I have very deep nasolabial folds. What would you recommend: fillers or laser treatment? Or microneedling? (Photos)

Hi,Thank you for including your pictures. There are many good fillers that can be safely injected into the nasolabial fold to soften their appearance. In some patients, volumizing the cheek can provide a lift that both improves the appearance of the cheek and the nasolabial fold. Another option is to lift the cheeks with absorbable sutures (Silhouette InstaLift) - this procedure helps to resuspend the cheek in a higher position and also acts as a volumizer by stimulating collagen production. I recommend visiting a facial plastic surgeon who can examine you and go over their recommendations in detail.Best,Mehdi Sina, MD

Cosmetic injectable fillers like Juvederm Ultra Plus or Restylane Defyne work well in this area--but do not remove the entire line; complete removal will make you look artificial.  I suggest 2 cc total for your nasolabial lines and also suggest you consider treatment of your marionette lines just below your mouth with the same.  If you want a more natural look, under treat these areas.  I would not recommend lasers or microneedling; microneedling is most useful for rejuvenation of the skin itself, particularly with Platelet-Rich Plasma, but not so good for filling wrinkles due to volume loss from aging.  I am confident you can get as much improvement as you wish.  Garry R. Lee, MD, Look Younger MD