Hi I'm concern about these creases near my smile lines, I'm also concerned my cheek does not have enough volume? (photos)

A combination approach would give the most improvement. Deep wrinkles and smile lines can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like J Plasma, RF treatments, lasers, microneedling/PRP, salt facials, Cosmelan for skin tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

There are several options beyond PDO threads and Botox that could be used to both add volume to your cheeks and reduce these creases, also called marionette lines. One option that could be particularly fitting for you and could also merge well with your current PDO threads and Botox injections is a combination of dermal fillers. For marionette lines, we commonly recommend Juvéderm Ultra or Juvéderm Ultra XC, which are both designed to reach deeper into the dermal tissue. Juvéderm Ultra XC (which includes lidocaine for a more comfortable process) is an ideal choice for mild to moderate nasolabial folds, as it is lighter weight and sits higher in the dermal layers. Juvéderm Ultra is designed to reach deeper into the dermal tissue, making it an excellent option for more major results on marionette lines. When it comes to restoring volume in the cheeks, we often recommend Restylane Contour for more major results. Formulated with XpresHAn technology, it is designed to restore substantial shape and volume and in fact was specifically developed (and FDA approved) for cheek augmentation. It is so important to feel comfortable and confident in your skin, and we hope this helps you get there!