Can anything be done about my pronounced nasolabial folds (in my mid 30s)? (Photos)

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

I do think that dermal fillers would be the best method to soften your nasolabial folds. Peels, ointments and ultrasound will not be of benefit for this issue. There are a variety of fillers that could be used, so be sure to discuss the options with the physician who might be treating you.

The best treatment for the folds are the fillers because they will smoothen out the difference in volume. For the folds peels will not work there. Peels are good for fine wrinkles. They cannot smoothen the difference in volume. For the 11 in between you eyes, botox or a nueromodulator like xeomin or juveau or good. They paralyze the muscle that causes the 11 and will help soften it over multiple treatment sessions.

I am assuming that you have not had any fillers at all to date, including to your lips?
If so, based on the pics provided, it would seem that you are beginning to experience mid face volume loss in your cheeks and under your eyes causing some of the skin to begin to sag, giving you the lines that are visible.
Improving personalised skincare would always be an important adjunctive action for anyone undergoing skin treatments but in this case, they will only do so much - skin needling, RF microneedling will stimulate collagen and improve skin texture and quality, but may not completely take away the lines if they are due to volume loss in the mid face.
It would be best to find a doctor you can build a relationship with who can help you personalise your treatment plan and then begin to work with you on it.

Thank you for your question. Skin care, peels, and laser treatments treat the skin surface and textural issues, such as fine lines and wrinkles. However, it seems that you are concerned with facial volume loss leading to pronounced folds, and these treatments will not be effective for that. While blindness is a concern for filler injections in the tear trough or the glabella region (for the 11's), it is not one of the most common risks for filler injections in the nasolabial folds. However, there are other risks, such as accidental blood vessel injection which can lead to necrosis (tissue death) and wounds in the area served by the affected blood vessel. Fat grafting is an alternative to facial fillers, but like any medical procedure, it comes with risk. Some alternatives include PDO threads or Instalift to pull up on the sagging skin, but this is not a permanent solution. (Fillers are not permanent either). I recommend that you see a fully-trained plastic surgeon for a full facial analysis, and discussion of different options and their risks, benefits, and alternatives to see what will work best for you.