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Deep Chin Creases. Treatment Options?

Hi all -
I'm 31, and I've had acne since the age of 16. After a course of Accutane about 7 years ago, the severity decreased and I was able to remain about 95% clear with just Duac. Using Duac(which contains Clindamycin) religiously for about 5-6 years, however, gave me Gram negative folliculitis, and to address this I was prescribed another course of Accutane last year. Now, four months after Accutane, I'm mostly clear except for some problem areas like the chin and forehead, which some 5% BP every night seems to take care of.
Having more or less gotten my acne under control, my focus has now shifted to the scarring. I have large rolling scars on either cheeks, but they don't bother me much (at least, not at this point) because they are kind of shallow. What bothers me is the two depressed linear scars I have on either side of my chin and the deep labiomental crease (see attached pictures). In my opinion, repeated incidence of acne in this area, harsh topicals, the dryness caused by Accutane, and my facial geometry all played a part in causing these. I say facial geometry because, when I smile (as you can see in the photo), instead of getting nasolabial folds, which is more common, I seem to get these deep wrinkles next to my chin.
What can be done to make these scars less pronounced? The labiomental crease, I think, is tethered down, but I'm not sure about the other two. Which of these could help: subcision, subcision with fillers, just fillers or maybe even microneedling. I'm trying to avoid lasers unless it's presented to me as the only option.
Also, I'm looking for doctor recommendations in the Sacramento area. I guess I want to see a doctor who doesn't just push expensive treatments like lasers but is willing to perform subcision, if necessary.

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This is my issue as well.  After my acne was under control these chin creases scream to me.  What are options to address?  I've had fillers to my cheeks and around brows.  Was told that fillers will not work to address the scaring issues and chin creases.  
I'd like to know what worked for others if anything.  
  

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@Felrog29 This is not Acne Scarring ;-) Repeated muscle movement, loss of fat, and tethering. You need filler and botox. Same thing happens to those with smile line, crows feet, etc... The gentleman above is caused by acne/scars causing the skin to age pre-maturely. Please see a expert injector. 

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On 22/03/2018 at 2:24 AM, labellavita1985 said:

I don't think it looks bad. I know that's not your question but just my $0.02! 

Well, when you have creases all overs your face + rolling scars + boxcar scar etc. it's not cute at all, and yes people stare because your face look weird, not just like acne scars. 
So yes it's dishearting and hard to keep your head up when ppl just want to know what happened with your face. 
Just my 2cents. 

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Beautifulambition Moderator I disagree with your assessment of my acne scaring.  I've had these extreme lines in my chin for 30 years.  I've fought acne over 40 years.  After many years in accutane that my acne, I was thrilled untill what was left were these deep creases in my chin area that age me over two decades.  Its disheartening to finally rid me face of chronic cystic acne to be left with grotesque lower facial creates of an 80 yr old.  I've been to the best botox derm on the main line in Phila.  He explained that fillers will not address my creases. I want answers from those ppl who endored 40 years of acne treatment to be left addressing lasting scars like mine.  

Close up of deep chin and mouth creases.  Even an active pimple.  What say you?

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Have you looked into adjusting your facial/mandibular/maxillar structure (nonsurgically) ? A wide and deep labiomental crease like you have is sometimes due to the way you move your mouth. Acne scars and thus premature skin aging in that area would exaggerate the look of it. Look up orthotropics, mewing, and forwardontics. Changing your mouth posture can change the ways your mouth muscles have developed (you might want to try to decrease the amount of work your lower lip and chin muscles are doing to keep your mouth closed). Changing your mouth posture can also start to shift your facial bones up into a higher, more forward position, which could flatten out that area on your chin. Face exercises/face yoga (also dermarolling) can help you target and fill in the sides of your chin, as long as you don't overwork your lower lip or center chin muscles. If you have the money for it, you can pay for orthotropic therapy and devices (nonsurgical) to help with all of this. I'm no expert, but I have a similar problem and my amateur advice is that the lines you have could be related to mouth position. Check it out, and good luck!

Edited by makovienka

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Lots of things you could do. I would visit a plastic surgeon of the face, not just a dermatologist. If you can find a plastic surgeon who also specializes in skin. I live in SF and I’m going to see Dr. Corey Maas, who is plastic surgeon specializing in skin. There are so many things you can do now to change/enhance your appearance, if something is bothering you change it! Don’t let it hold you back from being confident and living your best life! Happy new year! 

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