I went for a consultation to get a filler in my nasolabial folds. The Doctor suggested to inject Radiesse in my cheeks instead. Said that they are little flat, and filling them would take care of the nasolabial folds, (no need to inject Radiesse in them). Does this truly work?
Can I Skip Radiesse in Nasolabial Folds if Injected in Cheeks?
Doctor Answers (11)
Filling cheeks to improve naso-labial folds
Deep nasolabial folds and hollow cheeks often go hand-in-hand. With time, bone and fat atrophy, leaving cheeks hollowed and sunken. I often find that the nasolabial folds improve greatly once cheeks have been volumized. It may still be necessary to inject filler in the nasolabial folds as well, but usually less is needed. Additionally, injecting only in the nasolabial folds and ignoring the cheeks can produce an unnatural look. If all the areas of volume loss are adressed, a refreshed, natural look can be acheived. I like perlane, juvederm ultra plus, radiesse, or sculptra for cheeks.
Fillers in the cheeks vs. nasolabial folds
We all lose volume in our cheeks with age. This causes loss of support which in turn results in the nasolabial folds to fall, causing a deeper nasolabial crease. However, loss of volume also occurs in the subcutaneous tissue and bone under the skin between the upper lip and nose. Yes, injecting a filler in the cheek does reduce the naslolabial crease, but the need for additional filler in the NL crease would be determined by your needs and location of your volume loss. I generally find it necessary to re-volumize the cheeks but also inject fillers in the nasolabial crease as well in many cases. Loss of volume in the cheeks are one of the first signs of aging and they should be injected, but everyone is different as are their needs. Some NL creases and folds are so severe, one would have to make balloons out of the cheeks to sufficiently reduce the NL folds and creases.
Nasolabial injections are over-emphasized
My compliments to your doctor. Because the FDA approves fillers in the nasolabial fold, that is all that can be advertised by the manufacturer. Revolumizing the cheeks is more important that filling the nasolabial fold. Advanced injectors always address flat cheek before filling the nasolabial folds. It is an "off label" use of fillers like Radiesse and Perlane, but it is very much the standard of care. Stay tuned for Voluma from Allergan that likely will be the first filler approved for cheeks.
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Lifting cheeks with a dermal filler can help nasolabial folds
Absolutely radiesse in flat cheeks can help reduce the appearance of nasolabial folds. In fact, I will often recommend against filling the folds until the cheeks are filled back to natural, youthful contours and fullness. You are likely getting very good advice.
Radiesse in cheeks versus folds
Radiesse is a great filler to enhance the cheeks and they do soften the folds. As we age we do lose volume in the face and restoring some volume to the cheeks is a great way to rejuvenate the face. With respect to the folds, this depends on how deep they were to begin with and what you consider aesthetic. I often start in the cheeks and then use much less in the folds compared to if I just focused on the folds. Hope this helps. Good luck.
Radiesse in the cheeks
Radiesse in the cheeks or midface can help the nasolabial folds but usually not enough to eliminate having to treat them. For the majority of patients, Radiesse works fine as a first time filler. For apprehensive patients, a hyaluronic acid such as Restylane is better since it can be reversed.
Radiesse in cheeks can minimize nasolabial folds
Having not seen your photo, I will answer in general terms. I LOVE the idea of first revolumizing the cheeks and mid face with Radiesse or a hyaluronic acid filler when there is evident volume loss. Replacing volume and support to the overlying skin, often diminishes significantly the appearance of the nasolabial folds. For the most natural, and usually the most satisfying outcome, slow and steady wins the race. I would follow your doctors suggestion to first fill your cheeks and then assess a further need for nasolabial fillers at your two week and/or one month follow up. Best of luck.
Can I Skip Radiesse in Nasolabial Folds if Injected in Cheeks?
This makes little sense. Radiesse is a great filler to shape and contour the face. Aesthetically, the cheeks are the most important beauty feature, of the face and as such should be ideally shaped and contoured IMHO. However, if the NLF's are deep, these will not be affected by shaping the cheeks with Radiesse as no volume of filler was placed within the NLF. Treat both if both areas require treatment. I prefer using Perlane to shape the cheeks and fill the NLF's as it is associated with less redness and post treatment lumpiness than Radiesse, IMO.
These differences in opinions on how and where to use fillers, for facial shaping and contouring, highlight the fact that there's no inherent magic with any filler and you must find an MD that understands and follows the proper aesthetics of facial beauty for the creation of a naturally, more attractive face. At the end of the day that's what you're really paying for...not the filler but the correct aesthetic knowledge of what, where and how to use the filler in such a way that your face is more attractive.
Radiesse is Effective for Nasolabial Folds
It is very common to see loss of volume in the mid-face as we age. This results in a deflation effect and sagging of the cheek skin with the result being deepening of the nasolabial folds. If you correct the volume loss with a product like Radiesse, this will typically reverse the deflation and descent of the facial tissues and improve the nasolabial fold. Many times patients receive filler in the nasolabial fold, when the real problem is loss of volume in the cheek area. It sounds like your physician is on track with the recommended treatment. If you're not happy with the results, you can always go back and address the nasolabial fold at a later time. When performed properly, Radiesse treatment of the mid-face can have a very rejuvenating affect.
Radiesse is best for its lifting effects
I always prefer Radiesse, even for first time patients, because of it's superior lifting effects and longevity when compared to the hyaluronic acid fillers such as Perlane. It is often better to fix the cause of the wrinkle, not just treating the wrinkle itself. For this I use a volumizing filler such as Radiesse to inject higher along the cheekbone at "vector points" that provide the greatest lift. The nasolabial folds can be dramatically improved by injections elsewhere in the face. After this, a much smaller amount of Radiesse is all that is necessary to correct a much improved nasolabial fold. Seemingly small changes in shape, proportions, balance, and symmetry can have a surprisingly large effect on our perception of the aging face.
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.