Vivace or something else for newly deepened nasolabial folds? (Photo)

Relax. The problems described here are easily treatable and routinely seen in any active aesthetic dermatology practice. There not-surprisingly appears to volume deficit flattening in the cheeks, which is contributing to the development and greater prominence of the smile lines at this stage of life. Likewise, repeated daily motion of the cheek muscles (along with the massage-related issues you mentioned) have contributed to heavily etched-in creases within the smile folds. Appropriately injecting a robust HA filler in the cheeks can address both the flattening of the cheeks (and restore a more youthful cheek contour), but can also diminish the nasolabial folds. Additionally, a lighter, more cohesive HA filler can directly elevate and smooth the etched-in creases. Exercise a great deal of "buyer beware" caution when evaluating all kinds of glitzy, faddish "bells and whistles" energy-based devices. The hard science to support the use of these relatively expensive, supposedly "next big thing" devices lags woefully behind the heavy marketing to promote them. Make sure that you consult with an experienced, board certified cosmetic dermatologist and make sure to ask to see his/her personal befores and afters of this region before agreeing to proceed. Best of luck. ,