My cheeks puff out when I smile - what treatment would you advise? (Photo)

I recently attended a family event and was left speechless when I saw the photos. I’ve been working so hard to workout and I cleared my acne, but I don’t think I’ve ever looked worse. My cheeks puff out when I smile, my nose curves down, I have terrible upper tooth show, and I have a tear trough deformity. From some angles I look fine, but it’s definitely misleading. I’m willing to do anything at this point (non surgical and surgical) so I would appreciate any advice!!