Nasolabial folds look worse 4 months after fillers. Did they move? Why did this happen?

Unfortunately, there is not sufficient history nor a photo to allow for a better evaluation. What I can say is that after more than three decades experience in injecting volumizing fillers to improve the nasolabial folds (smile lines) is that experienced injectors have for well over a decade already moved away from the mere chasing of lines and folds by directly injecting into them. We have learned that the loss of volume as part of the aging process higher up in the cheeks is really the main cause of the appearance of smile folds (as well as marionette lines, jowls along the jawline, and even saggyness under the eyes). As a result of this understanding, we typically evaluate the cheeks to see whether revolumization there secondarily ameliorates the smile line problem. If so, treatment is performed there and not directly into the nasolabial folds. By doing so, we can potentially avoid several problems that you may be experiencing. One is overfilling the folds to the point of creating the so-called "simian facies," i.e. the smile-line less look of the chimpanzee. Another potential problem is slight shifting of the injectable material to the sides of the fold, which can actually make the sides higher and thus the depth of the fold appear deeper. Another is concern about tissue fluid retention around the injected implant, which is more common however with Juvederm products than Perlane. You would do well to return to your treating physician. You may need to have the material dissolved with hyaluronidase. Following this, you might consider a second opinion by a board certified aesthetic physician, and be sure to vet the next physician well and ask to see his/her before and after photos before agreeing to proceed. Best of luck. 

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting, and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Hi and thank you for your question! Any concerns with the results of cosmetic treatments can be best addressed with comparison of pictures obtained before the treatment and current pictures and I highly recommend going to your injector for a follow up and objective comparison. This being said, nasolabial folds are often best treated with injection of filler in the cheeks area. Fortunately with hyaluronic acid fillers such as Perlane, whenever the results are not satisfactory, we can easily revise and dissolve the filler with enzyme injection and you don't have to wait for the filler to go away on its own. I hope it helps and good luck!

Once the swelling has subsided it is possible to see the nasolabial folds look deeper. A year from now, when the filler is all gone, the nasolabial folds would even look more prominent because it doesn't have the volume lift. You should follow up with your injector to see if you could benefit from more injections to soften the nasolabial folds. 

Can not answer this better than my colleague, I absolutely agree with his approach as we now inject less in to the fold. I look at source of laxity, address that, and the fold is less pronounced. This gives the most natural look. You have an option of dissolving your fillers, and seeing a specialist with an eye for filling. Dr Davin Lim. Brisbane. Australia. 

Thank you for your question.
It's important to have before and after photos to adequately assess your outcome before advising on appropriate treatment options. Over time, the dermal filler will self absorb and return to the pre-treatment state.
I recommend that you consult with an experienced and highly trained practitioner to ensure your safety and for optimal results to be achieved.
Best wishes.