Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. Based on what you’re describing — prominent nasolabial folds, marionette lines, and visible midface volume loss — I recommend filler as the most appropriate next step before considering any surgical or thread-based options. In many cases, these lines deepen not because the lines themselves need filling, but because the midface has deflated and descended, leaving the lower face looking heavier. Strategic, deep filler in the cheeks and midface support points can lift the tissue upward, which softens the nasolabial folds and marionette lines naturally without making you look puffy. Once that support is restored, only a very small amount of filler (if any) may be needed directly in the lines. Thread lifts tend to give only temporary, subtle results and can worsen tissue quality over time, and a full facelift would generally be reserved for more advanced skin laxity than volume loss alone.
