What’s the recommended dermal filler and placement for correcting my nasolabial folds? 34 years old and side sleeper (Photo)

Question

I am interested in correcting my nasolabial folds with a dermal filler. These folds started to appear about 3 years ago. I am now 34 and have a naturally large and round face, so I suspect these folds are from a combination of 1.) midface sagging/loss of volume due to age and 2.) being a side sleeper (my left side is deeper).

Hung William Song, MD · Answer

Just about all of the FDA approved fillers are indicated for treating nasal labial folds. The choice of filler depends on how long you want it to last and whether your doctors feels you should get a deep or more superficial injection. Hyaluronic acid fillers are fine, calcium based filler may last longer or a PMMA based filler (Bellafill®) stimulates your own collagen and can last 5 years or more. The other option is to use your own fat. This is a long term solution and can allow you to get more volume. In addition to or even instead of filling the nasal labial folds directly, filling the lateral and medial cheeks can help to soften the nasal labial folds.

Nima Shemirani, MD · Answer

Hi @Twopointohgarden! I would recommend a hyaluronic acid dermal filler like Restylane Defyne or Refyne into the piriform fossa and nasolabial fold to help soften the area. You would also be a great candidate for Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting. Best of luck, Dr. Nima!

Jonathan Kulbersh, MD · Answer

The nasolabial folds can be treated using a variety of fillers, including Juvederm, Restylane, Restylane Lyft, and Restylane Defyne. Defyne has become an especially popular option for this area, as it fills in the creases nicely while maintaining natural facial movement. Results can also last up to 18 months with this product. However, it is more important to choose an experienced, board-certified injector for your procedure who has the expertise to select the right product for you based on your specific needs and goals.

Jason Emer, MD · Answer

folds need fillers, threads, morpheus for improvement.

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly, see linkt) should be started now to prevent further aging.

For facial rejuvenation,  I would suggest a combination approach of 
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.

Nelson Lee Novick, MD · Answer

Since your folds are really in their very early stage of development, you would likely profit from the use of a softer, cohesive filler, such as Belotero Balance placed--not directly into the fold (which would likely push the cheek upward and make the fold more obvious)--but medial to the fold to simply elevate and smooth the fold. It is difficult to say from the photos provided, but a bolus of lifting filler placed over the cheekbone regions may provide sufficient lift to soften the smile lines without even needing to directly treat them. This can best be determined in-person. Hope this helps. Best of luck.

Michele S. Green, MD · Answer

This is the most common area that patients ask for treatment in my office. You would benefit from one syringe of Restylane or Juvederm into these folds. Depending on your metabolism and the product selected, the results could last up to 18 months in duration. Each of these hyaluronic dermal fillers would give you a natural looking cosmetic result. Please consult an expert cosmetic injector for the best cosmetic results. Best, Dr. Green

Amanda Holden, MD · Answer

Hi!
This is a very common concern for our patients in their 30s. As we reach our third decade of life, we begin to lose a tablespoon of fat in our face each year, and this can start to create those annoying heavy folds in the lower face. Part of the problem is loss of volume in your mid-cheek, which holds up that nasolabial fold. I typically recommend a combination of filler in the cheeks and some filler in the nasolabial folds as well. For the cheeks, Voluma or Restylane Lyft would be a great option and would recommend 1-2 syringes. For the nasolabial folds, I would recommend 1 syringes of Restylane Defyne or Vollure!

Camille Cash, MD · Answer

Hyaluronic acid fillers will give you a nice improvement.  You will want to address the cheek as well as the nasolabial fold for a smooth contour.  You can also consider Morpheus8 treatments to improve overall skin tone and texture as well as stimulate collagen production.

Anteneh Roba, MD · Answer

Any of the Hyaluronic acid fillers that are used for mid to deep folds would work including those that are good for cheek filling.

Rebekah M. Zaluzec, DO · Answer

Hi Twopointohgarden- 
You have a few options here. Your nasolabial folds, while bothersome to you, are not very pronounced. It is important that we keep some transition point there, and not complete efface them. Generally what is recommended first is to lift the mid face with a deep filler, such as Juvederm Voluma or Restylane lift, then address the nasolabial folds if they continue to remain overly deep. I prefer a filler with good movement and "stretch" for that area. Two that I like are Restylane defyne or Juvaderm Vollure.

What’s the recommended dermal filler and placement for correcting my nasolabial folds? 34 years old and side sleeper (Photo)

Answers (17)

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