What's the best treatment for nasolabial folds?

Question

I have very visible nasolabial folds that can't be covered with make-up. The lines are very visible even when I'm not smiling or moving my mouth. I thought of getting radiesse but I do not like the idea of getting some type of gel injected in my face. I prefer something that your body produces, not something like gel...Are there any other options?

Harold J. Kaplan, MD · Answer

Hi Lala.  If you want a product that is very natural, consider Sculptra injections.  Sculptra is a fine particle injected with saline solution and it works by stimulating the production of your own collagen.  For this reason it has an extremely natural appearance and lasts up to 2 years.  For examples of our before and after photos for Los Angeles Sculptra patients, click on the link below.

Nima Shemirani, MD · Answer

Hi @Lalalouo. I recommend Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting. Best of luck, Dr. Nima!

Rod J. Rohrich, MD · Answer

You have several safe choices.Restylane and Juvederm Ultra Plus are
excellent hyaluronic acid fillers that are great for nasolabial folds. Radiesse works well in deep nasolabial folds. It can
last more than 6 months. This should be done in the hands of a
Board Certified Plastic Surgeon or Dermatologist with expertise in this area.

Jason Emer, MD · Answer

I find that "large" folds really need fillers placed in the cheeks, folds, and deep areas like the temples, pyriform aperture (deep nose) jawline to give support to the folds.  This is a complex process during aging and not just about line filling.  Please see an expert for a formal evaluation and a long / short term plan  All my patients use sculptra as the foundation and other fillers on top.  Best, Dr. Emer.

Michael A. Persky, MD · Answer

Hi Lalaliu,Bothersome nasolabial folds are the result of the loss of bone in the cheeks.  It is better to treat the cause rather than the result of the cause.  Therefore I prefer treating patients with Voluma (a long lasting hyaluronic acid gel) to replace the lost volume of the cheeks.  When done properly, we see improvement of the under eye area, the cheeks, the nasolabial folds, and in some patients even the corners of the mouth and jowls.  Most important aspect of the treatment is making sure that you choose your injecting physician most carefully based on their experience, skill, knowledge, and natural artistic vision.  Good luck and be well.Michael Persky, MDEncino, CA

Lily Lee, MD · Answer

"Best" is a tricky term, since we all have different facial features, budget and lifestyle. For nasolabial folds, my personal preference is to start someone with a hyaluronic acid (HA) based filler. Hyaluronic acid is one of the main components of your skin and so it does get produced by your body. My affinity for HA products is mostly because if you do not like the result, it can be melted away quickly with an enzyme that is also produced by your body. These results are temporary as your body will resorb the filler. Once you have a result that you like with an HA filler (Juvederm, Restylane, etc), though, we can think about injecting fat carefully throughout your face to fill the volume loss that is causing your nasolabial folds to be so annoying. Engrafted fat that takes on its own blood supply in your face is permanent and long lasting. Best to see a board certified plastic surgeon for an in person evaluation so that a plan can be customized for you. Good luck!

Edward J. Domanskis, MD (in memoriam) · Answer

The alternatives to help naso-labial folds are either non-surgical or surgical. You could have various fillers injected. Also, you could have an implant placed in the line. Finallly, you could have the lines cut out which does leave a scar but usually heals quite well.

Francis R. Palmer, III, MD (retired) · Answer

Hi, non smiling photos of your face from the front and side would help in the evaluation.   I have performed many facial shaping and contouring procedures using either dermal fillers or cheek implants for 30 years.  Nasolabial folds are typically created by shifting facial tissues off of the cheeks towards the nose and mouth.  There may be excess facial fat that accelerates the process as do cheeks that are flat or concave anteriorly (in the front).    Generally there are two options:  First to fill in the folds using dermal filler.  There are numerous HA fillers that are similar to the component of the cartilage in your body.  Restylane, Juvederm or Restylane Lyft which I prefer using for deeper folds.  The second option is to not only fill in the fold but treat the underlying cause of the nasolabial fold creation by augmenting the cheeks and/or removing and shaping excess facial fat if present. Based on the beauty concepts outlined in my book on face and body beauty, women look the most attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round anteriorly.  Cheek augmentation with a dermal filler or using cheek implants can create full round cheeks in the front that will feminize the entire face and lessen the creation of deep nasolabial folds by supporting facial tissues over the cheek area.  Hope this helps.

Richard W. Fleming, MD (retired) · Answer

Your own fat is an excellent choice to fill the nasolabial grooves. This will last much longer than the fillers you want to avoid.

Jon A. Perlman, MD (retired) · Answer

Though you could have fat injected the percentage of long term survival is variable.  The results from injection of Juvederm or Radiesse is so good that I would encourage you to give filler injection a try.  The results are pretty dependable and nearly instantaneous.  Good luck!  Jon Perlman MD FACS

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