Options for Improving Fat Above Nasolabial Folds?

The nasolabial folds after large weight loss result from a deflation effect. They are best treated by augmentation of the cheeks and nasolabial areas themselves. In our practice we prefer untraumatized autologous fat-fascial grafts for this purpose.
In some patients, direct excision of the nasolabial folds can be performed. However this is seldom performed due to visible scarring.

The best option for excess fat in the flat area of the cheek and nasolabial area is to put cheek implants in. These are wafers of silicone and come in four different sizes and can be placed in through the intraorbital route and from the bottom side lifted outward to volumetrically improve the cheeks. Cheek implants can be removed if the patient does not like them or later prefers a different size depending upon the patient’s needs, wishes, and concerns.

I would address this with a combination approach. Fillers or Autologous fat to the cheek and Nasolabial folc could help as the least invasive procedure. Alternatively a cheek lift with implants would likely give you the longest lasting result but may carry the highest risk