One sided crease on cheek (20). Is that a wrinkle or just fat loss?

It’s fat loss. The treatment is filler, and then if you like the filler, then fat grafting. Unfortunately there are no topical treatments that will work.

this is volume loss and sagging and fillers, threads and morpheus can help this.

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly, see linkt) should be started now to prevent further aging.

For facial rejuvenation, I would suggest a combination approach of
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

You are on the right track with the lasers! You may find improvement from lasers, Morpheus8 treatments, or microneedling. It will likely take multiple treatments for you to see noted improvement. We also encourage medical grade skin care products and wearing sunscreen every day.