2 months ago I had 4 qaud eye lift, brow lift, full facelift and lipo of the neck. I had some nasolabial folds before surgery, and the doctor assured me these procedures would correct the problem. However, the fold on one side is still there, and never seemed to get better. I feel the malar fat pad may not have been lifted as much as it should have been. I am not into fillers that don't last, after spending all this money for a more lasting fix. what should be done?
How Can I Correct This Naseolabial Fold Problem on One Side of my Face?
Doctor Answers 7
Fillers for nasolabial fold
When I was training they taught us that facelifts with tightening/lifting of the soft tissue under the skin improves or diminishes nasolabial folds. After being in practice a short time I found this to not always be the case especially if the folds are very deep or heavy. That is why all my facelift patients with deep nasolabial folds get fascial or fat grafts to these folds at the time of surgery.
Not knowing what you started with, what you look like now or exactly what surgery was done it is impossible to say what the problem is or how to fix it. Therefore your original surgeon is in the best position to fix the situation. The question then is do you need more adjustment/lifting of the deeper soft tissue on the one side and/or filling of the fold. Since you do not like fillers your best option is to probably have your original surgeon do fat and/or fascial grafting to the fold once swelling from the original surgery has resolved if fold filling is the answer. You may have to pay operating room and anesthesia fees but it is probably your cheapest option.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
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No facelift "fixes" the nasolabial fold.
Facelifts and midface lifts can do a number of things to help with our appearance. One thing these just can't do is eliminate a nasolabial fold. The fold is not just there because the malar fat pad has fallen. There is typically local fat loss, bone remodeling and changes in the distribution of the upper lid that also contribute. Your surgeon may honestly believe that these surgeries to help this area and to a degree this is true. On the other hand, you may have assumed that all this work would benefit the nasolabial folds. However, long term, it is very difficult to surgically make a significant difference in this fold without adding volume. I personally believe that hyaluronic acid fillers are an excellent means to do this.
Nasolabial fold correction on one side
Correction of the nasolabial fold on one side can be accomplished with fillers, fat transplantation or direct excition. Fillers have the disadvantage of only lasting one year. Fat injections can last longer and provide a more natural result. A thrid option is excision of excess skin in this area. I have found this to be a good option for patients over 5o, and the scarring result is usuall very acceptable. For younger patients, this option is less appealing due to the tendency for younger patients to scar more visibly
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It is now two months after the procedure and there has been a number of procedures performed, including your eyelift and brow lift and facelift, liposuction and neck lift. These are a lot of procedures and even though it has been two months there is still some reasonable amount of healing that needs to occur. Most people desire resolution of all their swelling and healing problems by a week or a month, but essentially three and six months or more is required.
Therefore assessing the nasolabial folds is somewhat premature at this phase, but a number of things can be discussed at this time. Facelift procedures can soften the nasolabial folds, but rarely get rid of the significant concerns of the nasolabial folds. Fillers are the best answer. There are a number of fillers; the temporary ones are beneficial. If you are interested in a “lasting fix” then more permanent type fillers are helpful, including Artifill and Sculptra, as well as fat grafting. Fat grafting tends to be the best answer in many instances due to its reliability and the fact that it comes from your own body to begin with.
So the best answer to your question is to wait a little bit of time, at least three months if not six months, and assess things and consider fillers after that period of time. Fat grafting would be my first option, Sculptra would be a second answer.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.