How to Get Rid of Cheek Wrinkles? (photo)

The creases that form parallel to the smile folds are a very common complaint and initially they present only when someone smiles but are not apparent at rest, which is similar to the frown lines between the eyebrows. The latter can be treated by Botox but if the same technique were done on paraconcentric smile folds, it would weaken the smile muscles to the point that eating and speech might be made more difficult. This off-label use of Botox might be done by advanced Botox providers with a more dilute Botox and yet the patient would have to clearly understand there is a risk of temporary muscle inability to animate, speak and eat correctly. The treatment is generally not done for those reasons and if it were, I doubt the lines would go way completely as the provider would not want to freeze completely those muscles. Laser resurfacing may only help to a degree and the result may improve with the use of topical collagen and elastin stimulators such as TNS Essential Serum and Alastin Nectar, and hyaluronic acid treatments such as TNS Hydrating Complex and HA5.Fillers may help but the lines will still be there with contraction because one can't treat completely the line when present with muscle contraction without creating some lumpiness in the skin at rest. The preservation of the skin's beauty at rest is a greater priority than improvement of dynamic folds (creases that are seen when muscles contract).Facelifts do not address this concern well as the skin can't get pulled back so tightly so that it doesn't fold with smiling.Newer technologies such as the minimally invasive ThermiTight may help this condition but there is down time and although safe, minimally invasive procedures involve more risk than Botox or gentle laser resurfacing. 

These lines are very close to the surface of the skin but can be "plumped" with some filler.  The closer you get to the skin the more risk the injection carries.  There is a new filler called Belotero that can be used very close to the surface without complications and would work well to fill in these lines.

Botox should not be used to relax mouth muscles associated with smiling as this could impair motor functions like speaking and eating. Laser treatments may help to boost collagen. But results are not very predictable and more than one treatment is likely. A filler called Belotero is designed for surface wrinkles. Results are apparent right away, after a single treatment. This female patient from my office (see link below) at the Dr.U Clinic faced the same problem with a vertical cheek wrinkle. Belotero was used to get rid of this issue. In the link below, you can see her before and after photos and watch her video testimony. 

To achieve the optimum result would be with the use of dermal fillers to help soften the appearance of smile lines. Depending on the type of filler used it can last anywhere from 12 -24 months.  Often an even greater facial rejuvenation can be achieved when combining with anti-wrinkle injections, skin treatments and medical grade skin care products.

Everyone's skin ages differently and the reasons include genetics, environmental exposure to sun, dry cllmates, smoking status.  Since retinols are very useful for supporting skin function like hydration, collagen formation and repair, their use is widespread in many medical skin care regimens. Cleansing and exfoliating the skin help, in addition to the retinols. You may benefit more from a stronger than over the counter retinol, and your plastic surgeon could prescribe this.

  Other treatments might include fractional laser, like fractional CO2 or erbium to smooth and tighen the skin.  Fillers are helpful, but since you are so young and would need them the rest of your life, it would be good to correct your skin health itself, not just use fillers.

Dear Violet,

It's very normal for young women to have laugh lines.  They will always be there so you can never completely remove them.  Using medical- grade skin care products is the first line of treatments.  Fillers will only help partially because the lines are cause by the attachments of the muscles to your skin.  Juvederm is my first choice in these line.  Botox will not help.  Skin resurfacing such as lasers can also help.  Subcision technique where your doctor undermines the lines with a needle can also help.   Get a consult from a board-certified doctor.  Best of luck.

You have a few options - Sculptra might be a good choice for generalized facial volumization. HA fillers such as Belotero and Juvederm can be used closer to the surface of the skin to smooth these discrete 'dimples'. Seek the care of a board certified plastic surgeon for an opinion.

Hi Violet.  You are a good candidate for a hyaluronic acid based filler like Restylane, Belotero or Perlane.  You may also respond very well to fractional laser resurfacing.  The lines will not be permanently removed but rather diminished and improved with treatment.  If the issue is important to you, then consider one of these options.  

Belotero would be a great option for you, its one of the most smoothest of the hyaluronic acid fillers. This would fill in the crease beautifully and would typically last 6-9 months. Seek a reputable certified physician who can deliver a natural, lasting result

Best of luck 

Thank you for your question! This types of wrinkles will need some "feathering" of a hyaluronic acid such as Juvederm, Restylane, or Belotero.  Due to the active component of smiling, these treatments will need  repeating as there is a lot of activity. Best of luck!