Best way to soften nasolabial folds? (Photo)

Question

I attached a picture taken with a regular camera at a slight distance so as not to warp the image with my cell phone camera. As you can see I have very deep lines around my mouth that I'd like to make less noticable. I've already had 1 syringe of voluma split between both cheeks in the apple. I felt it helped my face look less tired but it didn't remedy the folds. I understand that filling the folds directly is frowned upon but not sure what my other options are? Thank you!

Nima Shemirani, MD · Answer

Hi @CG1990! I recommend starting with 1 syringe of Restylane Defyne in your piriform fossa to smoothen out the NLF. Best of luck!

Suzette Miranda, MD · Answer

Thank you for your question and picture. With time, gravity or genetics, our faces can lose volume and our nasolabial folds can become more highlighted because there is thinning of the dermis with less collagen and elasticity. Voluma can help lift as it adds more volume to the upper cheek area, making them less apparent.  However, you can also certainly fill the nasolabial folds with a hyaluronic acid filler like Juvederm to help decrease the prominence of this fold. It is natural to have nasolabial folds but you should see a plastic surgeon who can help minimize their prominence and help give you the a more rejuvenated look. Good luck. 
Best wishes, 
Dr. Suzette Miranda

Jason Emer, MD · Answer

There are a lot of options for improving the nasolabial folds and this often means fillers for the folds themselves but also lifting around the mouth and cheeks to build underlying anatomical support. In our practice we combine sculptra with other fillers "layered" on top and lasers, rf treatments, J Plasma and peels to get the most conservative natural look. Please see a facial sculpting expert. Best, Dr. Emer

Alex Eshaghian, MD, PhD · Answer

Thank you for your question and for sharing your photograph CG1990.
I understand your concern. Fillers are used to restore lost volume in and
enhance the appearance of the face.The nasolabial folds are the lines that go from the sides of the nose to the corners of the mouth. Sometimes they extend as the marionette lines all the way down to the jawline. Nasolabial folds are actually very natural and are seen in children. However they can deepen over time. In order to address such concerns it is important to understand the underlying cause. Nasolabial folds get deeper over time because of structural changes in the face and collagen loss. The fat pads in the mid-face get smaller and the cheek bones move downward and inward over time. Collagen, the protein that maintains a firm and youthful appearance is slowly lost and with gravity structures move downward. To address these concerns fillers and energy-based devices are used.Fillers such as Voluma can be placed in the upper cheeks to restore the lost volume in the mid-face. Now many physicians address nasolabial folds by first placing Voluma in the upper cheeks. This has several advantages of placing fillers directly in the nasolabial folds as we had done previously. It addresses the cause of the concern, rather than the result. It also restores the youthful apple of the cheek. It does not lead to puffiness in the lower face. It can also address marionette lines and jowls and improve jawline definition. Finally it lasts longer than previous products which were injected directly into the nasolabial folds. For my patients I usually start with a conservative amount of Voluma in the upper cheeks such ass 2 syringes. We assess the results 2 weeks later once the swelling has subsided. At that point if further enhancement is desired either more Voluma can be placed in the cheeks or a filler such as Vollure can be placed in the nasolabial folds. The later option is more common in young patients.To address collagen loss, energy-based treatments such as fractional CO2 laser resurfacing, laser skin tightening, or radiofrequency can be used. These methods heat up to skin and stimulate the skin to form its own natural, new, fresh, and healthy collagen. This will tighten the skin and pull up on the nasolabial folds. I find that for my patients a combination approach works best.
Please consult with a doctor for specific
recommendations.  Good luck!

Maurice M. Vick, Jr., MD · Answer

Nasolabial folds can often be improved by lifting fillers like Voluma in the lateral cheek areas. If they still persist I further "soften" them with a filler like Vollure or Juvederm ultra plus into the NLF. Best Wishes, Maurice Vick MD

Renata Wix-Harris, MD · Answer

After using Voluma or threads to restore volume to the midface and  lift the cheek, I like to use the newer fillers like Restylane Define or Restylane Refine for the nasolabial folds. They blend and move really well with your own tissue giving it a very natural appearance. Make sure you see an experienced board certified physician. Good luck!

Richard E. Moore, MD · Answer

Thank you for your question and submitting your photos. It is quite common to still use filler in the nasolabial folds (NLF). The key is to soften the folds without overfilling. Filling out the cheeks to lift the angle of the NLF is often combined with placing filler in the NLF. There are a number of fillers that can be used in this situation. In fact, the majority of the fillers on the market have their principal FDA indication for filling of the NLF. Another option is ALMI which yields a very natural appearance using a small amount of fat harvested from your body, micronizing it and combining with platelet rich plasma. This removes the mature fat cells and gives a very predictable result with no downtime. The advantages are that it is all natural, long lasting, and predictable. Further, a small amount of fat can be micronized to restore volume to the entire face. I hope this was helpful - Dr. Moore.

Best way to soften nasolabial folds? (Photo)

Answers (7)