Get the real deal on beauty treatments—real doctors, real reviews, and real photos with real results.Here's how we earn your trust.
My first response to your question is that everyone has somedegree of nasolabial folds and they are a natural part of our face. Whenthe folds extend below the corners of the mouth the area looks drawn. This area becomes more pronounced with aging due to changes in facial volume,laxity and cheek descent. It would be ideal to see a full picture of yourface and have you come in for a consultation to give you the most comprehensiveevaluation. However, if you are more inclined to doing something that isnon-invasive to begin with and you had a consultation and were deemed asuitable candidate, then I might recommend adding volume to your midface with either Sculptra orVoluma and then adding fillers to the nasolabial folds with hyaluronic acidfillers and Radiesse. If you wanted a surgical approach with longerlasting results, then a midface lift or facelift with fat injections may berecommended, again after a comprehensive consultation and if you were deemed asurgical candidate.
Generally speaking complete removal of nasolabial folds is impossible and not recommended. Lessening, reducing and contouring are beneficial. Step 1 is a facelift- in your case, which will improve them somewhere between 50-80%, depending on the technique utilized. Step 2--- at the same time i would recommend reversible fillers or autologous fat to further improve the nasolabial folds.This combination of techniques will optimally treat this problem, restoring a more youthful face.
The other doctors who have answered so far have covered the topic very well. I believe there is one further option not discussed.This involves cutting the deep attachments of the fold with cutting wire or string. After the skin is detached, filler or fat is used to fill the area.The problems with using fillers alone when your fold is so deep is that the product can go on either side of the fold, and you might not get a good result.One doctor recommended cutting the fold out. This actually works really well, and I have had a lot of success with it. However, I would recommend you try other choices first.1- Try a common filler like Juvederm or Restylane. If they work then we can be happy. If they don't give you what you want then you can try something else. Rarely do you get a result that is worse than starting. Sometimes it is just not as good as you hope. It can always be dissolved if it works out poorly.2- Try my recommendation of cutting the attachments. This is done under local with needle and string-like devices. Fat is then used and is best. Since detaching the skin is done first, the fat can be placed more precisely and will have less of a risk of going on both sides of the fold.3- As discussed, a third choice is fold excision. Overall it will work very well but sounds scary. The incision is actual right where the deep fold is.4- Finally, face lifting techniques work really well too. This also should be added to the choices. It's more extensive and will rejuvenate other parts of your face. If you have and don't like your jowls or neck excess, consider this too.I hope this helps!Dr Chris Saunders
The presence of the nasolabial fold is a normal process that occurs with aging beginning in the fourth to fifth decade of life. When you look at the nasolabial fold you have to look at it as a process of cause and effect. The cause is loss of support in the cheek region that are keeping the fold from folding over upon itself. The second cause is loss of volume medial to the fold or closer to the nose. The effect is loss of volume with ensuing hollowing and depth to the region. This can be treated by supporting the cheek by lifting or volume replacement or by filling the hollow with either autologous or synthetic products. I hope this helps.
Best means something different to different people. One approach is to cut the extra skin out, this leaves a scar but could be done under local. You appear thin in the face and so fat grafting could be an option. Facelift is also an option. Each option has risks, scars, recovery and costs, so it is worth a consultation with a board certified plastic surgeon.
There is no "best" way to improve the NL folds. Try fillers or fat first but in your case the amount would be costly that you need. Or a direct excision of the "fold" but a potential scar is to be understood. Finally a mid FL operation...
Unfortunately you cannot remove them but you can make them less prominent.Injectable Dermal Fillers are a good option but they last for 12 months.I cannot see your whole face, but is suspect you have flat cheek bones. You can have injectable dermal fillers to the cheek as this will give you a 'fill and lift' effect.Surgical option are a mid face lift.All the best
I generally work from more conservative to more aggressive maneuvers. In your case I would first attempt to inject superficially with some thinner HA type fillers. However, these injections must be done superficially and the result may either be not noticeable or with some lumps or ridges (which can be dissolved if need be). A mid face lift where the cheeks are lifted vertically would probably afford some benefit but probably not enough to significantly reduce the severity of your creases. I would seriously consider simple excision of the folds. This procedure is technically straight forward and simple and can be done under local anesthesia with very little discomfort or significant downtime. Yes there will be a trade for an incisional scar but that can be camouflaged much easier than your existing folds and there are several adjunctive things such as laser that can be done to optimize the scars.
Fortunately there are many safe and effective options for treating cheek folds. The most popular treatments are soft tissue fillers, Sculptra and abdominal fat transfer.Soft tissue fillers (Radiesse, Voluma, Juvederm, etc.) were the second most common minimally-invasive cosmetic procedure in 2012 and over 2 million procedures were performed (American Society of Plastic Surgery Statistics). Many products are available and they are all reasonably effective. The advantage of using fillers is that the results are immediate and the materials typically used are found naturally in your body. The disadvantage is that fillers can be expensive and typically only last about 1 year.Sculptra differs from soft tissue fillers in that it works by stimulating your body's collagen-producing machinery. Consequently, results are not seen immediately, but rather grow over a period of several months. Results are perhaps a little less dramatic than soft tissue fillers, but last up to 2 years. For best results, 3-4 treatments are required.In abdominal fat transfer, your own fat cells are gently harvested from your belly. These are then carefully washed and injected into areas of volume loss (in this case, your cheek folds). The advantage of fat transfer is that living tissue is transferred. Those cells that survive the process will be present forever! However, around the mouth the survival rate is rather poor, so more than one treatment may be required.
Deep nasolabial folds are very often seen as a result of facial fat atrophy. Recently, there is much more information available to the public to aid in their understanding of how changes in the facial fat contribute to facial aging.I invest time in educating my patients that aging is not a "one tissue issue," but involves the combination of: skin aging (loss in elasticity),the loss of facial fat and,osteoporosis of the facial bones. The best rejuvenation plan addresses the aging of the face in a more comprehensive way. Studies show that patient satisfaction with their cosmetic treatment goes way up with a comprehensive plan compared to a simple wrinkle treatment. Today, the treatments can be with injectable fillers, laser skin resurfacing and/or rejuvenation surgery.