Smile lines and large pores at 21. What can I do to resolve this? (Photo)

Question

I am 21 years old. I have bad creases from smiling. I have battled acne for almost 10 years and I have been using Tazorac for one year and used Retin A on and off in the past. I moisture and wear sunscreen everyday. In these pictures especially when zooming in, you can see my pores and they almost appear to look like blackheads. What can I do to resolve both my smile lines and pores? I'm interested in lasers, fillers, etc. Help/suggestions are much appreciated!

Jason Emer, MD · Answer

folds can be genetic, from volume loss or sagging. I suggest an evaluation for fillers, threads, and morpheus. scupltra could be great for long term collagen. at home dermarolling and peels like cosmelan and enlighten will help your pores (see link to emeragecosmetics.com).
For facial rejuvenation, 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)
Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Rita Rakus, MBBS · Answer

Hello and thanks for your question. In this case I would consider medical grade skincare as a good option. Following this instead of injectables at your age energy based devices would give you a really good result- we would look at radiofrequency to tighten and boost the skins integrity. Seek a face to face consult with an experienced and qualified Doctor. Best wishes

Susan Fox, DO, RPVI · Answer

Hello, you would be a great candidate for vivace.  Vivace is fractional microneedling with radio frequency.  It helps to alleviate fine lines and wrinkles, tighten skin, minimize appearance of scarring, minimize pore size, and improve skin texture and tone.  A series of treatments will be necessary.  I recommend starting with 3 treatments spaced one month apart.  Good luck!

Smile lines and large pores at 21. What can I do to resolve this? (Photo)

Answers (4)

Answer: Vivace!

Answer: Vivace!

Recommended reading

Everything you need to know about Skin Tightening

Our mission is to create a world where every investment in modern beauty is Worth It.

Smile lines and large pores at 21. What can I do to resolve this? (Photo)

Answers (4)

Answer: Vivace!

Answer: Vivace!

Browse related questions

Recommended reading

Everything you need to know about Skin Tightening

Our mission is to create a world where every investment in modern beauty is Worth It.