hello. i have deep lines around my mouth and up to my nose. i have had sculptra on my face, but this does nothing for my problem, which i was told it would. i need to know the best filler for me . one that would last as long as possible. i have had restalayne, but it is no good for me. can you please advise.
Deep Line Treatment if Sculptra Fails to Work
Doctor Answers (8)
Deep Line Treatment if Sculptra does not work?
It is difficult to make a recommendation for your situation without any photos. Artefill and Radiesse may be options for you, but the extent to which your issue can be addressed depends on the depth of the lines and where they occur.
In some cases, we have had patients that incur volume loss in the cheeks such that their nasolabial fold (the laugh lines on the sides of the nose) actually move away from the edge of the mouth and into the cheek. When this happens, it becomes more difficult to remedy the problem as the problems are caused by the animation during movement of the mouth as well as volume loss.
Treratment of Deep Lip Lines and of Nose to mouth (Nasolabial) lines
Your description of " deep lines around my mouth and up to my nose" can be describe 2 lines which are treated differently either
- Lip (Smoker's) Lines OR
- Nose to Mouth (Nasolabial) Lines
Lip Lines would be treated first with fillers (Restylane or Juvederm), then with small doses of Botox and finally with a resurfacing modality such as a laser.
Nose to mouth Lines are nicely treated with a thicker filler (Perlane/ Juvederm Ultra Plus / Radiesse) deep in the skin and either Restylane or Juvederm in the more superficial skin. If you want further correction you would need a vertical Mid Face Lift - a surgical procedure which places the cheek in its youthful position and smooths the Nasolabial folds completely.
Dr. P. Aldea
Deep smile folds
Depending on how the Sculptra was injected in the cheek, it might lift the sagging cheek and flatten the smile fold. There are many different techniques to using Sculptra; some physicians only place it directly under the fold, and others apply it across the area underneath the fold (perpendicular to the fold). If the deep inner cheek fat pad, which thins out over time, is filled, then the fold may improve. A few sessions are usually needed, several weeks apart, and the result is often not seen for more than six months as more collagen grows.
For other patients, Radiesse works very well and can be placed right underneath the fold for an immediate filling response. Deeper hyaluronic acid fillers such as Perlane and Juverderm Ultra Plus might give you long lasting results provided that enough product is used to give you an adequate augmentation. Some patients get six to eight months duration of a substantial volumization, and although the result diminishes over time, there are patients whose results with these fillers last more than a year.
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Missing links - Sculptra Treatments
There are some missing pieces to the puzzle, such as how many Sculptra treatments have you received, how far apart were they administered, how old are you, and what is your skin quality like?
Without the answers to these questions it is very difficult to offer you a treatment plan. Sculptra treatments are a process that require patience while your body produces Collagen in response to the product.
It may take two, three or even four sessions, spaced 4-6 weeks apart to get a correction. In the interim, while the Sculptra is working a more immediate filler such as Juvederm, Restylane or Radiesse can be added to give you a shorter term effect.
If your skin is very loose in addition to lacking volume in your facial soft tissues, then you may need a Facelift or some modification of one to correct this component. Fillers don't correct everything in everyone. Good luck!
For the deepest lines there is no equal to Artefill
Artefill is a permanent filler which is the most durable for the deepest naso-labial folds. It is particularly good for men whose dense skin does not seem to get much support from hyaluronic based fillers.
Radiesse is also a second best choice, epecially in that it is less expensive and does not require a skin test.
Fillers after Sculptra
I like to use Radiesse or Juvederm for nasolabial folds if more is needed after Sculptra and Restylane. These should last at least 9-12 months. Sometimes it helps to put some into the cheeks, not just the nasolabial folds. Perhaps you didn't use enough Sculptra or Restylane?
Deep Nasolabial Grooves
If the nasolabial grooves are very deep and do not correct easily with Sculptra then you can use a collagen based filler like Cosmoplast which can be injected in superficial layers to reduce the deep lines.
It sounds like Radiesse might be your next option. It often gives the biggest bang for the buck. Typically, Radiesse will last 9-18 months.
Please understand, however, that nasolabial lines cannot be totally reversed with filler without getting a muzzle-look to the face. You might need cheek augmentation with filler too, or perhaps a lower face lift if the folds are very redundant.
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.