Close up photos would have been more helpful. However, it does appear, particularly from both the tilted head photos, that there are a number of rolling scars on the right cheek, as well as significant textural and pigmentary irregularities on both cheeks. If this is indeed so, then subcision for the rolling scars would be an appropriate and relatively inexpensive approach. I would personally not use injectable fat, since lumps, which will be very difficult to treat, can occur. Instead I would choose a biostimulatory filler, such as Restylane Lyft which, through its ability to stimulate new, native collagen and elastic fiber synthesis, can serve to further enhance the effects of the mechanical subcisions. Following this, medical microneedling can prove helpful for blending the residual surface color and texture problems. Subcision, which has been around for over a quarter of century, and medical microneedling that also has an over two decade history, are both relatively inexpensive and tried and true procedures. I am hardly suprised by the lack of success with the fraxel lasers. I have been writing for years that these over-hyped and over-advertised, relatively expensive devices are far more backed by industry-supported marketing hype than actual hard science. The same in my opinion applies to radiofrequency and ultrasound devices. Unfortunately, the quality of the lip photos is not adequate enough for me to comment. You would do well to seek consultation and treatment by a board certified aesthetic physician. Best of luck to you.
