Permanent treatment options for nasolabial folds? Have tried dermal fillers. (photos)

Microdroplet Silikon-1000 may be considered for permanent improvement of your nasolabial folds. Several treatments at monthly intervals may be necessary for achieving a desired result. I would not suggest facial fat removal.Necrosis, blindness, biofilm, infection or migration do not occur after microdroplet Silikon-1000 filler treatments. Thank you. Dr Joseph

You will need to add volume to the mid face as well as to the nasal labial folds. This would certainly take more than 2 syringes of filler. Autologous fat transfer would be the best option since we can harvest and implant larger volumes. The fat once engrafted should last you the rest of your life but as you age you may need to top it off as you naturally lose volume. Alternatively, you can use an injectable implant like Bellafill® which when combined with platelet rich plasma from your own blood, can give you a very long lasting result (5 years or more). I don't think this particular product is available in the UK but you are welcome to come to the US to have the treatment. 

The idea of permanent fillers is excellent - permanent improvement. The downside of permanent fillers is that your face is going to age, and the fillers are permanent. Over time, permanent fillers can change in the appearance as the skin changes. For this reason, there are very few surgeons who still perform permanent fillers in the US and even abroad. You would likely benefit from seeing a board-certified expert to evaluate you for injections, and try again with the fillers. I wish you success!

The folds you notice are called the nasolabial folds (nose to mouth) and labiomandibular folds (mouth to mandible). These are normal folds which we all have and they tend to get deeper over time. There is no way to permanently remove these folds nor should you try as these are a normal part of facial anatomy. Fillers are by far the best way to reduce these folds as these treatments are quick, easy with minimal downtime and minimal risk. You may benefit from additional filler or a different type of filler (thicker) based on your anatomy. I would wait one month and then reconsult your physician to discuss further options. I would strongly advocate against direct surgical excision as this leaves a permanent scar which can be very visible and unnatural.

Those are the permanent and semi-permanent solutions. Neither is amazing but in the long run would be more cost effective. Of course the first leaves a scar. The second doesn't last forever but silicon or Bellafil can lead to some side effects that are pretty irreversible. Hope that helps!

When dealing with NLF, you must make sure the cheeks are also volumized. I would do that too. For long term correction of the NLF, Bellafill is a good choice as well as fat transfer. I would go with the Bellafill - I have 8 syringes in me FYI.

Your long-term options would be to fill the area with Belafill (5+ years) or fat transfer (8-10 years).  Some form of volumization must be done to correct this, not surgery.

Facial fat grafting can be a good option for a more permanent result than dermal fillers. Be aware of two caveats with this though. One, the results will likely be very similar to what can be achieved with filler, just permanent. So if you are unhappy after filler, this may not be for you. Second, the "take" of fat grafting is unpredictable; often patients will need more than one treatment to get the result they are going for. Make sure you find a well credentialed Plastic Surgeon, and have an in-person consult and physical exam. That is the only way to see if you are a good candidate for facial fat grafting. A good surgeon should have an open and honest discussion with you out about realistic expectations of what is achievable. Good luck!

.if you find a plastic surgeon like myself who has been using autologous fat grafting techniques for a long time, they can definitely help you with a permanent solution. Good luck from New York City