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.

I recommend fillers for the lines themselves but also lifting around the mouth and cheeks to build underlying anatomical support. In our practice we combine sculptra with other fillers "layered" on top and lasers, rf treatments, J Plasma and peels to get the most conservative natural look. Please see a facial sculpting expert. Best, Dr. Emer