I visited a new facial PS as I wanted my tear troughs filled, and this isn't something my general PS often does. I also wanted filler in my nasolabial folds. My new PS explained that his approach to nasolabial fold filling had changed in the past year, and he now avoids it. Instead he injected quite a bit into my cheeks which did pull up the fold and created a younger, more round-faced look. I'm mostly pleased with the result, but it cost a lot more. Anyone else share this perspective? Why?
Facial PS Says No to Nasolabial Folds, and Instead Injects into Cheeks, Is this a Common Approach?
Doctor Answers (2)
Fillers in the mid-face look more natural
I often tend to fill the cheek or mid-face region to soften the folds, rather than fill the folds itself. The reason most people have the folds in the first place is because the the fat (and volume) from your cheeks has descended. So you are left with a lack of volume where your cheekbones used to be, but all that volume is now sitting closer to your mouth, immediately above the nasolabial folds, which creates these deep folds. If we then put filler into the nasolabial folds, we are just making the area around your mouth look even fuller and not even addressing the fact that your mid-face and cheek region look shallow. This fullness around the lower face and lack of volume in the mid-face is what leaves people with that "bull-dog" appearance. In my opinion, it looks very fake and is a dead give-away that someone has filler in their face.
Instead, by using filler to recreate and restore volume in the cheek, I am able to make patients look much more refreshed and natural-looking than if I were to only fill their nasolabial folds. In addition, depending on the product that is used, the extra volume in the cheek can actually "lift" the folds a bit to make them appear softer and less deep. There are cases where I have filled a patient's nasolabial folds after I have filled the cheeks. However, it looks much more natural and they often need less product in the folds than if I had not filled the cheeks at all.
In addition, I have noted that filler placed in the cheek generally lasts longer than filler placed in the nasolabial folds. So, while it may have cost more to fill the cheeks than the folds, you will probably not need to maintain it as frequently. I think your facial plastic surgeon really understands the dynamics of facial aging and gave you good advice. I hope this helps!
No problem in plastic surgery has only one solution and it sounds like your doctor gave you a nice result by adding volume to the cheeks which then pulled the face up a bit and lessened the folds. I would bet you look better than if just the folds had been done because of the enhanced cheek volume. What is the price you are willing to pay for a nice result?
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.