Why do the Nasolabial Folds Look Bigger After Endotine Midface Lift? (photo)

I wanted something for my nasolabials and marionette lines and jowls which started showing in my mid-40-is, the surgeon recommended Midface lift (incisions in the hair line with endotine ribons in the the upper cheeks) stating that the ribbons will be released very low and will lift nasolabials , marionette lines and jowls. He also ran threads inside to the corners of the mouth. Why The folds now look bigger? the surgeon says: “ You have very thick skin – that’s why” . What should I do next?

Update: I am 6 months post-op now.

Doctor Answers 19

Thread lifts have problems

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It is difficult to answer your question without examining you but you mentioned that you had threads running to the corners of your mouth?  Is it possible that they are pulled up slightly more tightly than the other threads thus increasing your nasolabial folds?
Threadlifts have many problems and most plastic surgeons avoid them.  It is usually non-plastic surgeons who perform these procedures.... is your surgeon a board certified plastic surgeon?

Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

Endotine mid face lift result

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Thank you for your question about your endotine mid-face lift result.

I am sorry things turned out poorly.

  • The endotine procedure you describe cannot do what your surgeon hoped.
  • The photo suggests you have swelling around the 'ribbons' themselves.
  • I suggest you consult a Board Certified Plastic Surgeon to decide what to do.
  • There are various ways to improve your folds, so don't give up hope.

Hope this helps. Best wishes.

Face lift

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Dear Van_d_man,

   Thanks for submitting your pictures and sorry for your disappointment. I wonder if your surgeon is board certified plastic surgeon and if you checked the before and after pictures of his  face lift results. After 6 months the result should not look worse than the before picture. The good news is that it can be corrected. Consult with a board certified plastic surgeon who is experienced in face lift. There are different techniques of face lift. My recommendation to you is find a surgeon who performs the MACS face lift.

         Best of luck,

                              Dr Widder



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Why do the Nasolabial Folds Look Bigger After Endotine Midface Lift?

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Because the choice in the endotine was not a good one. There are other options to correction the severe nasolabial folds you need to seek. 

Improve nasolabial folds

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I agree that direct excision is the most effective approach to diminish prominent nasolabial folds. 

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon

Nasolabial folds

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Naso labial folds can be difficult to address by a face lift or even a mid face lift with the endotine. If a patient has persistent heavy folds after the facelift, a direct excision of skin along the fold works really well in selected cases. I only have done this in men, and the scar heals beautifully, but not all plastic surgeon are comfortable with this approach. But, believe me, it works great!

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Thread lift/ Endotine not for everyone

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You should wait for the swelling to subside before making any determinations. Endotine lifts are not particularly sucessful in the long term. I would seek a second consult and consider proper repositoning of fat through another surgical procedure. The particulars can be discussed only after an appropriate exam is conducted

Nasolabial folds and Endotine, string-based cheek lifts

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Hopefully when the swelling subsides there will be some improvement overall, although lifting of the cheek in this fashion may not be your only option.  In fact, string-based procedures tend to slide through the tissues and become ineffective.  Surgery works much better when something is separated, placed in a new position, and allowed to heal in that position with temporary sutures.

Depending on how the sutures were placed at the corner of your mouth, this may actually compound the problem.  Complex deep adjustments of the volume of the face, with addition of volume in strategic spots, will ultimately give you a much better result than strings.

Rather than focus on eradication of the nasolabial fold, it may be better to focus on what procedures would maximize the handsomeness of your face-- that is assuming that is your goal.

A very experienced plastic surgeon with a good aesthetic eye will be able to guide you.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

The nasolabial fold is generated by facial expression in will eventually emerge after any facelift.

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The nasolabial fold which resides next to the nose in this generated by facial expression such as smiling in grimacing. Even an aggressive facelift which dismantles the fold will eventually see this aesthetic feature reemerge as facial expression generates its existence.

Endotine lift

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The type of lift that you had with an endotine is generally not very effective for correction of the nasolabial folds. There are other surgical options available which you should explore after healing is complete in 6-12 months.

Jamil Asaria, MD
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 139 reviews

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.