Uneven nasolabial fold. How is this problem corrected? (Photo)

Question

I recently had two syringes of Juvederm placed in my nasolabial folds and into my lips. Ive always been told that one side of my face is wider than the other. Every time I get filler in my folds, they look uneven. How is this problem corrected? Do I need more fillers in my cheeks (had radiesse back in February)

Martin Jugenburg, MD · Answer

Juvederm treatments are completely customizable to the patients face.  You can potentially add a bit of filler to the cheek of the deeper fold to get a bit more lift.

Jason Emer, MD · Answer

Fillers, implants and fat can all be used to sculpt and contour the face. Additional filler can be placed to improve facial symmetry. I suggest consulting with a facial sculpting expert. Best, Dr. Emer

Nelson Castillo, MD · Answer

Thank you for your question and for sharing your photograph.  Nasolabial folds are often asymmetrical in patients, and require an uneven placement of dermal fillers.  I see your area of concern and if it is has been at least two weeks since your treatment I would recommend additional JVD placement into your left smile line to help smooth the transition from your cheek to your upper lip.  It would also be important to check on your left cheek relative to your right.  If your left cheek is smaller, placement of filler material into the left cheek can help improve the nasolabial fold and lower the amount of filler that may need to be placed there.   Hope this helps.

Benjamin Barankin, MD, FRCPC · Answer

Most people have asymmetric or uneven nasolabial folds. These folds can be corrected by injecting directly into them, as well as by injecting above them in the medial and/or lateral cheek. Best to see an expert injector such  as a dermatologist to try and correct this ; note that sometimes it is not correctable.

Nicole Hayre, MD · Answer

Thank you for providing a photo with your question.  Everyone is asymmetrical, some more than others.  Simply putting more into the nasolabial folds will not help.  You need more lift from the cheeks.  A skilled injector should be able to even your cheeks out using more filler.  Good luck!

Dennis Gross, MD · Answer

There is no reason why this should not be able to be improved upon - most everyone has some sort of asymmetry to their face, which is why I believe fillers and Botox require a completely customized approach. The in-person consultation is key for understanding a patients concerns and goals as well as assessing facial structure so that we can customize  a treatment plan to fit your needs. My best advice for you would be to seek out a board-specialized dermatologist or plastic surgeon with a lot of experience with injectables as well as a great track record. Unless you find someone willing to take the time to customize the treatment to your specific needs, you may get the same result.

Richard Ort, MD · Answer

You might benefit from additional filler to the left nasolabial fold.  You might also benefit from injections of filler to the left cheek if the left cheek is less full compared to the right side.  Putting filler into the cheeks can help lift the nasolabial fold.  Make sure that you are seeing an experienced injector, preferably a cosmetic dermatologist or plastic surgeon.Regards,Dr. Ort

Steven Wallach, MD · Answer

Everyone's face is a bit asymmetric and therefore, one fold is often deeper than the other. Best to be seen in person to determine how to better balance the two sides.

Hardik Soni, MD · Answer

The simple answer is that you can add more filler in the nasolabial fold on the left and it should look more symmetrical. But looking at the limited picture, the left check has more volume loss and I would recommend actually putting the filler into the left cheek to give a lift which will naturally soften the laugh line and make you look more balanced.  When I see clients concerned about their laugh lines, I evaluate their cheeks and this is usually the first place filler will be injected to create a lift and if they want more softening , then I will consider placement of a small amount in the laugh lines themselves.  Too much filler in the laugh lines can look unnatural and almost impart a simian like characteristic. I would go back to the provider and have this discussion with them.All the bestDr Soni

Benjamin C. Paul, MD · Answer

Thanks for your question.  Asymmetry is present to some extent in everyone.  Everyone has a wider cheek bone and a higher cheek bone, for instance.  In your case, you look beautiful although adding a little more filler on your left side may be beneficial.  I have had patients that needed 1.5cc of filler in one nasolabial fold, and 0.5cc on the other.  Go back to the person who did your injection and discuss the option of only injecting your left nasolabial fold as it may require more.Best of luck.

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