with RF)

Ebru Acar, MD · Answer

Hi, These lines can be removed by botolinum toxin. And to make them smoother, some rejuveneration products such as hyalorudynic acid can be used.

Anshul Gambhir, MD · Answer

Thank you for your question! Filler will not help with the lines you are showing. Botox can help around the crows feet which will help soften into the cheek lines as well. I would suggest doing 25 units of botox to start for the crows feet. Hope this helps!

Jo Herzog, MD · Answer

These lines can be partially relaxed with a neuromodulator Botox/Xeomin/Dysport/Juveau but I think that you need a soft filler in area to decrease them as the skin bunches  up from the smile below and we do not want to stop the smile. I agree with Dr Clark that you need a board certified physician that specializes ion this, not the nurse.

Sheryl D. Clark, MD, FAAD · Answer

Hello arae11:

These lines can easily be softened with a small amount of Jeuveau or Botox, with or without a bit of filler to the lateral cheek area.

Please choose an advanced injector who is a board-certified dermatologist or plastic surgeon for the best results!

All the best from NYC!
Sheryl Clark MD FAAD

How can I remove upper cheek lines when smiling? (Photo)

Answers (7)

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