What is the best option to treat nasolabial folds before considering a facelift? (Photo)

Question

I am noticing that my lower face is dropping significantly lately and I don't like that. What options do i have? I want a natural look, without looking like my face is swollen or have a feeling that i have fillers in my face. Thank you!

Marc Polacco, MD · Answer

Thank you for your question. Filler would definitely be the treatment of choice. Typically one can use just enough to soften shadowing of the nasolabial folds without overfilling. A facelift is certainly the best and longest-lasting surgical treatment. All the best!
-Dr. P

Alan Gonzalez, MD, FACS · Answer

Hello Dear @HUHO, thank you for your question and showing your pictures. As an alternative to surgery, you may develop a nonsurgical plan, which will bring about improvements in some aspects. However, you must be on top of the program constantly if you want your results to last. It is likely that a treatment plan targeting the second and third thirds of the face, as well as the first and second thirds of the neck, would improve the depth of the nasolabial folds, marionette line, and mandibular border. Ultherapy in conjunction with Radiesse can be an effective alternative. I suggest to consult one or several board certified plastic surgeon for more information and recommendations. Best wishes! Alan Gonzalez MD, FACS.

Suleyman Tas, MD, FEBOPRAS · Answer

Dear HUHO,

Thankyou for your pictures for reference. As per your pictures, it seems you have thick and oily skin which tends to sagg faster than less oily skin. You can look into both surgical and non surgical treatment. Non surgical hifu treatment can be  done or surgical procedure like a neck and face lift can help you get your expected result.

Best Regards,
TAS TEAM

Gianfranco Frojo, MD · Answer

I would recommend a facelift/necklift with facial fat grafting. Once the descent of the mid-cheek/face has begun, it creates an exaggerated nasolabial fold crease. The only way to correct that with a natural long-term look would be a facelift to actual re-suspend the tissues into the correct place. I would recommend seeing a board certified or board eligible plastic surgeon with aesthetic surgery training/experience who can perform a full exam and provide safe recommendations.

Peter Chang, MD · Answer

Thank you for your question and photo submitted. Based off your information provided, you would be a good candidate to receive fillers to the nasolabial folds. They appear deep with a loss in volume, and this can be corrected by adding volume with the filler. Depending on the amount of correction you are looking to achieve, a conservative approach can be taken to not have a swollen or over-filled appearance. This is a temporary fix that will require maintenance injections over time. A more permanent fix would be a facelift or necklift when you feel you are ready to take that step. This will help remove the lax skin that is causing the folding in the nasolabial folds and the neck/jowls. The next step to take would be finding a qualified and experienced Board Certified plastic surgeon to do a full facial evaluation and provide you with a designated treatment plan to reach your desired goals.

Jonathan Kulbersh, MD · Answer

Thank you for posting your question. There are many injectables that work with your facial movements instead of against them for natural looking and feeling results. A liquid facelift may be a great option for your needs. A liquid facelift can treat many symptoms of aging, including marionette lines, expression lines, volume loss, jowls, and jawline contouring. Be sure to work with a board-certified facial plastic surgeon or injection expert for natural results.

Michele A. Shermak, MD · Answer

Hello!
I do think filler would be the best first go. Starting with treatment of the cheek area may pull up the tissue from the nasolabial fold and reduce its visibility. That may help. The actual fold itself may also be addressed directly with filler, which I would recommend to follow filling the cheek. The filler need not add significant fullness to the face, just help elevate the deflated skin that is emphasizing the crease.
Best of luck to you!

Kerem Sami Kaya, MD · Answer

Hi,The deep plane or composite plane face lift surgeries has a long-term and natural effect and also the best methods to solve the symptoms that occur in the middle and lower face with aging.Have a nice day.

Warren Schutte, MD · Answer

You are likely too early for a facelift and facelifts generally only minimize nasolabial fold lines minimally. It is always a great idea to be thinking about doing treatments that maximize the health of your skin. These are typically laser and/or microneedling treatments that boost collagen and create thicker/healthier/plumper skin. In my clinic, we offer the Lutronic CO2 laser, or a combination of Lutronic's Genius Radio Frequency Microneedling combined with LaseMD. I acknowledge that you do not want filler, but you appear to be a great candidate for Juvederm to the NLF's. I recommend starting with 1 vial, split between each side and focusing on placement up high. This can lead to a very natural look while minimizing the contour of the facial line.

Zoran Potparic, MD · Answer

Injection of NLF with fillers would create desired effect. Deep nasolabial folds are result of multiple factors of aging, one of them being atrophy and sinking of perioral space. Filling of sub-periosteal areas around upper jaw and nose, as well as grooves itself, will soften NLF. Sometimes combination of fat and nano-fat grafting with fillers may be a good choice. In person consultation with a board certified plastic surgeon is recommended. Good luck.