What's the best way to get rid of my nasolabial folds? Age 42 (photo)

Although there are many alternatives for improving nasolabial folds, there is no true way to completely eliminate all types of nasolabial folds. If one has sharply etched wrinkles, usually the course of action is to improve or eliminate with fillers. However, a lot of people have in addition to the wrinkle, overlying redundant skin. This is much more difficult to treat. A standard facelift will help improve this although this is most noted on the lower part of the nasolabial fold but rarely will a standard facelift fully eliminate redundant skin. Similarly, mid facelifts are difficult. There is no reproducible technique with midface lifting to fully eliminate the redundant skin that some have. There is also more visible scarring with these techniques as often the scar line is placed on the hairline. Other techniques have been tried including direct excision of the fold itself in replacing all the redundant skin with a scar line. This is definitely not for everybody. A good consultation with your plastic surgeon can help guide you through the various options.

There are several options including a standard cheeklift to tighten cheek skin towards the ears, along with conservative liposuction to reduce the fat fullness in the upper jowl area just behind the folds. A more direct and less extensive surgery is the direct excision (removal) of a long ellipse of skin and fat along each fold, but that does leave a scar within the NLF, although the scar is camouflaged by the crease and the skin/fat removal flattens the area quite nicely. Alternatively, a non-surgical approach is just to inject fillers into the depth of each fold to plump up the fold and thereby make it less distinct and less noticeable.