How can I get rid or soften the deep lines that show up on my face when I smile? (Photo)

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. Based on your concerns, I recommend treatments with Sculptra. Sculptra is a unique dermal filler that offers several benefits for volume loss and correction of smile lines. Unlike traditional hyaluronic acid fillers, Sculptra is composed of poly-L-lactic acid, which works by stimulating the body's own collagen production. This helps to gradually restore volume and improve skin texture over time. Sculptra provides subtle and natural-looking results by enhancing facial volume and filling in deep smile lines (nasolabial folds) from within. The gradual improvement in collagen production results in a smoother and more youthful appearance. While results may not be immediately apparent, Sculptra provides long-lasting benefits. The collagen stimulation process continues for several months after treatment, typically lasting up to two years or more. In addition to smile lines, Sculptra can be used to address other areas of volume loss in the face, such as sunken cheeks or temples, providing comprehensive facial rejuvenation. I love using Sculptra on my patients and highly encourage you to try it! I hope this helps and best of luck.

I can see the presence of slight grooves in the areas where you are concerned about when you smile. Depending on your examination, this can be permanently smooth out with microdroplet Silikon-1000 injections. I hope this helps. Sincerely, Dr Joseph

This is quite a common problem that is often referred to as parallel laugh lines, I.e. smile (laugh) lines that appear on the lower cheeks parallel to the sides of the mouth with smiling. In my experience, this responds quite well to the fanning injection technique employing a low viscosity, malleable, cohesive HA filler. This is not a treatment that should be left to the novice, inexperienced hands of injectors accustomed to the use of simple Juvederm or plain Restylane for treating smile lines directly. So, be sure to consult with an experienced, board certified cosmetic dermatologist filler expert and make sure to ask to see his/her personal before and after photos prior to agreeing to proceed. Hope this helps and best of luck.

Dealing with deep smile lines, also known as nasolabial folds, can be a common concern as we age. These lines can become more prominent due to various factors such as loss of skin elasticity, decreased collagen production, and repetitive facial expressions. Here are several options to consider for reducing or softening these lines:

Non-Invasive Treatments
1. **Topical Treatments:**
- **Retinoids:** Prescription retinoids (like tretinoin) or over-the-counter retinol can help stimulate collagen production and improve skin texture.
- **Moisturizers:** Use products that contain hyaluronic acid, peptides, and antioxidants to keep the skin hydrated and support its natural repair processes.

2. **Chemical Peels:**
- Light to medium-depth chemical peels can help improve skin texture and reduce the appearance of fine lines by removing the outer layer of dead skin cells.

3. **Microneedling:**
- This procedure involves tiny needles creating micro-injuries in the skin, promoting collagen and elastin production, which can help to reduce the appearance of lines over time.

4. **Laser Treatments:**
- Fractional laser treatments can help resurface the skin and stimulate collagen production, leading to smoother skin with fewer lines.

Minimally Invasive Treatments
1. **Dermal Fillers:**
- Hyaluronic acid-based fillers can be injected into the nasolabial folds to plump the skin and reduce the appearance of deep lines. Results are typically immediate and can last from 6 months to 2 years, depending on the type of filler used.

2. **Botox:**
- While Botox is primarily used for dynamic wrinkles (caused by muscle movement), it can sometimes be used in conjunction with fillers to relax the muscles around the mouth, reducing the depth of the lines.

3. **Radiofrequency Treatments:**
- Devices like Thermage use radiofrequency energy to heat the deeper layers of the skin, stimulating collagen production and tightening the skin.

Lifestyle Changes
1. **Skincare Routine:**
- Consistently follow a good skincare routine that includes cleansing, moisturizing, and sun protection. Use a broad-spectrum sunscreen with at least SPF 30 daily to protect the skin from UV damage.

2. **Hydration:**
- Drink plenty of water to maintain skin hydration from within.

3. **Healthy Diet:**
- Eat a balanced diet rich in antioxidants, vitamins, and minerals to support overall skin health.

4. **Avoid Smoking and Limit Alcohol:**
- Smoking and excessive alcohol consumption can accelerate skin aging and the formation of wrinkles.

Surgical Options
1. **Facelift:**
- In more severe cases, a surgical facelift can provide a more permanent solution by tightening the skin and underlying tissues.

Consultation with a Specialist
- It’s essential to consult with a dermatologist or a plastic surgeon to discuss your concerns and explore the most suitable options for your skin type and condition. They can provide personalized recommendations and perform the procedures safely and effectively.

There are various ways to address deep smile lines, ranging from topical treatments and lifestyle changes to more invasive procedures. The best approach depends on your specific needs, skin type, and the severity of the lines. A professional consultation will help tailor the treatment plan to achieve the best results.

Your lines are quite dynamic, not really a result of volume loss. As one gets older you lose collagen and elastin in the skin. It doesn't stretch and bounce back like it did when you were a child. Filler that stretches and moves with the skin can soften the dynamic folds. It is not a good goal to eliminate the lines with over-filling the cheeks. Everyone has seen the "puffy face" that some celebrities have embraced, too much volume is not a good look.
The goal should be an improved appearance and a more youthful appearance. Some folds with smiling are natural and attractive, no folds can be artificial and even weird :)

You will likely have the best outcome from a combination of treatments. Fillers can be used to help define contours and improve deep folds. Treatments such as Morpheus8 are used to improve overall skin tone and texture. We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.

If you did not have the same smile lines when you were either a teenager or in your early 20s, then I would correct these by adding more volume to your face. Fat grafting will restore the youthful volume in your face and at the same time get rid of these smile lines. I hope this helps and good luck from Leonard Grossman MD organic Plastic Surgery