Are there any options available to help with my sagging nasolabial folds other than a surgical face lift? (Photo)

Question

33M I've lost about 150lbs in about 18 months through diet and exercise. I now have very pronounced nasolabial folds. Is there any options other than a surgical facelift that could effectively improve their appearance? Any laser therapy or micro needling etc? I'm still currently losing weight and am working towards losing another 40-50lbs.

John Reilly, MD, FACS · Answer

Hello,

Congratulations on your weight loss! Losing weight can have adverse effects on facial fat. Areas of flatness in the face especially where there should be curves or fullness can be fixed with volume replacement. The best way to do this initially is with a filler since it is temporary and can be reversed immediately if you don't like it. Adding volume to the cheeks, in a much smaller amount than a female, is a very positive Improvement in facial aesthetics. If you like the filler result you can use your own fat for a more permanent solution. Facelifts, no matter what technique, do not provide reliable long-term correction of the nasolabial folds in many patients.

Thomas A. Mustoe, MD, FACS · Answer

On your pictures you have lost volume in your cheeks in addition to deep nasilabial folds. Your best option would be a deep plane facelift to reposition cheek mass which Would soften folds. Adding fat transfer to folds at same time would also help. Direct excision is also an option.  The scars are well hidden in the crease of the nasilabial fold but that Would not reposition the sagging midface.

Tanveer Janjua, MD · Answer

In some extreme cases of prominent nasolabial folds a direct excision can be performed. The scar falls into the natural nasolabial line and heals well. Sometimes even a facelift might not improve the nasolabial fold in a significant way. 
Regards
Dr. J

Ajaya Kashyap, MD · Answer

Thank you for your query. Hyaluronic acid  fillers will be very helpful for your problem.  Once you have lost more weight, additional  fillers can be injected. This will  improve both your naso-labial folds  and the loss of volume. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Robert M. Wald, Jr., MD · Answer

Micro needling and laser therapy will not help these folds. A facelift will help. You can also do direct excision of these folds which helps considerably but will leave you with scars. I would loose all your weight before considering any treatment.

John Michael Thomassen, MD · Answer

After your complete your weight loss, a temporal cheek lift procedure will lift your cheeks and efface your nasolabial folds.  Fillers will not be effective.

Jacob Tower, MD · Answer

Hello, hope you are well. I would be very curious to see your face from a profile (side view). My guess is that the shape/projection of your cheeks is relatively flat and volume deficient. Placing cheek implants can help to support the skin-soft tissue envelope from beneath to reduce the appearance of sagginess. Losing weight caused volume loss and revealed these pronounced nasolabial folds; replacing that volume in the form of implants can help reverse that effect.

Best,
Dr. Tower

Best,
Dr. Tower

Michael P. Morrissette, DDS, FACS · Answer

I am seeing this problem a lot with the weight loss medications. Patients are losing fat volume in their faces as well as their bodies. The volume needs to be replaced. Both the flatness of your lower eye region and the depth of the nasolabial fold can be improved with lower eyelid cheek implants. These will lift the midface and restore loss volume. Biostimulatory fillers a another option but are only temporary. Cheek implants are permanent but reversible as well.

Michael I. Echavez, MD · Answer

In my opinion, there are two treatments that could improve your nasolabial folds without doing a facelift.  One option would be using a filler to add volume above your nasolabial folds.  This generally will help pull the nasalabial folds back and improve their appearance.  The other option would be directly excising the excess skin of the nasolabial folds.  This is a much simpler procedure than a facelift and would bring more improvement than a facelift generally would.  I would recommend doing the filler first and then see how much better the nasaolabial folds improve.  You could then do the surgery to remove any excess skin if needed.

Michele A. Shermak, MD · Answer

Hello and thank you for your question. 
You can avoid surgical management. The face has defined anatomical fat compartments both superficially and deep in the cheek area. With your significant weight loss this area has deflated. If the area was treated with a hyaluronic acid filler like Voluma or Contour, or with a biological stimulator like Sculptra, you would see improved fullness in the cheek that pulls up against the descent of skin over the nasolabial folds. Skin treatments like Sofwave in conjunction with filler would provide great results with lift and refreshing fill. You can definitely go nonsurgical. Be sure to see a board certified plastic surgeon. You can find one at plasticsurgery.org. Best of luck to you!

Are there any options available to help with my sagging nasolabial folds other than a surgical face lift? (Photo)

Answers (18)

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