What procedures would be recommended for my nasolabial folds and volume loss? (Photo)

Question

I’m a 29 year old male with concerns about my nasolabial folds and loss of volume in my mid face causing excess skin around my mouth and sagging cheeks. I also would like to address my eyes, my right eye seems to be lower than my left, I’m unsure if it’s because of the skin or the orbital. I’m pretty skinny at around 140 pounds and about 5’8”. I feel like the concerns I have about my face make me appear older than I am, the volume loss began to appear a couple years ago. What’s the best solution?

Lexie Wang, MD · Answer

Hi! I believe you correctly identified your issues in that a lot of this is related to loss of volume that either happened as you aged or possibly was related to wt loss intentioanlly on your part or any other of variety of things. Volumizing procedures like filler/sculptra/fat grafting are going to be your best bet. I would be careful near the eye region because it almost seems like you may have malar edema (I can't totally tell from these photos/angles) so make sure you go to someone who can give you good sincere advice about that.

Ronald J. Edelson, MD · Answer

You will get many different opinions on this. I think you would be a good candidate for upper eyelid surgery and possibly lower lids. Injectable fillers are also an option

Gary M. Horndeski, MD · Answer

I recommend an upper blepharoplasty (eyelids) and a lip lift. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. This will also improve the nasal labial folds. You can also undergo fat transfers to the nasal labial folds if you desire more volume.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Jacob Tower, MD · Answer

Hello, hope you are well. I would be very interested to see a profile view of your face (from the side). My impression from these views is that you lack forward projection of the cheek--essentially a deficiency of volume and structure. You should consider submalar cheek implants to improve the foundation for the soft tissue envelope and secondarily conservative microfat grafting under the eyes and for the nasolabial folds. I would suggest the implants first and then wait 3 months before proceeding with any further fat grafting (or filler). Good luck!
Best,Dr. Tower

Mats Hagstrom, MD (license on probation) · Answer

Mid face volume and nasal labial folds are best treated with the use of fillers. It’s important to recognize that there is a significant component of skill involved with getting quality outcomes. Finding the right provider is key to get quality outcomes. Not all practitioners offering these treatments have mastered the art of facial aesthetics.
Consider taking a look at the website of Dr. David Marbrie MD in San Francisco. He has an impressive collection of before and after pictures of patients who had facial volume restoration using only fillers. I’m not suggesting everyone fly to San Francisco to get fillers but seeing his results can be inspirational and let people understand what the gold standard is and what can be achieved using only volume restoration. Look for other providers in your community who can do that type of work and you may be all set.
Best,
Mats Hagstrom MD

What procedures would be recommended for my nasolabial folds and volume loss? (Photo)

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