Should I Fill These Nasolabial Folds, or Should I Wait a Few Years? I Am 27 Years Old. (photo)

Question

I always had nasolabial folds and it was always smt I did not like so much at me, but I never felt it was so huge of a problem..I guess it's my genetics and my bone structure..The last two years, though, its has started to bother me a lot, as it has gone worse! I feel it makes me look older and constantly tired. However, I think that if I start doing derma fillers at 27, what am I going to do when I get 37?? I am struggling with these thoughts.. What is your opinion? Go for it, or wait a bit??

Daryl K. Hoffman, MD · Answer

You are right, it is your bone structure. Your have a narrow face and your cheekbones are flat and narrow. Cheek implants can help with that but you may not like the change and they are infamous for looking fake. They first thing to do is to try a temporary filler like Juvederm or perlane in the cheek bone area, not the folds. Putting it into the folds just adds volume and weight to the central face, not your cheek bones. If you like the look of the temporary filler, you can go for something more long lasting. My preference is transfer of your own fat.

Jerome Edelstein, MD · Answer

If you start now, you can actually prevent these folds from getting worse and encourage the production of your own collagen along the way, which would have longterm positive effects for your appearance.

Kenneth D. Steinsapir, MD · Answer

You will immediately feel better about yourself.  

	I agree that you have a longish lower face with a relatively flat cheek plane.  This may represent a lack of maxillary projection.  Having cheek filler one a year, is probably a better option than having orthognathic surgery.  I agree with McNeill that you need more cheek volume than nasolabial volume.  You also could use a hit of volume in the lip edges, the corners of the mouth and in the lateral aspects of the labiomental fold.  The change from two milliliters of Perlane, and one milliliter of Restylane would be profound.

Harold J. Kaplan, MD · Answer

Hi Katie.  Dr. Hughes assessment was excellent.  While you do have very minor nasolabial folds, what's more apparent is the flatness of the cheeks.  Radiesse can help build the cheekbones which can provide a very attractive look and at the same time lessen the appearance of the laugh lines.

	The choice of when to start these procedures is a very personal one, but we certainly have patients as young as you are in our practice.  Good luck.

Kenneth Hughes, MD · Answer

Hi Katie. You're at a perfect age to start preventing any future signs of aging. Based on the photos provided it seems you may benefit from Radiesse to help build volume and contour the cheek, this will help the nasolabial fold as well. A proper exam would be ideal, I suggest finding a board certified physician who can give you the best natural result you wish to achieve. 

	Best wishes

Phillip Chang, MD · Answer

The cause of facial aging is volume loss. Many people begin to notice this first in the area of their nasolabial folds (NLF). From looking at your picture it appears you have actually lost more volume in your cheek area (malar fat pad) than the actual fold. Filling just the NLF may make you appear a little front heavy. The good thing about filler is that you can put a little bit in each area. Filler is used for preventative aging as a volume replacement, I do think you are a good candidate for dermal fillers at this point.

Nissan Pilest, MD · Answer

You appear to have insufficient volume in the area that we refer to as the "apple" of the cheek. That is a larger issue than the nasolabial fold itself.

	Because you want to create and maintain visually proportional natural contours, your best option is to consider placing volume in that cheek area which will also "lift" the tissue that creates the shadow from folds. (If you ONLY fill in the nasolabial folds, your face will be quite flat which in essence would only make you appear even older or more tired.

	Filler choices: Radiesse is instant and you can get a nice cheek enhancement, but from an overall perspective, Sculptra (a bio stimulator of your own collagen) plus some filler would appear to be a better choice since your doctor has more ability to finesse the way the volume is proportioned..

Cheryl A. Hull, MD · Answer

I also agree with previous comments to fill the mid face, because your pictures so show volume loss in that area which exacerbates the folds. By filling in the cheeks, the fold often lifts and you have an overall refreshed look. There are many filler options; I prefer Sculptra or Radiesse.

Jo Herzog, MD · Answer

I agree with the others who feel that the best way to fix this is to add volume to the mid-cheek. Not only will you soften the NLF but you will augment your cheeks. I would choose Radiesse or Perlane for this.

Steven F. Weiner, MD · Answer

Your nasolabial folds are prominent because of the loss of support in the upper medial cheek. This is most likely related to fat loss, bone loss, or genetic. Injecting in the medial fat pad area with Restylane or Perlane will greatly improve the nasolabial area. After that is done, you might want a little in the area right near the nose (piriform area) to make it perfect. See my video. Steve Weiner, MD, Facial Plastic Surgeon.

Should I Fill These Nasolabial Folds, or Should I Wait a Few Years? I Am 27 Years Old. (photo)

Answers (15)

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