Can Botox minimize the appearance of dimpling and lines in the cheek area or should I consider Sculptra? (photos)

Since your problem. largely in the upper cheeks region surrounding the eyes, appears to be accentuated by smiling, it would not be unreasonable to consider first Botox to diminish the dynamic (I.e. muscle movement-related) dimpling when smiling broadly. Within a few days following treatment, when the Botox takes effect, you will know the degree of benefit achieved by this approach.
Should additional treatment be required, however, the use of a low viscosity, cohesive, malleable HA filler properly injected in the problem area can provide additional support to that region and further diminish the dimpling. Alternatively, an HA skin booster may be considered in order to provide additional tissue support.
As an aside, I gave up using Sculptra many years ago, since it is relatively expensive and there is no specific dissolving enzyme for getting rid of it (as there is with natural HA fillers) should there be any adverse reaction or undesirable results from its use. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler expert and best of luck.

When considering options for minimizing the appearance of dimpling and lines in the cheek area, both Botox and Sculptra can be effective, but they serve different purposes and work in distinct ways.

Botox: Primarily used to relax muscles and smooth dynamic wrinkles, Botox can be effective for addressing lines that appear due to muscle movement. However, it is not typically used for treating dimpling in the cheeks or for adding volume. If the lines you are concerned about are primarily due to muscle activity when you smile, Botox might help to some extent, but it may not be the best solution for volume loss or static lines.

Sculptra: This is a dermal filler that stimulates collagen production over time and is designed to add volume to areas of the face that have lost fullness. Sculptra can be particularly effective for enhancing the cheekbones and adding volume to the mid-face, which might help reduce the appearance of lines and give a more youthful contour to your cheeks. It gradually improves skin thickness and smoothness over several months, making it a good option for addressing volume-related concerns.

Given your description of having less volume in the upper cheekbones and the presence of lines when you smile, Sculptra might be a more suitable choice for enhancing volume and improving the contour of your cheeks. Consulting with a qualified dermatologist or cosmetic surgeon will provide a personalized assessment and help determine the best approach based on your specific needs and aesthetic goals. They can also evaluate your photos to give you a more accurate recommendation.