I have a double line on both sides of my cheeks and in some lighting it looks really bad. Any suggestions?

Dr. Dean Kane Q & A shutterstock_68653879 Q. The line goes downward, and one line is above where the cheek is and one is near the lower mouth. Also, I know its because I lost volume and I spent thousands of dollars to fix this with fillers but nada. I am thinking on getting a mini facelift to tighten the skin but will it help with the double lines and how do you get rid of the shadow in your face, especially in a lot of lighting? I am only 37 and don’t see anyone who has this problem. Any ideas? A. Facial wrinkles are created from 4 different layers of the skin, fat and muscle. The top layer or stratum corneum of the epidermis is the rough, pigmented layer of the skin; creating most of the depth of the wrinkle. Exfoliation is best for this using
  • microdermabrasion,
  • Retin-A (ZO Obagi Skin Health System), which also renews and regulates improved function of the deeper epidermis,
  • some lasers and chemical peels.
The second layer is the dermis which thins with aging. The natural collagen, elastin and hyaluronic acid (which hydrate and toughen the skin) are thickened by the use of:
  • fillers (Restylane and Juvederm), or
  • Retinoids (ZO Obagi Skin Health System), which also renews and regulates improved function of the deeper dermal skin cells.
  • Sculptra properly managed is the latest sensation in stimulating firming and thickening of the dermis
The next layer or fat also thins or droops with age and maybe:
  • filled (Restylane and Juvederm), fat grafting or
  • redraped (facelift)
Finally, the muscle which creases the skin into wrinkles and folds is weakened and rebalanced with Botox or similar injectable muscle relaxers like Dysport or Xeomin. ​ ​On myth is that a facelift will tighten skin. Other than the healing of tissues with the formation of scar (collagen), a facelift elevates the skin off the underlying tissues and redrapes it upwardly. It does not shrink or tighten skin. An analogy I use is that the skin (like a bedspread on your bed) is picked up and unfurled in the desired direction. The texture (wrinkles, coloration, fabric) of the skin like that of a bedspread is not changed. The texture or fabric of the skin maybe modified with epidermal and dermal options above. Everyone needs one or more layered improvement and in personalized combinations to achieve their optimal result. ​ ​I hope this has been helpful. Good luck with your decision making. Remember to consult with a well experienced and talented Board Certified Plastic Surgeon or ENT Facial Surgeon for your best evaluation and  recommendations.
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