Alternative to dermal fillers for nasolabial and "marionette" lines? History of anaphylaxis (Photo)

Question

I am a 40-something woman with a history of anaphylaxis. I have tolerated (and benefited from): IPL photofacials, Fraxel and derma-rolling and had ultherapy (no side effects, no benefit). Formerly very confident about my appearance, I am unhappy about nasolabial folds. I understand that lasers, RF and IPL cannot really address nasolabial lines. Surgery is not an option at this time. Do any alternatives for addressing the nasolabial folds remain?

Nima Shemirani, MD · Answer

Hi @Stephanie Falcone. PDO threads are a great option for softening the nasolabial folds.

Best of luck,

Dr. Nima

Jason Emer, MD · Answer

I suggest seeing a cosmetic dermatologist with experience in using fillers that are more permanent.  Best, Dr. Emer.

Afshin Parhiscar, MD · Answer

Dear StephanieAnaphylaxis is a general term and if you have had  a reaction to one medication, it does not mean that you will react to another. In order to see if its safe to have fillers, more information would be helpful.Frankly facelifts minimally improve  nasolabial fold and unless one does a midface procedure, Nasolabial folds improve in a limited fashion with facelifts. In my experienced and based on what I know, Ulthera does little for Nasolabial folds.If you do not want fillers, one good option is to use your own fat to enhance your cheeks and soften your nasolabial folds. I think an in person discussion with an experienced surgeon certified by the American Board of Plastic Surgery who has comprehensive training to offer you the entire spectrum of options is likelyto help you make a safe and well informed choice.

Alix J. Charles, MD · Answer

Thanks for your question.  I still think your best options for correcting these areas are with injectable fillers.  Provided your skin laxity is not an issue, you can achieve some spectacular results if a physician has an eye toward global revolumization of your face.  Please find a skilled injector with whom to consult as they might make recommendations about filling the upper and mid face (temples, cheeks, etc) that would have a positive impact on the appearance of your nasolabial folds and marionette areas. Best of luck to you!

Edwin Ishoo, MD · Answer

Having ruled out everything else, reduction of your nasolabial FOLD (not just line) will need volumizing the cheeks or the fold itself. Ultherapy would be a good way for you to maintain mid face volume moving forward.

Robert T. Buchanan, MD (retired) · Answer

Anaphylaxis is quite specific to a particular allergan. Most fillers are non allergenic, and, unless the anaphylaxis was due to one of the ingredients in the filler, there is no reason to avoid fillers. However, if you wish to do so, then your own fat can be used instead. Make sure whomever you see can do both dermal fillers and fat and is an expert injector. (ExpertInjector.org)

Alternative to dermal fillers for nasolabial and "marionette" lines? History of anaphylaxis (Photo)

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