Nasolabial Folds - Best Way to Remove Them?

Hi : While considering fillers for removing the naso labial folds ( very mild) what is the best technique ? Fill the folds or use fillers on the cheeks to lift it ? I have high cheek bones already and i am aftraid I may look over dobe. And also this will be first time I am considering fillers. Is it good to start with Juvederm then Perlane ? I am very familiar with all the fillers and have done enogh reading over the past few months.

Doctor Answers 6

Best method for removing nasolabial folds

It is often not a good idea to remove nasolabial folds completely, by any method.  It is usually better to soften them.  If the nasolabial folds are "build up" to the level of the ptotic cheekpad above them, or the lip below them, this can result in an overaugmented appearance, as though the patient had something in their mouth.

If the nasolabial area is augmented, the cheek area (malar, possibly submalar) regions may benefit from volume augmentation as well, in order to prevent a disproportion from occurring.

For mild nasolabial folds, hyaluronic acid fillers are usually adequate.

For deeper lines, the patient may want to address what is causing the folds.  Sometimes, this means a volume adjusting facelift, a cheeklift, or both.  Volume alone can't overcome drooping plus volume loss.

Large volume augmentation of the face is possible.  The" liquid facelift", large amounts of temporary filler, offers a quick recovery, but expensive and temporary, fix.

Fat injection is a popular option as well to multiple areas of the face.

In our practice, we prefer autologous fat fascial grafts for this purpose (LiveFill).

In rare patients, excision of the nasolabial folds is an option.

So in deciding which option to choose, it is nice if your doctor is familiar and skilled with all of the options above, and understands the proportions of the face.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Best fillers for Nasolabial lines.

If the NL lines are just thin lines then juvederm or restylane ($550/syringe) is good and lasts about 4-6 months.  If the NL has grooves or wider, deeper creases then Radiesse ($600/syringe) is great and lasts about 1 yr.  Most patients need 2 syringes to do either  job.  Sincerely,  

David Hansen,MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

Fillers to improve nasolabial folds

Thank you for your question. In my opinion, fillers work very well for improving nasolabial folds. Nasolabial folds can be secondary to cheek descent and by adding volume to the cheeks the folds will improve and then any residual folds can be improved with fillers. For natural results, I would recommend to soften the folds and not fully remove them.

I hope this helps. Best wishes. Dr. Salameh (Plastic surgeon - Bowling Green, KY)

Bernard S. Salameh, MD
Bowling Green Physician
5.0 out of 5 stars 17 reviews

Nasolabial Folds - Best Way to Remove Them?

Injectable fillers (restylane, perlane, juvederm, radiesse, sculptra, your own fat) are good ways to soften (not remove) deep nasolabial folds.  They can be injected directly into the folds and in the cheeks above.  The key is to go to a very experienced injector because a lot of physicians and non physicians are claiming to do this now.

Ramtin Kassir, MD, NY, NJ Facial Plastic Surgeon

Ramtin Kassir, MD
New York Facial Plastic Surgeon
4.7 out of 5 stars 143 reviews

Fillers for nasolabial fold

Without photos or a face to face examination I cannot say what would be best in your case. Prior to the advent of dermal fillers facelifts were recommended to lift the cheek fat so it would not hang over the nasolabial folds. The problem was this made them look better but did not efface the very deep folds enough. This led to the use of fat grafts to the area placed at the time of facelift surgery. Now we have dermal fillers and this has saved many patients from surgery with its associated higher costs. The current standard is to inject filler directly into the fold to efface or fill it. Every doctor has his or her favorite way to inject and favorite filler to inject. I prefer Radiesse in the nasolabial folds because it lasts longer than most other dermal fillers. Patients like this because they then do not have to come back so often and it is cheaper over the long term.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Fillers and the folds

Placing fillers in the nasolabial folds will help soften a bit. You do not want them to disappear completely because that would look strange.  And yes, sometimes lifting the cheeks a bit with fillers or surgery will soften them as well.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.