Nasolabial fold filler vs midface filler? (Photo)

Question

I went recently to a consultation about fillers for my nasal bifold & Marionette lines & the injectionnist mentioned to me that it would be a better result to inject where my cheek bones are.She mentioned 3 small areas in the mid face area and since I ve never heard of that, I passed. Im scared to get a lionish look as many are having right now. I m nit looking into getting bigger cheeks at all but really just want to smooth those areas out to get a fresher look. What shall I do?

Nima Shemirani, MD · Answer

Hi @Bhk21. I recommend starting with midface filler--this can help soften your nasolabial folds.

Best of luck,

Dr. Nima

Ramandeep Sidhu, MD · Answer

Thanks for sending the picture. We recommend staging thetreatment and for best results do the cheek bone filler first and wait for 2 weeks and then procees with nasolabial fillers to give you the best results.

Jason Emer, MD · Answer

For nasolabial folds, I recommend fillers for the folds themselves but also lifting around the mouth and cheeks to build underlying anatomical support. In our practice we combine sculptra with other fillers "layered" on top and lasers, rf treatments, J Plasma and peels to get the most conservative natural look. Please see a facial sculpting expert. Best, Dr. Emer

Barry Ginsburg, MD · Answer

it does depend somewhat on your budget.. you clearly need mid face volume restoration.  i cant see your jaw line but you probably need lifting also.. injecting the cheek bone and mid face will give you a much better appearance but will require much more filler.

Georgine Nanos, MD · Answer

Thank you for your question. From what is shown in your picture, I would recommend a combination of dermal filler injections. Voluma could be injected in the cheek region to replace lost bone and fat in that area. Then, fine tuning the nasolabial folds and marionette line with Volure would give a very natural look.

Shaun Patel, MD · Answer

I think you would benefit from a combination of both. I would used Restylane Lyft in the midface/cheeks which would help lift the face and soften the nasolabial folds and then I would directly inject the nasolabial folds with Restylane Defyne. Alternatively, you could used Sculptra Aesthetic in the midface and Restylane Defyne for the laugh lines.

Patricia Faraz, MD · Answer

Hello and thank you for your photo and question.I agree with your provider. By adding filler to the volume loss you have in the cheeks it will take some of the heaviness away from the nasolabial folds and marionette lines. If after the cheeks are injected, you can use less product to the nasolabial and marionettes, resulting in not having that overly filled "lionish" appearance.Best to you,

Cheryl A. Hull, MD · Answer

Thank you for your question and submitting your photo.  To give a person the most refreshed and youthful look, we as injectors always look for balance, symmetry and creating the "triangle of youth" or "V-shape".  With the aging of tissues and the action of gravity, this youthful triangle or V-shape diminishes and even inverts, and concerns you have with nasolabial folds and marionettes begin to appear.  So based on your photo, I see you have full cheeks, but I agree with treating the mid face first with Voluma and more to the left side as it has more volume loss than the right. Small amounts of product in the right place can make a huge difference in enhancing your youthful appearance.  I would also consider filler like Vollure or Juvederm to balance the lower third of your face and support the corners of your mouth.  Best wishes to you!

Jean M. Casello, MD · Answer

Based on your photos I would agree with your injector.  The filler in the midface would be used to lift and restore any volume to that area that you have lost.  Once the fat pads are re-positioned than the folds can be filled in to give a more natural appearance.

Anteneh Roba, MD · Answer

Based on the photo, you have loss of volume in your mid face. By filling the midface with a filler like Voluma you can improve the NLFs . You can also have Juvaderm injected into the marionette line as well some in the NLFs.

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