"3 Dimensional" Nasolabial Folds with Indented Cheeks

Hi, I'd really appreciate a response, as I can't find any helpful information online.I'm 26 and am concerned about changes in my face over the past 3 years, as people keep asking me if I'm sick (I'm not). I have nasolabial folds that are, for lack of a better term, 3-dimensional, and above them there are very noticeable indentations in my cheeks. They show up very clearly in the attached pics and make me look very unhealthy for an otherwise healthy guy of only 26. Any advice appreciated.

Doctor Answers 7

Filling the cheek fat pad

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It looks more like you are deflated in the mid cheek region as opposed to the nasolabial fold.  This can be treated with fillers or fat.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Treatment of Prominent Fat Loss / Absence in the Cheeks

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Your do not have a Nasolabial fold anomaly but loss of fat in the cheek pad. This can be corrected with several sessions of fat grafting or of Sculptra treatments.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Nasolabial folds

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You appear to have a low fat content to your face, and probably overall. This is accentuate when stone-faced since the muscles go lax. If your cheeks fill out when you smile a bit,  then usually perform a subperiosteal midface intraoral lift and eversion (SMILE) procedure. If it is still inadequate other volumizers like implants or fat grafting can be contemplated.


Robin T. W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

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The groove that is evident is the midcheek groove.

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You have a very thin face and are missing buccal fat volume.  Fillers are an excellent option for this and do not require surgery.  Although expensive, you might consider Sculptra give the extensive nature of your volume deficiency.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Treatment for submalar deficiency

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Based on your photographs, the problem is not really your nasolabial folds. I have several patients like you with similar concerns. The areas between your nasolabial fold and the cheekbone has a loss of volume likely due to fat loss. The volume loss combined with your bony anatomy in the cheek area is causing the illusion of a prominent nasolabial fold. The solution lies not in treating the nasolabial fold but in filling the volume loss in your submalar area. This can be done with a variety of injectable filler. My preferred method is sculptra injections which, in my hands, have been very effective with in treating this type of volume loss, thus reducing the prominence of the nasolabial fold.

Anita Mandal, MD
Palm Beach Facial Plastic Surgeon

Prominent Nasolabial Folds vs. Facial Volume Deficiency

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As previously stated, the problem and concerns you discuss are not a nasolabial fold problem, but rather a volume deficiency problem. Personally, I would recommend fat augmentation of the entire depleted area from the infraorbital area, into the midface. It may take two or more procedures to get you fully corrected, but it working on a more permanent correction from your own tissue. You will, however, see a noticable and dramatic improvement after one session. I augment facial volume deficiency every week and it is a wonderful and gratifying procedure. The only complaint i ever got was, i love it, but want more fat !  Other than fat, there is sculptra which take two or more seesions and even Voluma from Allergan would work well for your volume replacement. 

Deficiency of Mid-Face Volume

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Hi there-

While the appearance of your nasolabial area has you focused there, the real problem, and the reason it looks "3-dimensional" to you, is that you have a relative lack of volume in the mid-face area.

This is easily improved with fat grafting, and even more easily with Sculptra, an injectable volumizer than can be placed under local anesthesia and which can be expected to last a very long time.

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.