I am 19 years old and have deep lines on either side of my face when I smile. How can I get rid of them? (Photo)

Question

I was left with these lines as well as many acne scars after taking Accutane for 5 months over a year ago. I have been getting DermaPen procedures by a plastic surgeon (for the acne scars) and he suggested that a mini facelift could get rid of them, but I am very young for this. Injecting Voluma filler into my cheeks so that the skin doesn't fold as much was another idea he had. Does anyone have any comments on whether these procedures would work or not, or any better solutions? Thanks!

Jason Emer, MD · Answer

You are too young to need a lifting procedure.  There are plenty of noninvasive lasers that can help scars even in combination with microneedling that work fantastically (such as fraxel, clear and brilliant, and sublative, to name a few).  As for lines with smiling, botox/neurotoxins are very useful and fillers if injected properly can help.  I suggest going to an expert in treating young men and avoid any very aggressive approaches at this age.  You do not want to end up looking fake or someone who is not like your already good looking self.  Best, Dr. Emer.

Michael A. Persky, MD · Answer

Hi G,You are way too young for a facelift, I would run away from anyone suggesting that unless you wish to look freakish.  If you were my patient I would use Dysport or Botox to soften the Crow's feet muscles.  Voluma or other fillers are not the answer.  Please make sure that you choose your treating physician most carefully.  Good luck and be well.  By the way, enjoy your youth!Dr. P

Harold J. Kaplan, MD · Answer

Hi GDouglas.  Even though you are young, we do see very prominent "crow's feet" lines at the sides of the eyes and upper cheek.  If this is one of your concerns then we would not recommend the Dermapen or Voluma.  Rather, we would be using Botox or Dysport.  Botox and Dysport relax the muscles that cause the crow's feet lines and if you click on the link below, you will see an example of another patient that had a very similar appearance before and after her injections.  We may consider a dermal filler after the Dysport injections and if so, our choice would be Radiesse.  It lasts the same amount of time as Voluma but costs about half as much for 50% more product.We would also consider fractional laser resurfacing for acne scars.  To see the examples of before and after pictures for the treatment of crow's feet and acne scars in Los Angeles, click on the link below.

Karen Stolman, MD · Answer

I would recommend Botox or Dysport (or Xeomin) for your crow's feet.  Your cheek wrinkle is actually an expression dimple, that could be filled with a hyaluronic acid filler.  I prefer Juvederm or Perlane for filling a dimple b/c Voluma is very thick and may be more likely to lump up when placed in the dermis to fill a dimple.  Voluma is intended to be placed deep to periosteum and does better in that location rather than higher up in skin or subcutaneous.  While the other fillers do not last as long, they will give a natural result with lower risk of lumping.  In addition, I specialize in acne scar treatments.  While Dermapen (which I have at my practice) is helpful for acne scars it needs to be repeated frequently and rarely compares in efficacy to radiofrequency with needles or the most efficacious (in my opinion) for moderate to severe facial acne scars - treatment with minor surgical subcision followed by fractionated laser resurfacing done in one treatment.  I recommend you see a dermatologic laser surgeon for this treatment.

Humberto Cantu, MD · Answer

I do not think the solution is dermapen for lines; if you notice the lines are formed when you smile, then the lines are caused by the movement of the skin. Think botox would be the best option for improvement. I do not think the lift is a solution too.

Francis R. Palmer, III, MD (retired) · Answer

You do have significant lines when you smile.  I believe the best option for you would be Botox/Xeomin/Dysport type injections to soften those lines.  It may not completely remove them, but will soften them.  In addition, you do have a very flat cheek area.  Adding volume (male cheek implant or filler) to the cheek area (not the lines) would also help.

I am 19 years old and have deep lines on either side of my face when I smile. How can I get rid of them? (Photo)

Answers (6)

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