My Second Way to Look Younger without Plastic Surgery: Reduce Facial Folds


As we age our skin becomes thinner because of a natural reduction in our collagen layer.  With this thinness comes a hollowing of the cheeks and a loss of skin elasticity. The tell-tale signs of loss of facial volume and a decrease of skin elasticity are:

  • A fall of the cheek tissues from the cheek bone (malar eminence) resulting in a downward dropping of the corner of the mouth and a deepening of the fold from the side of the nose to the corner of the mouth (nasolabial fold)
  • A fall of the eyebrow secondary to a loss of the elasticity of the forehead skin
  • An uneven jawline because of the fall of the cheek
  • A deepening of the marionette line (corner of mouth to chin)
  • Folds beneath the eye

So the aim is to restore our lost facial volume and secondarily reduce the unsightly facial folds. Over a 30 year history, I have come to realize that the best non-invasive method to restore facial volume is with the use of dermal fillers.

Dermal Fillers have been drastically improved over the past 10 years. In the earlier years, fillers were primarily used for lip augmentation only. Now we have fillers for facial lifting, fillers for the treatment of folds and fillers specifically designed for treating the areas around the eyes. One of the most common mistakes that I have seen with the use of fillers is an overzealous injection beneath facial folds which can often produce a “done” and unnatural appearance. Fillers if employed properly should be used to lift as well as a method for fold reduction and volume replacement. When putting this all together I try to approach each patient with a detailed evaluation of the facial volume loss and then employ a systematic plan to restore volume and reduce folds to produce a younger, natural, and more rested appearance.

So let’s paint the picture and use our fillers as the different available colors on our volume replacement palette.


Subtle changes with dermal fillers can  produce a more even facial contour and project a more youthful appearance. My next post will be on the third way to attain a more youthful appearance without surgery (Smoothing the Facial Skin Envelope). 

Joseph W. Rucker Jr. M.D. F.A.C.S

Article by
Eau Claire Plastic Surgeon