What’s the best long term solution to my deep nasolabial folds? (Photo)

For a more permanent solution to deep nasolabial folds I would recommend a "lift" procedure with Microaire midface endotines. Your cheek can be elevated without changing the shape or size and the folds will be markedly diminished. The procedure can be accomplished in the office with IV sedation. Recovery takes about 3-5 days. This is an excellent procedure for lifting the midface.   

Hi @lacybunny! I recommend Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting.

I recommend 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

Thank you for your pictures and questions. I can appreciate your concerns. I think that a lot of your issue also comes from the fullness in your cheeks which you will lose somewhat with aging, so be careful about what you choose. I think fillers are a great option but yes they do fade with time. Fat grafting would be a good long term solution but I would be very careful about over-correcting this area and I think long term as your cheek volume decreases, it will change your facial dynamic. Best of luck!

Structural fat grafting in the nasolabial folds and on your cheeks will give a long and durable result.  it’s best that you have a consultation with a board certified plastic surgeon to discuss all of your options.  Thank you

The best option for nasolabial folds is filler which typically last 1 year. I like the newer generation flexible gel hyaluronic acid based fillers Restylane Refyne/Defyne when treating the laugh lines. Fillers could also be injected into the midface/cheeks to address age related volume loss and to lift the face. Sculptra is a collagen stimulating filler which gives results that last up to 2.5 years. 

Hello and thank you for your photo's and question.  I also inject fat into nasolabial folds since it is fairly permanent.  Visit a Board Certified Plastic Surgeon in your area for a consult and tell him or her your concerns.     

For areas such as nasolabial folds we suggest longer lasting fillers such as Voluma or Sculptra.  Both last up to 2 years

Your situation appears to relate to a combination of fullness of the soft tissue 'above' the fold; and a lack of bone support just below the fold. Fillers are good short term solutions but the long term approach is to have a tapered gortex-like material placed 'on the bone' underlying the area. This will 'blunt' the top end of the fold specifically and is a long term solution, especially with aging where the lip tissue 'falls back' against the bone over time.