What should I do about these awful smile lines? (Photo)

You have dynamic wrinkles which show up with movement of facial muscles and they are a bit hard to fill. However, hyaluronic fillers like Juvaderm ultra plus XC or restylane lift , should help a lot.

This is a common concern in women your age and can be addressed successfully
once the cause(s) of smile line accentuation is determined. So here’s what is
going on.  It sounds like the hollow
below your cheek and near the mouth corners is a favorite area for skin to
gather when you smile. A smile is a beautiful thing, but many patients tell me this
can be nuisance. In lean individuals, the smile lines can be due to volume loss
throughout the face (thin face, fat loss) that allows skin to drape toward the
mouth and collect in “parentheses” with smile activation. In older individuals
or facial skin that has suffered collagen and elasticity damage (thin skin,
wrinkles), loss of skin integrity or thickness can accentuate the “corduroy” lines
appearing below the cheeks, even before smiling. Now here are some options.  For the thin face or loss of fat padding, strategic
volume correction using structural filler such as hyaluronic acid or calcium
hydroxyl apatite can improve the drape of the skin and prevent so much of it
from collecting near the mouth. Typically in someone your age only one or two
syringes is necessary. To improve the integrity of thin or aging skin, a skin stimulator
such as PLLA applied in multiple sessions (2-4) a month apart can provide
correction with several months that lasts for a few years. If you have
experienced a significant amount of sun exposure or UV damage from tanning bed
sessions you may have elasticity problems that should be addressed. In this
case, your Doctor may choose a collagen induction method that employs thermal
energy, such as fractional Radiofrequency, to address your skin laxity. Again,
serial treatments 4-6 weeks apart can provide noticeable results months after the
treatments are completed that can last years with regular maintenance. As with most
non-surgical cosmetic corrections, an agreed maintenance plan with your Doctor is
important to enjoy the results over time.