Facelift Cannot Fix Nasal Fold and Pouty Mouth? (photo)

Four weeks after facelift. When swollen, no nasal fold and pouty mouth. However, as the swollen subside over time, the nasal fold and pouty mouth got back to my face. After having a very traumatic experience of face life, back to almost original (the condition before surgery), so disappointing. Facelift cannot address the nasal fold and the curve lines from nasal folds to lines at the ends of mouths? If not, what can be done to improve other than filler (fat or artificial)?

Doctor Answers 11

Facelifts and Smile Lines

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Facelifts are not designed to change the smile lines or nasolabial folds.  They are used to help elevate sagging faces, improve jawlines, and necks.  Nasolabial lines are not necessarily a sign of aging in of itself (i.e. many toddlers have nasolabial folds present).  Rather the facial shape should represent an inverted V appearance to create a more youthful and attractive appearing face.  


For patients concerned about nasolabial lines, consider the use of facial fillers.

Chicago Facial Plastic Surgeon
4.8 out of 5 stars 177 reviews

Limitations of the facelift procedures

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The NL fold has long been a concern of surgeons since its well recognized that facelifts don't do as much to resolve this fold as we would like.  And it doesn't matter what style of facelift (sub SMAS, extended sub SMAS, or deep plane), because even though some will help more than others, its still an area that will return after surgery.  So your situation is not surprising, its more of the norm.  So I would agree with others that you must have had a miscommunication with your surgeon as to expectations to that area (and the pouty mouth).  More surgery is not really a great solution either.  Even a midface lift, which does elevate the cheek pad and therefore soften the NL fold, will leave some degree of persistent fold.   Your options require volume, whether its hyaluronic acids like restylane and juvederm, radiesse, sculptra, or even fat transfer.  Continue to work with your surgeon about your concerns and make sure your lines of communication address expectations from both sides.  #facelifts

Kevin Robertson, MD
Madison Facial Plastic Surgeon
4.7 out of 5 stars 15 reviews

Injectables could help

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Facelifts typically are only slightly effective in improving the
nasolabial area. A midface lift is more effective usually. I would also recommend injectables such as Restylane,Juvederm or Radiesse for that area. They typically last anywhere from
6-12 months and many patients find that they are very pleased with the

results. Consult with your board certified plastic surgeon.

Good luck!

Dr. Sam Speron

Sam Speron, MD
Chicago Plastic Surgeon

Facelift to Fix Nasolabial Folds

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   Facelift techniques can improve the nasolabial fold to some extent.  Facial fat grafting or filler can be used to improve this further.  Direct excision has been described, but I would not recommend it in your case.  Kenneth Hughes, MD Los Angeles, CA

Facelift Cannot Fix Nasal Fold and Pouty Mouth?

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Facelift surgery is not very effective at changing the shape of the mouth or eliminating the lines that concern you. The best options for this area at this point are dermal filler (Juvederm) and Botox. Both can be used as part of an office procedure to reshape and fill the areas around your mouth including the corners of the mouth as well. I hope this information is helpful.

Stephen Weber MD, FACS

Weber Facial Plastic Surgery

Facelift and Perioral Effects

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If you were under the impression that a facelift would improve the nasolabial folds and the corners of the mouth, then your peroperative education was inadequate or there was a miscommunication. The central part of the face around the mouth is the least affected by a facelift procedure because it is the furtherest away from the point of tissue pull. These adjuntive or secondary procedures. Since you have removed any type of filler from consideration, there are no other good options for the deepened nasolabuila fold and the donwturned corners of the mouth, with the exception of a small corner of the mouth lift.

Facelifts and even aggressive midface lifts do not eliminate the nasolabial fold.

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These surgeries can help side of the face but not the perioral area.  For this, direct treatment with fillers is the way to go.  You are still swollen from your facelift.  Occasional, after a surgery disappointment can lead to feelings of depression that make recovery even harder.  In reading your post, I wonder if you might be clinically depressed.  You might consider talking to your surgeon or your internist if this is the case.  Generally depression that follows after a surgery is short lived but occasionally treatment is beneficial.  

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

Persistent nasolabial fold after face lift

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it is clear that you are not interested in fillers or autologous fat transfer to the nasolabial folds and corners of the mouth.  Another option may include the use of a permanent implant, but I would  consider trying a filler to see if you like the look before going to a permanent implant.

Todd C. Case, MD
Tucson Plastic Surgeon

Disappointed after facelift

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Fillers work well for the "pouty" look and for nasolabial folds.  Your face is not too full in its lower aspect, so there is plenty of room for filler there.  The risk is if too much is added you will have unnatural fullness.  Some women prefer a rounder, fuller face, so this may be an appropriate choice for you.

Persistent Nasal Folds and Pouty Mouth after Surgery

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It is almost impossible to totally remove the nasolabial fold or your pouty mouth problem with the facelift procedure.  Ways to improve the nasolabial fold are:

  • Microfat injection of the fold during the facelift procedure
  • Dermal Fillers placed into the fold after the healing process has finished.

The pouty mouth or what I can the 50 year old  Frown can be improved by:

  • Fillers injected at the outer edge of the upper lip
  • BOTOX injected into the frowning muscles at the lower corner of the mouth.

Joseph Rucker, MD, FACS
Eau Claire Plastic Surgeon
4.7 out of 5 stars 21 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.