What is the most effective procedure to get rid of my deep nasolabial folds / laugh lines? (Photo)

Question

I’ve had these deep nasolabial folds ever since I can remember, but they do seem to get more pronounced as I get older (I’m 43). What procedure do you recommend to soften these lines and lift my cheeks? There’s also my double-chin which I want to address. Would a neck lift, combined with a lower face lift give me the best results? I was thinking of fillers first, but I’d really prefer to get a procedure that’s more “permanent”.

William Groff, DO · Answer

For the double chin, I would recommend a combination of liposculpture to remove the submental fat and ThermiTight to tighten up the skin and restore definition to the jawline. These procedures can be performed at the same time using local anesthesia and recovery is typically just a few days. The results are very long-lasting. The nasolabial folds can be treated with a dermal filler like Restylane Defyne, which produces good results while preserving the natural movement of the face. I would also suggest filler in the cheeks to add some volume and lift, which would also help to improve the nasolabial folds. I advise you to schedule a consultation with an experienced, board-certified dermatologist for further assessment and treatment recommend

Jason Emer, MD · Answer

to be honest you need a facelift to get a substantial improvement. noninvasively you can do volume to midface and folds, therads and morpheus to help.

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly, see link) should be started now to prevent further aging.

For facial rejuvenation,  I would 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/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

Michael P. Morrissette, DDS, FACS · Answer

In the photos, you have good facial volume and minimal skin laxity. At 43 you might not be ready for short incision facelift but you are a good candidate for a isolated mid-face lift. This procedure requires just a small incision in the hairline and the area of the nasalabial fold is elevated and held in position with an absorbable device called an Endotine ST. This results in a decrease to the depth of the nasaolabial fold and an ant-gravity vector to the cheek.  The chin can be improved with a platysmaplasty  and liposuction.

Harold J. Kaplan, MD · Answer

Hello Shaefchen.  Yes, for the most dramatic results a lower face and necklift would give you the best results.  If you are not looking for surgery right now, that is when you would consider dermal fillers like Radiesse or Restylane Lyft (see photos).

Michael A. Persky, MD · Answer

Hi S,

There are both surgical and non-surgical options to help you achieve your facial aesthetic goals.  Your nasolabial folds are caused by loss of bony volume in your cheeks.  A quick non-invasive fix would be the proper use of facial fillers. A combination of non-invasive device treatment with fillers would give you an excellent result (Sculptra, Profound RF with PRP, light Fraxel, and Voluma.). If you are ready for surgical treatment then a face/neck lift would correct your concerns.  The most important aspect of any aesthetic procedure is making sure that you chose your treating physician most carefully based on their skill, experience, training, knowledge, and natural artistic vision.  I would be happy to help you with a virtual or in person consultation. Good luck and be well.

Michael Persky, MD
Encino, CA

Camille Cash, MD · Answer

If you are looking for the most permanent and dramatic results, then a face and neck lift is the solution.  If you are wanting to avoid surgery you can consider FaceTite.  This procedure can tighten skin up to 40%.  No general anesthesia is required.  Results can be optimized by adding Morpheus8 treatments.  You also could consider Silhouette InstaLift which can provide lifting results lasting 18 months or more. The best place to begin is a consultation with a board certified plastic surgeon near you.

Anshul Gambhir, MD · Answer

Thank you for your question! I think you would benefit from filler in the cheeks as well as the nasolabial folds. Placing filler in the cheeks can also help improve the nasolabial folds by lifting the area up and then putting additional filler in the folds will help soften even more. I would suggest at least two syringes of Voluma for the cheeks and two syringes of Vollure for the folds to start. I know you are looking for something more permanent than fillers but even face lifts/neck lifts aren't permanent and usually need to be redone in 5-10 years. You could consider Thermage and Sculptra which stimulate collage growth to lift the face. In regards to the chin, you would be a good candidate for CoolSculpting which is a non-invasive permanent fat reduction procedure. The applicator used for under the chin even has indications for skin tightening as well. I would suggest having a consultation for CoolSculpting to make sure the applicator would fit. Hope this helps!

What is the most effective procedure to get rid of my deep nasolabial folds / laugh lines? (Photo)

Answers (7)

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