I have an indentation when I smile big above my nasolabial fold on the right side. At rest it is normal. What can I do? (Photo)

Question

I have an indentation when I smile big above my nasolabial fold on the right side. At rest it looks completely normal. When I pull the skin back it looks normal so I don't think it's a volume issue? I'm 42. What are my options?

Nima Shemirani, MD · Answer

Hi @lhmeacham. You can add some volume in the area to reduce the line while you smile. Another option would be Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting. Best of luck, Dr. Nima.

Jason Emer, MD · Answer

Volume and contouring of the cheeks can be created with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra. Implants or fat are alternatives. Botox and radiofrequency can help slim and contour the jawline. Liposuction can help slim the face. Ultherapy, J Plasma and RF treatments can provide skin tightening and lift. I would recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Stephen Giordano, DO · Answer

We fix this issue all of the time :)  Although this is totally benign and nothing to worry about, I understand the aesthetic implications.  I would recommend a hyaluronic acid filler such as Juvederm or Restylane to fix this issue. Juvederm is longer lasting in my experience.  These are reversible, so if you don't like the result you can instantly go back to where you started.  This is also a huge plus for patient safety as well!!   Best, Dr. Giordano

Nelson Lee Novick, MD · Answer

By sheer coincidence, I treated a patient with a similar problem on both cheeks just last week. At rest, like you, the indentations were not visible, however, they became quite apparent with smiling. I opted to treat her with a small amount of hyaluronic acid-based skin booster, injecting it quite superficially and confining it only to the triangular indentations that become apparent with facial expression. The results were immediate and extremely gratifying for both patient and doctor. She has since notified me that the results have continued to improve, which is likely due to the improved tissue hydration promoted by the skin booster. She was treated in my Israel satellite facility, where quite a few injectable skin booster products are available, with Viscoderm Hydroboosters.  In my NY office, I would opt for Restylane Silk for this purpose. Make sure that you consult with a board certified aesthetic physician. Best of luck.

Morgan Rabach, MD · Answer

If you have never had this issue until recently you can certainly add some volume in the area to reduce the line while you smile. It most likely is caused from volume loss.

Leonard Grossman, MD · Answer

Muscles create all sorts of things as we use them. The indentation you're referring to is the product of the muscles squeezing the fat. As long as you do not have any issues when the face is is at rest, I would not address this condition. If however it bothers you greatly you can always be evaluated by a plastic surgeon in person. Good luck from New York City plastic surgery

I have an indentation when I smile big above my nasolabial fold on the right side. At rest it is normal. What can I do? (Photo)

Answers (6)

More Dermal Fillers Questions

Is there a dermal filler for actual dents in my skull? (Photo)

Is Versa a good choice for enhancing a weakish chin?

I've been dealing with intermittent swelling under my eye caused by HA filler for 9 months. No dr has been able to help (Photo)

Would diluting hyaluronic acid with saline reduce the chances of occlusion?

Will asymmetrical nasolabial fold improve after orthodontic work? (Photos)

Which filler won't cause tyndall effect?

WE SEND PRETTY
EMAILS