I get big wrinkles when I smile. I don't know if surgery like a facelift would help or cream? (Photo)

Doctor Answers 8

Treatment options for smile wrinkles

Without seeing you in person, impossible to give you truly accurate advise. You look young in your photo so I would suggest that you start with non-surgical options. If you don't use a Retin A product yet, start. Also, proper posture is going to make a big difference. In your photo, you've tucked your chin back which creates additional wrinkles. Maybe try an exercise program such as Pilates or Yoga which elongates the spine and lengthens the neck.


Kouros Azar

Thousand Oaks Plastic Surgeon
4.9 out of 5 stars 33 reviews


It's a little hard to tell what's going on with your face due to the severe animation.  However, it does appear you have a lot of laxity that would benefit from a face/neck lift.  Photos at rest and an examination of your skin tension would tell the story and dive the answer to your question.

R. Scott Yarish, MD
Houston Plastic Surgeon
4.4 out of 5 stars 39 reviews

Skin elasticity can be improved without surgery

I have added a link that might be helpful...

Hi and thanks for the photo.  With smiling, it appears that you have skin with laxity/less elasticity and this can be treated without a facelift.  The use of topical Retin A can encourage collagen growth and make the skin less wrinkled.  Radiofrequency Microneedling like the Profound system is designed to provide skin tightening and has been shown to clinically increase collagen, elastin and hyaluronic acid (provides suppleness & plump look to skin).  A single treatment can make significant changes with minimal downtime, simple local anesthesia is all that is needed.  Keep in mind that we all need some elasticity and excess skin to accommodate the changes in posture that come from moving our face, head & neck.  Best wishes!

Vaishali B. Doolabh, MD, FACS
Jacksonville Plastic Surgeon
4.9 out of 5 stars 33 reviews

I get big wrinkles when I smile. I don't know if surgery like a facelift would help or cream?

 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  From the photos, those wrinkles represent a significant amount of loose skin over the lower face and neck.  Non smiling photos of the face from the front and side would help in the evaluation.  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

 My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
 I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

I get big wrinkles when I smile. I don't know if surgery like a facelift would help or cream?

Hello weegillz,Surgery such as a facelift will only help conditions you see at rest, not lines you see with muscle activity such as smiling.  I wouldn't recommend it but you could use Botox to help minimize how much you smile.  The problem with that is you probably wouldn't like the way your smile looked afterwards.  I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Facelifting #woundhealing #cosmeticsurgery #BOTOX

Dear WeegillzThank you for your question and photo!  A facelift will not change this.  The line that you see is form the muscle insertion into the skin and the skin insertion to the bone.  This will deepen over time- NOT GOOD NEWS, and really only the static component can be fixed.With warm RegardsTrevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 115 reviews

Smiling and wrinkles.

As your face goes through different expressions the muscles pull the skin in different directions to show your emotions. Smiling is one of the more dynamic facial expressions. It's natural to have some wrinkles or folds appear. If the wrinkles and folds go away when you relax your face, it is unlikely you need any treatment. It's best to be seen for a physical examination and standardized photos to analyze your facial muscles, facial volume, and skin. With that information your doctor can suggest treatments available to you, including doing nothing. Safety comes first. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Facelift ??

You should send some pictures without smiling from the front and side views. That will give us a better idea on what you face looks like at rest. The picture you have sent exaggerates even a small amount of loose skin and most people, even if they do not need any face or neck rejuvenation, if they pose in exactly that position will have lots of lines

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.