33 y/o - What can be done to improve my nasolabial folds and overall appearance? (photos)

The photos provided suggest volume deficit in the cheeks. Since the upper cheeks are a major support to both the under-eyes, as well as lift to the lower cheeks/smile lines region, simply using a robust HA filler for the cheeks would not only create a more ideal, feminine, heart-shaped, oval face, but would likely also treat the hollows under the eyes AND soften significantly the smile lines. In experienced hands, this treatment should take about ten minutes, yield immediate "Wow!" results and engender little to no significant downtime. Now, how's that for an appearance improving treatment? You would be wise to consult with an experienced, board certified cosmetic dermatologist filler injector.

Dear whippetsnappet,
Sometimes the nasolabial folds are prominent as early as childhood or adolescence and at those ages are considered somewhat youthful looking. When those individuals hit their 30s the folds begin to have an aging appearance. There are options for correcting prominent nasolabial folds, fillers and fat transfer predominantly. Also, on your lateral (side) photo, it appears that you have a bit of a recessed chin and we can't see your jawline or neck completely, but these characteristics may be contributing to your feeling of being "generally off." Seek consultation with an American Board of Plastic Surgery board certified plastic surgeon for an examination and discussion of your concerns and options. Good luck!

Fillers are a great tool for softening the appearance of nasolabial folds. You could consider filler in the cheek area as well to better define facial contours. We always recommend using medical grade skin care products like Transform MD and wearing sunscreen every day to keep skin healthy.