Nasolabial folds and Marionette lines at age 55 - I hate them. Any suggestions? (photos)

Question

The funny thing, I don't mind wrinkles. However this nasolabial fold, combined with marionette lines, I can't take it. I simply can't stand the way it makes me look, so drawn out and hard. Every time I see a doctor, they ask how much I drink. Seriously. My mom has this as well, started in our 30's. So, def a combo of loose skin/loss of fat/hereditary factor. Is there anything I can do to at least make if better, that won't cost thousands of dollars? Maybe even just one or the other would help.

Jason Emer, MD · Answer

You can use fillers to treat this issue and there is a combination of fillers and lasers that can help.  Please see a facial sculpting expert.  Best, Dr. Emer.

Nima Shemirani, MD · Answer

Hi @Kpkenn! 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 to you!

David Hansen, MD · Answer

Radiesse is such a nice filler for the nasolabial and marionette grooves and last about a year. Expect to use 2-3 syringes but it will be so worth it.

Andrew Campbell, MD · Answer

I certainly agree that fillers like Voluma, Juvederm, and Restylane can greatly improve the appearance of nasolabial folds and marionette lines. And I'm sure that your appearance is directly related to genetics considering your mother also has this same problem. The real problem is that you don't look on the outside the way that you feel on the inside. By improving these problem areas, we can get you to look the way that you feel, and this allows you to have a better relationship with the person that matters most, you.Also realize that the cost of these fillers over time will easily go into the thousands of dollars. Something else to consider would be a minilift. It may cost thousands of dollars, but it will lift the jowls and improve the marionette lines, virtually eliminating the problems you describe in your lower face. That surgery won't improve the nasolabial folds, but the majority of your concerning areas are down below the mouth. A minilift will last forever if you consider that you will always look better than if you never had the surgery. You will slowly continue to age after a minilift, and the jowls and marionette lines will eventually come back, but that takes years. Something to consider that can make a huge impact on your overall appearance.Andrew Campbell, M.D.Facial Plastic SpecialistQuintessa Aesthetic Centers

Todd C. Miller, MD · Answer

Hi Kpkenn, aging can be a frustrating process. I frequently see patients who are in outstanding health who are in the early stages of aging and feel like they look old and tired when, in fact, they feel great. You have signs of sagging in the jowl region as well as volume loss in the midface. If you would like to start conservatively and are constrained by a budget I would consider fillers. Juvederm would be a great option for the nasolabial folds and the marionette lines. Find an experienced injector for an evaluation. You may be satisfied with the improvement that you get from fillers.

Martie Gidon, MD, FRCPC, FAAD · Answer

Fillers, such as Juvederm or Restylane, and Botox can restore a youthful appearance.  Please consult a cosmetic dermatologist or plastic surgeon who can examine your face and determine which treatments would be best for you.

Sandra M. Johnson, MD · Answer

Fillers are great for volume loss in the face. Voluma looks great when injected into the cheeks to raise up the nasolabial fold, while Juvederm is great for injecting around the mouth to help with the marionette lines. Find an experienced injector near you, plastic surgeon or dermatologist, to discuss which fillers would work best for you. Stay Skintastic

Rebecca Baxt, MD · Answer

Juvederm or another hyaluronic acid filler can help soften the lines around the mouth. Voluma can be used to help lift the cheek and restore volume to the face. Plastic surgery such as a facelift is a possibility but would be more expensive and is probably not necessary. Consult with a great board certified core doctor such as a dermatologist or plastic surgeon and get some in person real opinions.

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

Hi, from the photos there is evidence of excess skin over the face and neck with nasolabial folds, jowls (Marrionette Lines) and flat cheeks anteriorly.  This creates an elongated and "drawn" look to the face.  Following the beauty principles outlined in my book, on face and body beauty, women look the most feminine and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round anteriorly (in the front).  Cheek augmentation using a dermal filler (I prefer Restylane Lyft) can create cheeks that are full and round, in the front, femininzing the entire face.  This should, IMHO, be part of any type of facelift.  If you have "jowls" this is sagging
facial tissues and an indication for some form of a facelift, not Cheek
Augmentation.  I have performed many Cheek Augmentations over the past 30
years and the notion that Cheek Implants or dermal fillers alone to the cheeks
will lift tissues is an urban myth.  Filler to the cheeks or cheek
implants will shape the cheeks but will not lift up the jowls.  The
underlying SMAS layer, of the face, must be dissected, lifted, trimmed and
re-sutured.  The excess skin is then removed and the facelift incisions
closed.

My most popular facelift is the minimally
invasive, short incision facelift that has all the benefits of more invasive
facelifts (traditional, mid-face, deep plane and subperiosteal facelifts) but
with these added benefits:

•very small incisions

•minimal tissue dissection = less bruising and
swelling = rapid recovery

•can be performed in 90 minutes or less, with or
without anesthesia

•no incisions within the hair = no hair loss

•excess fat can be removed

•excess skin removed

•cheeks, chin and jaw line can be augmented with
dermal fillers (I prefer Restylane Lyft) or facial implants

•most patients fly back home to parts all over
the world in as little as 3 days post-op

Hope this helps.

Nasolabial folds and Marionette lines at age 55 - I hate them. Any suggestions? (photos)

Answers (9)

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