Will Botox help these indents when i smile? Or is there something else that will fix them? (Photos)

Question

These indents have gotten worse as I’ve gotten older. They only appear when I smile. I’m sure I have fat loss in my cheeks as well. So I’m not sure if filler or Botox is something that would fix them.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing the photos and the details—this really helps in understanding what’s going on. From your description, it sounds like the indents you notice when you smile are largely dynamic, meaning they appear with muscle movement, and are also influenced by volume loss in the cheeks over time.

Here’s a breakdown of your options:

Botox:
Botox works by relaxing muscles. It can soften the appearance of dynamic lines and creases, so if the indents are caused by overactive muscles pulling the skin in certain areas, Botox may provide some improvement. However, Botox cannot restore lost volume, so if the depressions are partly due to fat loss in the cheeks, Botox alone is unlikely to fully correct them.
Dermal Fillers:
Fillers are generally more effective for volume-related indents. Adding filler to the cheeks or along the area of the indents can lift and smooth the skin, making the depressions less noticeable when you smile. The choice of filler type and placement is important to achieve a natural, subtle result.
Combination Approach:
Often, a combination of Botox for muscle relaxation and filler for volume restoration gives the best result, especially for areas that are affected by both muscle movement and fat loss.
Other Considerations:
Skin quality also plays a role. If there’s some loss of elasticity, treatments like microneedling, laser resurfacing, or radiofrequency can help improve texture and make the area look smoother overall.

Will Botox help these indents when i smile? Or is there something else that will fix them? (Photos)

Answers (1)

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