Nasolabial Folds, Under Eyes and Marionette Lines - Filler or Tightening for Me?

It's time. I just turned 40. I'd like to work on my nasolabial, undereye and marionette lines. I've done some research and have looked at countless before and after photos. I'm very afraid of a puffy look/result that can happen with filler. After all, it's a sagging, the filler fills it in more, adding more to the face. I'm more interested in tightening (Ulthera perhaps) but the research doesn't look promising. Can any doctors recommend something for me? Thank you!

Doctor Answers 3

Fillers are the best/only non-surgical skin tightening option for folds under eyes

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Properly placed fillers particularly in the infra orbital cheek area, can give some elevation in the nasolabial fold region. You could also have filler placed both there and in the perioral area without looking puffy, if done well. There is no none surgical skin tightening modality which would give you the result you are trying to achieve and having just turned 40, fillers are quite appropriate to maintain you until surgery becomes the better choice.

Fillers vs. lift surgery

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In my opinion your best option is fillers. I do not think a lift will deliver the result you want because your concerns are caused more by motion and thinning than sagging.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Your deep lower eyelid grooves and nasolabial folds may be improved by a well-performed Injectable Filler procedure.

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I read your concerns and reviewed your frontal photo. You appear to be a good candidate to have your folds and grooves filled. Based on your photo, I would not likely suggest facelift surgery for you. My personal preference is to use Silikon-1000, an off-label filler, for permanent results.

I do not have any personal experience with the use of Ulthera for facial rejuvenation.

Regards from NJ.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

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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.