Deep nasolabial folds and cheek volume loss at 29, what procedures could help? (Photos)

Question

I'm 29 and have started to feel bothered about volume loss in my midface as it ages me a lot and makes me look tired/angry, specially under certain lighting. I wanted to understand what procedures could help as I have read conflicting opinions about filler in this area (risk of making it look heavier). Moreover, what results can I really expect? Out of everything I've seen online, it appears only a facelift would give this area the "lifting" I'd like. Thanks in advance.

Camille Cash, MD · Answer

It appears from your photos that you would benefit from volume restoration to the cheeks.  You can consider traditional HA fillers or other options such as Sculptra or Renuva.  Renuva is specially formulated to provide the volume benefits of filler but it is different in that over time your body gradually rejuvenates lost fat to the injected area.  You can visit my website to learn more.  I've also included a video on Sculptra and how it works that I hope you find helpful.

Nelson Lee Novick, MD · Answer

The assumption here that surgical facelifting would be appropriate is flawed here. A person with a thin face, in particular, as in this case, with obvious volume depletion, would likely end up with a "skeletonized" facial appearance if skin is cut away and pulled tight. Think of it this way, let's say you had a beautiful dining room table with three center leaves and you purchase a gorgeous table cloth to cover it that hangs gracefully halfway down the sides of the table. Now, imagine taking out the three leaves of the table once the guests are gone and finding that the tablecloth now rests on the floor all the way around. Would you consider for even a second, going around the table cloth and cutting it away all the way around, so it can once again drape the table gracefully. Or would you instead, simply put back the three leaves. Well, getting a facelift where supposedly "excess skin" is cut off would accomplish the same thing; it would leave the face looking pulled overly tight and stretched over bone, so that everyone looking would say the killer words, "Oh, he's been done." 
From the photos provided, there seems to be significant volume deficit in the central face, suggesting that restoring the volume to the cheeks using a robust HA volumizing filler would likely give the desired volume and lift to the face and give rise to an immediate, on the spot "Wow!" reaction. 
You would be wise to consult with an experienced, board certified cosmetic dermatologist filler expert. And, one other piece of advice. Don't go into any consult asking for a particular treatment or surgery, as, to your later financial loss, disappointment and frustration you are likely to get exactly what you asked for. Hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

There are several non-surgical and surgical procedures that could help improve the appearance of deep nasolabial folds and volume loss in the cheek area:

1. Dermal Fillers: These are injectable substances used to restore volume to the face. Hyaluronic acid fillers such as Juvederm and Restylane are commonly used. They can fill in the nasolabial folds and enhance the cheek volume. However, it's true that if not done correctly, they can potentially add weight to the face. Therefore, it's crucial to find a skilled injector who understands facial anatomy and aesthetics.

2. Fat Transfer: This procedure involves taking fat from one part of your body and injecting it into your face. This can provide a more natural-looking fill and can help with volume loss in the cheek area.

3. Facial Thread Lift: This is a less invasive alternative to a facelift. It involves using dissolvable threads to lift and tighten the skin. This can help with sagging and volume loss.

4. Cheek Implants: These are a more permanent solution for cheek volume loss. However, they come with more risks and a longer recovery time than the non-surgical options.

5. Facelift: A facelift can provide the most dramatic results. It tightens the underlying muscles and removes excess skin, which can help with both nasolabial folds and cheek volume loss. However, it is a major surgery and comes with risks and a significant recovery period.

As for what to expect, it really depends on the procedure. Dermal fillers and fat transfers can provide immediate results, but they are temporary and will need to be repeated. Thread lifts and cheek implants can provide longer-lasting results, but there may be a recovery period. A facelift will provide the most dramatic and long-lasting results, but the recovery period can be significant and there are more risks associated with surgery.

It's important to have a discussion with a board-certified plastic surgeon or dermatologist to understand which option is best for you. They can provide a realistic expectation of results based on your individual anatomy and goals.

Deep nasolabial folds and cheek volume loss at 29, what procedures could help? (Photos)

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Deep nasolabial folds and cheek volume loss at 29, what procedures could help? (Photos)

Answers (3)

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Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.