How to get rid of wrinkles on cheeks and around eyes? (Photo)

You continue to have some wrinkles of the cheeks and lateral forehead. These areas generally are not treated by Botox injections. However, we often use hyaluronic acid fillers and skin resurfacing procedures to treat these areas. I would recommend discussing fillers and skin resurfacing procedures with your surgeon for those concerns. Good luck!Dr. Harmych 

Wrinkles may be minimized with a combination of treatments. Botox is great for around the eyes and forehead, but for the skin underneath the eyes and on your cheeks, you might want to consider laser treatments. Filler is another option to address volume loss.

While botox does a great job for fine lines and creases in the crows feet, the high cheek is more difficult.  I call these malar smile lines because they are more a function of the cheek mass elevating with a smile, and the inelasticity of skin no longer able to camouflage such movements.  So you get creases that can't be natrually treated with just botox.  Your temple skin and likely the rest of the skin of the face is probably showing the same thinning, and loss of elasticity.  The only alternative therefore is to restore more tone and elasticity to the skin. That can be done with a number of resurfacing agents, with results based on the tool used and the depth of treatment required.  Lasers do better than chem peels, full field lasers yield more results than fractionated, and longer healing times give greater improvement.  Those are all things reviewed with your practitioner when setting up a treatment plan.

You are in need of laser resurfacing.  Many people use botox for all forms of wrinkles and this is not the best treatment option, botox should only be used for movement wrinkles.  Wrinkles at rest or accentuated with movement need laser treatments.  For you, given the extent, co2 resurfacing should be offered.  Please see a cosmetic dermatologist with experience in lasers, fillers and skin care.  Best, Dr. Emer.

It looks to me like you have inelasticity of the skin, leading to unwanted wrinkles. While Botox can diminish the lines created by the muscle motion around the eyes, the cheek elevation while smiling is leading to the wrinkles you are complaining of. The temple wrinkles are most likely from skin inelasticity as well. The only way to improve those lines, that I know of, is the use of a laser. There are many lasers out there, but you need a treatment that can improve wrinkles significantly. The only real options are CO2 and Erbium. They can be fractionated allowing for an easier recovery, but there is downtime. The newest laser by Sciton is called the Halo. It is a combination of erbium and new frequency. It can create a significant amount of skin tightening without any downtime. Ultimately, it is important that you see someone that can give you options regarding your request. See someone with extensive experience with lasers. Not all lasers can do everything. You want one that can give you the results you want while minimizing risks and downtime.Good Luck,Andrew Campbell, M.D.Facial Plastic Surgeon

Depending on your facial
structure, age, and sun damage, these wrinkles can be a challenging
problem. Recall that normal aging
involves all the layers of your face: the skin loses elasticity, collagen,
color uniformity, and firmness, the fat pads underneath descend (and sometimes
diminish) and aren’t there for support, muscle thickness and tone diminish, the
tendons and supportive connective tissue weaken, and the bone structure also
changes, again reducing support. This
sounds scary when we discuss it all at once, but fortunately these processes
are happening very slowly and some are less important than others for
particular individuals. You can see why
comprehensive rejuvenation might involve treatment at multiple levels.

But to get to you in
particular, it is great that the Botox helped for the crows feet, and it makes
sense that it didn’t help certain issues such as skin laxity and sagging of
your eyebrow and cheek fat pads. You
would notice short-term improvement from treatments that tighten the skin, such
as radiofrequency (Pelleve, Thermage), or chemical/laser peels. Conservative filler or fat grafting just
under the eyebrow and at the outer cheek would also help. For longer-lasting
improvement, you’d be a candidate for minimally invasive surgery: expertly
performed endoscopic eyebrow lift, endoscopic cheek lift, upper eyelid
blepharoplasty, and/or lower eyelid blepharoplasty could each have a role.
Obviously your tolerance for down-time, risks, and financial concerns would all
be important factors in deciding which options make the most sense. Good luck in finding an experienced cosmetic
physician in your community who can offer you a wide range of alternatives.

Thank you for your pictures. The wrinkles and appearance that these photos
demonstrate are actually not that unusual in patients that have skin laxity in
that area and have Botox to the crow’s feet. Botox can only do so much. And in
fact, It appears that the Botox has done a great job treating the crows feet
specifically, but now you are left with some skin bunching and wrinkles just a
little lower, on the cheek.



You
would see the best result from laser resurfacing. Resurfacing will provide the
tightening that you need to make that area smooth.

Thank you for your
question. For fuller cheeks, Voluma is a great hyaluronic acid filler to boost
and lift the skin. To lift the upper eye lids, Ultherapy can be used to tighten
and lift the skin where you will see a difference in the temple area. Another
option is Carbon Dioxide laser resurfacing. This is a great treatment and
reduces wrinkles around the eyes and face. In addition, Botox also relaxes the wrinkles
around the eyes where it can reduce those vertical lines. 

Thank you for your question and photos. Based on your photos, I would suggest that you have an in-person consultation for a laser resurfacing treatment.  You will likely achieve the best results with a CO2 laser, preferably fractionated to minimize downtime and adverse effects.  Best of Luck!

Crow's feet is mostly the result of sun damage and age.The two muscles that accentuate the lines are primarily the obituaries oculi muscle and zygomaticus muscle.The orbicularis oculi muscle is the muscle we use to close eyelids. This is typically the muscle we inject when treating crow's feet.The zygomaticus muscle is the main muscle used for raising the corner of our mouth to smile.Obviously, you don't want to weaken that muscle. That gives an almost stroke-like appearance.As such, crow's feet treatments work best for the outer and upper lines.The lower outer crow's feet lines are mostly caused by the smile muscle or the zygomaticus.Some improvements can be made on these lines by injecting the orbicularis oculi muscle in that same region.Great care must be taken to not contaminate the zygomaticus muscle, which is deep to the orbicularis muscle.A technique known  as microinjections works well for this area. It simply consists of multiple injections with very low dosing injected directly into skin, not below the skin.I believe the lines on your outer upper eyelid may also improve by simply extending the treatment pattern to include this area as well.Best of luck,Mats Hagstrom, M.D.