Fillers for Hollows Around Nose/nasolabial? (photo)

First I would try a filler such as restylane or juvederm. Perlane might be a little to thick for you. If don't like the results there is a dissolving agent. I wouldn't suggest a permanent implant due to complications and your young age.

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting, and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Hi @MCscott. I recommend trying a hyaluronic acid dermal filler like Restylane Defyne. Best of luck to you, Dr. Nima!

hi, perlane can be used for your problem. the outcome in experienced hands its always the expected. the thing with this kind of filler its that it will go away. permanent procedures can be artefill, fat injection and also silicone implanta or cartilage (self). 

Translation provided by doctor:

hola , perlane puede ser utilizado para tu problema. el resultado en manos experimentadas es siempre el esperado. el problema es que este tipo de relleno desaparecera con el tiempo. los procedimientos permanentes son artefill, inyeccion de grasa, implantes de silicona o cartilago propio.

dr jpc

Without assessing you in person, it's difficult to determine which product will provide your best result. Any dermal filler is going to improve the area and consulting with more than one provider is always a great plan when considering cosmedic treatments.

The triangular, shaded, upper portion of the smile lines (nasolabial folds) is a common location  for using volumizing fillers. Perlane L is my favorite for this purpose, especially in a young person just beginning to show this problem. Perlane L gives excellent lift, draws little tissue fluid to itself after injection, and is reasonably robust and long lasting (about a year in this location that is very prone to considerable movement-related break up of the injected material). (In older individuals with deeper and longer furrows, I generally prefer a combination of Radiesse and Perlane L for this purpose). Injecting these triangular hollows takes less than five minutes and typically engenders little to no downtime.

If the area that bothers you is around the nose and in the upper nasal labial fold area, I would recommend injecting Sculptra in this area.  Sculptra is a collogen stimulant injected in the area of needed enhancement.  The initial response looks great but is temporary and lasts about 24 hours.  The bacteriostatic water that was mixed with the Sculptra is absorbed by the body but the particles are then distributed in the collogen.  The collogen is stimulated and gradually grows.  You would probably require 2-3 sessions of Sculptra (approximately one vial at each appointment).  After waiting three months after last appointment, your final results would appear which last approximately 2-5 years. This specific area has a blood vessel that should be avoided, therefore Sculptra is the best product to use because it is a liquid and will not compress the vessel where as Perlane would have an increased risk.  Perlane would give immediate results and last for about 9 months to 18 months. You need to be sure an experienced injector is treating with either product,  I do not recommend permanent placement of implants in the face, especially at such a young age.  Your face will change as you age, but remember, the implant remains the same.  Therefore, the implants position on the face will change and you may not be pleased.  Do understand, if Perlane is placed in the nasal labial fold only, and not deep in the corners of the nose, the chance is slim of hitting the vessel I spoke described.  From you description, giving increased support to the nares/under lower portion of nose will decrease the contour deficiency you are seeing.

Thank you!

I always start with a temporary filler like Perlane or Juvederm before I consider something more permanent like Artefill, fat transfer, or even surgical implants in that particular part of the face.  The hyaluronic acid fillers are so safe and reliable, that in the right hands, you almost can't go wrong.  The most significant risk in this area is usually from injection into a blood vessel, and this can be avoided by using a blunt cannula for injection.  You have a bit of a deficiency in the bony projection and soft tissue volume of that part of your midface, and you are an excellent candidate for volume correction.  I would suggest Perlane or Juvederm as first choice of fillers for that area, and if that works out for you, then you can explore other options for the future.

Hello 'MCscott', thanks for your question.  I think you are a great candidate for filler placement to smooth out your nasolabial folds.  It is a simple office procedure with minimal downtime and immediate results that typically last a good 9 months to a year.  I generally discourage patients, especially younger patients such as yourself, from getting permanent facial implants as there can be long-term problems with these implants.  For instance, there are risks of implant infection, malposition, and hardening, leading to facial deformities that can be very difficult to correct.  If you want a more permanent solution, then I recommend autologous fat transfer injections that can potentially last the rest of your life.  The benefits are that it is your own tissue that can change and 'age' with you without the risk of foreign implant distortion.  However, the down-side is that since only about 50% of the fat grafts 'take', there is a small risk of some lumpiness or irregularities of the contour.  Also, this would entail an operative procedure that would be more invasive and require more recovery time than a simple filler injection.  I tell my patients that sometimes it is good to have a temporary fix since our bodies change with the aging process, and if we do not like the results of a treatment, the products will gradually go away with time.  Hope that helps!

-Dr.92660

Before considering implants, you can use:

1) Perlane

2) Juvederm Ultra Plus

3) Fat transfer where you can remove fat from another part of the body and transferring it to the hollow. If the fat transfer is not done expertly, not all the fat that is transferred will live. The benefit of the transfer is that it is natural, since it was a part of you.

4) When I looked at your pictures, I also evaluated your smile lines. Many times, when the smile lines or nasal labial folds deepen, the tissue of the cheeks drop. So another option is to fill in not only the nasal labial fold, but to also give a little fullness to the middle of the cheek and that'll give your nasal labial fold a lift.

5) And of course, the last option is implants. I generally only recommend this if the other options don't work well as sometimes you can get movement of the implants or you can occasionally feel the edge of the implant. This used to be popular in the past, but with the new filler options above, we prefer those over implants.