My first response to your question is that everyone has some
degree of nasolabial folds and they are a natural part of our face. When
the folds extend below the corners of the mouth the area looks drawn.
This area becomes more pronounced with aging due to changes in facial volume,
laxity and cheek descent. It would be ideal to see a full picture of your
face and have you come in for a consultation to give you the most comprehensive
evaluation. However, if you are more inclined to doing something that is
non-invasive to begin with and you had a consultation and were deemed a
suitable candidate, then I might recommend adding volume to your midface with either Sculptra or
Voluma and then adding fillers to the nasolabial folds with hyaluronic acid
fillers and Radiesse. If you wanted a surgical approach with longer
lasting results, then a midface lift or facelift with fat injections may be
recommended, again after a comprehensive consultation and if you were deemed a
Generally speaking complete removal of nasolabial folds is impossible and not recommended. Lessening, reducing and contouring are beneficial. Step 1 is a facelift- in your case, which will improve them somewhere between 50-80%, depending on the technique utilized. Step 2--- at the same time i would recommend reversible fillers or autologous fat to further improve the nasolabial folds.
This combination of techniques will optimally treat this problem, restoring a more youthful face.
While there is seldom a "best way" to remove nasal labial folds, because every patient is somewhat different and would respond to a different procedure, the real answer to the question is that the only permanent way to remove nasal labial folds is the excision of the nasal labial fold itself through an open approach directly over it.
There are many procedures that will help the nasal labial fold - primary in our practice the mid facelift in which the nasal labial fold becomes part of the mid face lifting. In this manner, it is diminished to a great extent. Sometimes judicious removal of fatty tissue at the nasal labial fold, but never above it, tends to help as well. If the nasal labial fold is farther away from the nose and more towards the corner of the mouth, typically a check lift or cheek/neck lift will significantly help it. There are certain patients, however, that have reached the 4th, 5th or 6th decade of life, and in which the nasal labial fold has either not responded to the usual procedures or they are significantly aware of the folds, in many instances because a member of their family (father, mother, grandparents) has or has had them, and wish to remove them completely. In this instance the complete excision of the nasal labial fold by removing the offending portion of skin is carried out through a direct approach, followed by CO2 laser between 3-5 weeks after the procedure, with excellent results. During many years of carrying out this procedure, I have not had a patient who developed an unsightly scar in this area following this procedure, although I have to say that my patients are carefully selected.
As we age, the tissue of our cheeks fall with gravity. Many times, filling the area with a temporary filler will help, but must be repeated every several months to keep it up. If the tissue has sagged significantly, you may want to think about a mini-type facelift which will lift and tighten the folds.
You can soften the nasolabial folds by injectables alone. If you have excessive facial skin laxity you may need a facelift with fat injection to improve the folds. Every case is different. Good luck. Donald R. Nunn MD Atlanta Plastic Surgeon.
Best means something different to different people. One approach is to cut the extra skin out, this leaves a scar but could be done under local. You appear thin in the face and so fat grafting could be an option. Facelift is also an option. Each option has risks, scars, recovery and costs, so it is worth a consultation with a board certified plastic surgeon.
There is no "best" way to improve the NL folds. Try fillers or fat first but in your case the amount would be costly that you need. Or a direct excision of the "fold" but a potential scar is to be understood. Finally a mid FL operation...
Nasolabial folds are caused by descent of the cheek tissues to the point that a ligament prevents any further descent. There are 2 basic ways of improving them. One is to fill them with a filler. This is quite common and is very effective in people who have minimal cheek descent or only early folds. When the folds are significant and there has been marked cheek descent, as in you, then the cheek needs elevating. There are 2 ways to accomplish this. A surgical cheek lift or a modern facelift can accomplish this. Short of this, the cheek area just below the orbital area can be filled with a filler or fat. This corrects the cheek hollow as well as elevates the cheek tissue back to its normal position while reducing the nasolabial folds.
Agree with previous Dr's. My recommendations would be:
1.The new 2 year lasting dermal fillers
2.Augment the folds and the cheeks
3.Also would avoid any direct surgery to improve folds
In office 15 mins procedure. minimal bruising.
Unfortunately you cannot remove them but you can make them less prominent.
Injectable Dermal Fillers are a good option but they last for 12 months.
I cannot see your whole face, but is suspect you have flat cheek bones. You can have injectable dermal fillers to the cheek as this will give you a 'fill and lift' effect.
Surgical option are a mid face lift.
All the best