Would filler at zygomatic arch or upper cheeks take care of these dynamic wrinkles? (photos)

Question

I know there are marionette lines at rest but it is the dynamic lines that appear with smiling. Would filler in the upper cheek around zygomatic arch help alleviate these wrinkles? I am looking for the most natural outcome possible and avoid the waxy over filled appearance that is possible if overdone.

Jason Emer, MD · Answer

A combination approach would give the most improvement. Deep wrinkles and smile lines can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like J Plasma, RF treatments, lasers, microneedling/PRP, salt facials, Cosmelan for skin tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Scott K. Thompson, MD · Answer

Hi!Fillers can be an excellent choice for even dynamic facial lines because they can restore volume below the lines and can in some cases be injected directly into the lines.  I would recommend setting up a consultation with a physician who specializes in the face so that he or she can assess your individual situation and make an appropriate recommendation.

Anne Marie McNeill, MD, PhD · Answer

Fillers in the cheeks are the best way to restore the volume to this area and decrease those lines you get when you smile.  I like Voluma and Restylane/Perlane in these areas.I usually start with 2cc but realize that it may take more (~4cc+) to get the result you want.Also realize that it usually looks more balanced to put some of the filler in other areas, for example depressions in the temple and/or sides of the chin, at the same time.  This gives the most natural look, so it doesn't just look like big cheeks.  Best, Dr McNeill

Kevin L. McBride, DDS (retired) · Answer

Facial lines that occur when smiling, known as dynamic lines, are usually best treated with Botox or similar muscle relaxing product.  Fillers are usually chosen to treat passive lines, those that occur at rest. In some situations a combination of filler and a muscle relaxer, like Botox, will provide the best results. The treatment selected will depend upon the exact nature of the lines, whether they occur at rest or when smiling, and the degree of improvement desired by the patient. In some cases trying to eliminate deep lines resulting from very loose skin will result in distortion of the area, so surgery may be a better choice to reduce the lines appropriately.

Would filler at zygomatic arch or upper cheeks take care of these dynamic wrinkles? (photos)

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