perlane vs. restylane vs. evolence vs. juvederm
Best Filler for Deep Nasolabial Folds?
Doctor Answers 1
Filling deep nasolabial lines
The lines which run inferiorly from the nose to the outer corner of the mouth are called nasolabial lines. Some individuals who are young and have otherwise full faces, still have deep nasolabial lines. I would recommend Evolence to this subset. This is Johnson and Johnson's first entree into the aesthetic medicine market and is very well accepted just for this zone. It is porcine collagen with local anesthetic and generally lasts up to 11 months.
If you are seeing more than just a deep nasolabial fold, such as marionette's lines, which are the downward slope starting at the corners of the mouth and extending down to the chin, you should consider adding another filler, usually the larger particle size hyaluronic acid molecules, such as Perlane or Juvederm Ultra plus. Currently, these are not combined with local anesthetic but are usually well tolerated either with dental blocks and/or topical anesthetic cream. These products may last up to 6-8months.
Finally, if you have lost your cheeks and appear "gaunt", you should enquire about Sculptra, which has just been approved by the FDA for cosmetic purposes (7/29/09). It is a "volumizer", which stimulates your own collagen production, so it may need to be dosed 2-4 times, spaced by 4-6 weeks, in order to avoid excessive "overcorrection". Since it is mixed with local anesthetic, it's very well tolerated, and can be expected to last at least 2 years.
Make sure that your injector is well versed on all the alternatives and has both a light hand and artistic perspective. Good luck.
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