Dynamic cheek wrinkles when smiling - Botox/filler? (Photo)

Hello and thank you for your question.  After looking at your photo, I can suggest a few options for you.  The goal for your skin should be to boost your collagen and smooth out the existing lines as well as prevention of deeper and more static lines to come.  Being that thin skin is in your genes, it is a good idea to start with a moderate type laser such as Fraxel and then maintain your results with either Clear and Brilliant or PRP 2-3 times a year.Fraxel is a wonderful laser that can greatly reduce those existing lines by resurfacing your skin and rebuilding collagen within the skin's deeper layers.  This procedure is well tolerated and has about a week or so of downtime that includes some swelling, redness and slight flaking.  For a young woman like yourself, you wouldn't need more than a few treatments of this (spaced about 6-8 weeks apart) to get great results.  I suggest doing maintenance after any laser procedure to keep the collagen in your tissues strong. As mentioned above, options like PRP and Clear and Brilliant can both promote collagen and elastin rebuiling and strengthening.   PRP uses microneedling along with your own platelets while Clear and Brilliant is like a milder version of the Fraxel (with less downtime).  Hope this was helpful! Make sure to see a qualified and experienced provider that can offer options like these to give you long lasting results.  Best of luck!

Thank you for your question. I think a combination of Botox and fillers would work great to treat the crease on your cheek. Another option you may find to be of interest are PDO threads. Threads are inserted under the skin and threads grip the skin underneath. Pulling these threads tightens the skin from within, resulting in an instant lift.  Again, collagen production is stimulated as the skin heals itself around the threads. The threads dissolve over time and this treatment is recommended for the cheeks. 

The issue with fine lines on the face and body has to do with skin collage and elastin as well as general skin health. Definitely, genetics play a huge role. I recommend that you see a dermatologist who also does cosmetic therapies so that your skin quality can be assessed and managed. There are many different treatment options that would definitely help your situation.Please make sure that you see an experienced doctor for a thorough consultation and assessment prior to undergoing any treatments.Best regards and I hope this helps, Dr. Sapijaszko (Fellow, American Academy of Cosmetic Surgery)

The problem that you describe and is evident in the photo on the lower cheek region to the sides of the angles of the mouth is actually a fairly common one. I have personally found the use of injectable skin quality boosters to be an effective means for reducing this problem. Skin quality boosters are fillers specifically designed to be injected high up in the skin and to promote increased skin hydration and turgor and some degree of tightening following a series of two to four treatment sessions spaced at four to six week intervals. Although currently there is no product approved for this indication in the States, in my NY practice I rely upon fillers, such as Restylane Silk or Belotero Balance for this purpose. In my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available, I opt for Restylane Skin Boosters & Hydromax. The material may be injected as microdroplets in a grid pattern or  fanned throughout the region. Occasionally, to soften the underlying movement that gives rise to this problem, dilute microdroplets of Botox may also be injected in a grid pattern, but this should only be done in this region by an experienced injector and in quantities and concentrations that do not interfere with normal smiling. Microneedling and superficial chemical peels may also be occasionally needed to achieve optimal results. Be wary of claims for this or that supposedly new and improved light or energy-based devices, as these relatively expenses approaches are backed far more by device manufacturer backed marketing and advertising than hard science. You would be wise to consult with a board certified aesthetic physician and ask to see his/her personal before and after photos before agreeing to proceed. Best of luck.

Fillers are commonly injected to smooth these lines. HA or hyaluranic acid fillers such as Juvederm or Restylane work well in this area. Filler in this area will last 6 to 9 months.
I hope this helps.