I'm male in my late 30s with deep nasolabial folds. It gives my face a droopy look. (Photo)

Question

It's impacting my confidence, I have read about fat transfer, midface lift and fillers on this forum.I seek your advice on long-term/permanent surgical or non-surgical treatment options, Your advice will be a big help.

Nima Shemirani, MD · Answer

Hi @your_param2006! Cheeks fillers with Voluma and Restylane Defyne in the nasolabial folds will help soften the appearance of your nasolabial folds. Another great option is 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!

Michael P. Morrissette, DDS, FACS · Answer

You have a significant amount of midface sagging and jowling at an early age that may be genetically related. Your face is full so adding more filler will just give your face a more rounded appearance. Cheek implants alone will elevate the midface and provide more definition, but cheek implants and a short incision facelift would provide the the best results. Good luck

Omar Lazos, MD · Answer

Even though your in the 30s, some people have heavy tissues in the face... You are too young for a formal face lift, so I advice dermal fillers to improve it, like volift on the nasolabial folds or voluma on the cheeks.Still the most effective method will be surgical. Hope this helps you on your questions. Best regards!

Jason Emer, MD · Answer

For this type of face you really need implants and a face lift to get the most improvement.  You have very little underlying anatomy to support fillers and even at a younger age you have skin sagging. With that said if you are not willing to do surgery to get the most improvement you can do other treatments to help your skin and volumization and laxity/sagging but results will be just small improvements.I suggest a combination approach of :
1) skin care with products and PRP/microneedling

2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel, Viva, or Co2/Erbium
4) Sculptra injections a few times a year for collagen production
5) thermage/ultherapy for yearly skin tightening6) fillers to help lift and contour the cheeks, under eyes and folds7) sculptra to build collagen long term8) threads to lift the cheeks and folds like instalift

Ramandeep Sidhu, MD · Answer

Great question. Of course there is face lift and aggressive resurfacing but that involves lot of down time too. Among no down time, the options are ultherapy and /or fillers. I like starting with lifting and tightening with ultherapy and then follow with fillers if needed. Consult with an expert is essential to address ear;y and mild laxity.

Nicholas Gentry, MD · Answer

I would recommend trying dermal fillers initially to see what you like and don’t like without permanent results. Then consider fat transfer to get a more permanent effect. I like to combine platelet rich plasma with both treatments

Kurt Kuhlman, DO · Answer

Nasolabial folds respond very well to dermal filler injections. From your pictures, it appears that your cheeks have atrophied which is probably contributing to your deep nasolabial folds. I would consider getting injections in your cheeks and nasolabial folds. Depending on the filler used, it will last 1-2 years.

I'm male in my late 30s with deep nasolabial folds. It gives my face a droopy look. (Photo)

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