I’m 22 and have deep nasolabial folds: what do I do? (photos)

Question

I am 5’9 and 140 lbs. There are deep folds near the sides of my nose that do not extend all the way down. I’ve had these for a long time, and I went to a cosmetologist to get them filled, but she recommended against that because they would seem “overfilled” and look unnatural and prominent from the side. Is it because I have a weak mid face? I don’t want implants though, but maybe a mid face lift? Thank you in advance.

Jason Emer, MD · Answer

in younger clients this is often treated with threads, fillers, morpheus, thermage, and ultherapy.  See an expert! we also suggest at home dermarolling weekly (see protocol from emeragecosmetics.com where we do daily free skincare consults virtually). For facial rejuvenation, 
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.

Nima Shemirani, MD · Answer

Hi @Random_Girl_Online! I would recommend getting filler into the piriform fossa. This will help soften the smile lines. Another alternative would be PDO threads. PDO threads is a non-surgical procedure that lifts desired facial anatomy and promotes collagen and myofibroblast stimulation improving overall skin texture and health.

Michael A. Persky, MD · Answer

Hi RGO,Ahh, to be 22 years old again!  Enjoy your youth and beauty.  If the area continues to bother you, I would recommend consulting with an expert in facial fillers.  I would examine you carefully in person and then decide on your best treatment plan.  Deep nasolabial folds are usually caused by lack of mid face boney support.  In your case given your youth, a small amount of filler in your mid face and possibly directly into your superior nasolabial fold should help your achieve your aesthetic goals.  I would likely use either Voluma or Sculptra.  Make sure to choose your injecting aesthetic physician most carefully based on their skill, experience, training, knowledge, and natural artistic vision.  Good luck and be well.Dr. PEncino, CA

Toby Mayer, MD · Answer

Deep Naso-labial grooves-Treatment The treatment I like best for this is Juvederm or Restylane. It lasts 9-12 months and I’ve never had any complication other than occasional bruising. A personal evaluation is needed as this genetic problem may be improved with Voluma to your cheeks as well and ultimately cheek implants.

Leonard Grossman, MD · Answer

When it comes to evaluating the face, it's all about the proportions. The reason your face appears to have more nasolabial folds than one would expect in a 22-year-old is because genetically you do not have much central cheek and lower eyelid fat. This condition is inherited from the father's side of the family as a rule. I would recommend to have your cheeks recreated through the means of fat grafting. As long as the procedure is performed by an experienced in fat grafting plastic surgeon, the results will be natural and very long lasting. I hope this helps and good luck from New York City plastic surgery

Maeve Kenningham, MBChB, MRCGP · Answer

Dear Random Girl online,
First of all, even though I can't see all of your face, you are very pretty and you have beautiful lips, aren't you so very lucky? Im an aesthetic doctor with 12 years of experience, I should know!!
Secondly I think your original aesthetic doctor is probably right, as I too don't think you have a problem here and I would certainly not class these nasolabials as deep. If you have a look at a babies faces, they all have some shadowing in this area, its natural. However it clearly bothers you for you to seek a second opinion. At a push and after medical assessment of you and how it bothers you, I may offer a small amount of filler into strategic points on the cheek and in the nose crease very deep onto the bone. But only a smidge. The aim would be to reduce the shadows but definitely not eradicate them. Your aesthetic doctor was right, if the shadows were completely eradicated, you would look over done.

Gerald Wittenberg, MSc, DMD (retired) · Answer

The use of fillers in that area is common but has to be repeated every 6 to 10 months. Ideally the long term solution is to augment the bone underlying the side and base of the nose with implant material carved to fit your situation. Placed from inside the mouth, it effectively  treats the issue which is lack of bone support.

Robert T. Buchanan, MD (retired) · Answer

Nasolabial folds are, in themselves, not abnormal. However, if they increase from deflation of the cheek, then the best treatment is filling the area of the cheek with the volume loss. You do appear to have some volume loss in the malar areas. Just filling the fold frequently makes your face look square and older. Make sure you see an expert injector.

I’m 22 and have deep nasolabial folds: what do I do? (photos)

Answers (8)

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