25 years old with smile lines: what can I do to get rid of them? (photo)

Question

I have had smile lines appear since I was 21 yrs old often when I was dehydrated or smiled a lot thru out the day only recently since turning 25 I noticed they are here to stay what can I do to get rid of them I am confused about wether you are suppose to get injections in the cheeks or in the actual wrinkle

Sammy Sinno, MD · Answer

Nasolabial folds or "smile lines" are often distressing and can occur in even young patients. Depending on the depth and nature of the lines or folds, I prefer using on of the Juvederm products (Ultra, Ultra Plus, or Volbella). Fat grafting is another option that can work great for rejuvenation of the perioral area with longer-lasting results and slightly longer downtime.

Benjamin Caughlin, MD, FACS · Answer

This is an insightful question.   I personally prefer to use the cheeks as the area to volumize for this. This is because the cause of these lines is the cheek dropping and fat loss in this area. It is not becasue the crease itself becomes deeper.  Sometimes I will put a small amount in the lines to camouflage them but that is exactly what it is doing it is just minimizing the effects of the dropped cheek. You could also consider fat transfer. You are young and would do well. We are less limited with volume using fat.Hope this helps.Best of luck,DrC

Nima Shemirani, MD · Answer

Hi @MadisonO18. I would suggest you consider hyaluronic acid dermal fillers like Restylane Defyne for your nasolabial folds/laugh lines. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck, Dr. Nima!

Jason Emer, MD · Answer

There are a lot of options for improving the smile lines and this often means 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 and peels to get the most conservative natural look. Please see a facial sculpting expert. Best, Dr. Emer

Michael A. Epstein, MD, FACS · Answer

Thank you for your question.  Sometimes it's better to inject in the wrinkle, other times it's better to inject away from the wrinkle to stretch out the skin so the wrinkle isn't as noticeable.  I recommend you seek out a skilled injector who will discuss your options.Best,Dr. Michael EpsteinMAE Plastic SurgeryNorthbrook, IL

Renata Wix-Harris, MD · Answer

It depends on what is causing the lines. In some people it is caused by loss of volume in the cheeks causing them to drop, making the folds more noticeable. In that case it would be better to fill the cheeks first and than reassess to see if you will need additional filler in the smile lines too. Some people just naturally have more pronounced smile lines and in those cases using filler in just the smile lines can be enough. It is hard to tell from your picture and I recommend a personal evaluation by an experienced board certified physician to see what would be best for you. Good luck!

Sahar Nadimi, MD · Answer

Soft tissue fillers are a very common procedure performed in clinic. It is used to treat fine lines and wrinkles (such as smile lines or radial lines around the mouth), to soften the transition areas such as the nasolabial fold, to fill in depressions or irregularities such as the tear trough area in the lower eyelid region, for lip enhancement, or for volume augmentation in areas such as the malar/cheek, submalar, temporal regions. The main category of soft tissue fillers are the hyaluronic acid group, such as Restylane, Restylane Silk, Juvederm, Belotero, Voluma to name a few. There are subtle differences between these fillers so I prefer certain fillers for various indications in the face. Most of these fillers contain lidocaine in them so the injections are comfortable. The real beauty of the hyaluronic acid fillers is that they are adjustable. If we have a bump or an irregularity (which is very uncommon), we can go back with a small enzyme injection called Vitrase and make that bump go away almost immediately. A proper physical exam is necessary to determine the best filler injection technique for your wrinkle pattern. I recommend a consultation with a facial plastic surgeon experienced in soft tissue filler treatments.

Jean M. Casello, MD · Answer

this is a good question.  It depends on the depth of the lines and what is causing the lines to occur. Usually injecting into the cheeks will lift the cheeks and smooth out this area.  However if there has not been a lot of volume loss and sag than sometimes injecting into the lines may be enough to soften the lines.  Your provider should be able to advise you.

Michael S. Mall, MD · Answer

Thank you for the picture.  You can absolutely use fillers to add volume to your laugh lines or you could consider fat grafting with a board certified plastic surgeon.
Best wishes

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