Options to correct Nasolabial Folds and loss of cheek volume. (photo)

I'm 38 years old and noticed a definite shift in my cheek and nasolabial area. What treatment would worek the best to bring back the youthful appearance? II'm getting ready to schedule a consultation but would appreciate an input and possible ideas of different options

Doctor Answers 6

Facial Rejuvenation With Dermal Fillers and NovaThreads

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Thank you for sharing your question and photo. You appear to be an excellent candidate for a combination of dermal fillers. I would recommend Restylane to restore lost volume to the tear trough area and corners of mouth, and Restylane Lyft or Juvederm Voluma to rejuvenate the midface. This combination will make you appear well rested while also enhancing your natural features. In my practice, I like to use the microcannula technique for injecting fillers, which is essentially bruise-less and allows filler to be injected evenly with few needle sticks.

You may also be a good candidate for a non-surgical lifting procedure called the NovaLift. Utilizing absorbable suture material, NovaThreads are inserted beneath the skin and positioned to subtly lift sagging tissue of the mid and lower face. Once the threads are in place, I like to use dermal fillers, such as the ones I suggested above, to enhance the result and restore lost volume. Together, this procedure is known as the NovaLift and is an excellent way to refresh your facial features without surgery. I recommend consulting with a board-certified specialist who is experienced these procedures in order to get more information. Best of luck.

Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 73 reviews


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Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  With that being said, based on your photographs, you appear to be a good candidate for fillers, such as voluma (cheek bones) and juvederm (nasolabial folds).   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 172 reviews

Mid-facial Rejuvenation

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Thank you for your question. As we age, we see three major aging signs. Gravitational decent of our muscles, volume loss, and loss of elasticity. Your midface shows signs of all three. Ther are many commercial fillers available that can revolumize and add definition. Fat grafting is also an option. A fractionated CO2 treatment can improve the tone and quality of your skin. You should see a surgeon who can perform computer imaging for you. That way you can see what is realistic based upon your anatomy.

Bast wishes.

Greg Chernoff, MD
Indianapolis Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Full facial rejuvenation with lasers, microneedling/prp, sculptra, fillers

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There are a lot of options for improving the nasolabial folds and this often means fillers for the folds themselves but also lifting around the mouth and cheeks to build underlying anatomical support. In our practice we combine sculptra with other fillers "layered" on top to get the most conservative natural look. Lasers, microneedling/prp and ultrasound are great to tighten and lift the skin. Please see a facial sculpting expert.  Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

38 years old and noticed a definite shift in my cheek and nasolabial area. What treatment would bring back a youthful face?

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 Hi, I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.  From the photos, your cheeks are very flat in the front, jowls are present and the chin is weak as are the posterior (back) portions of the jaw line.  These combine to create an elongated, oval shaped face.  

 Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

 I have performed many Chin Augmentations using chin implants for over 30 years.  When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. 

 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty.  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.

 The back portion of your jaw line is a bit weak and can be augmented, without making your face appear masculine, using precise placement of a dermal filler (I prefer using Restylane Lyft).  

  I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  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, cheek lift and subperiosteal facelifts) but with these added benefits:

  • very small incisions and no incisions extend or are placed within the hair.
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed from the face and below the chin (neck)
  • excess skin can be removed from the face and below the chin (neck)
  • 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

I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Options to correct nasolabial folds and loss of cheek volume

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 In our practice, nasolabial folds are usually treated with fillers placed in the office setting. Fillers can also be placed in the cheeks for a temporary augmentation, while cheek implants can be used for a permanent volume augmentation to the mid-face. Cheek implants are composed of silastic, and are placed through an intraoral approach under brief general anesthesia as an outpatient surgical procedure. For more information and many examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 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.