Thank you for your question regarding over filling of NLF - naso labial folds. A common misconception is that we should get rid of things or fix things. You may often see a NLF on a four year old or a two year old. Obviously they are not looking old and that is simply a normal feature. Much of what happens to the appearance of the NLF over time is due actually to sagging of the mid face skin. As the skin starts to try to drape over the area to the sides of the mouth, above and below, there is a wave like phenomenom. The issue is more the wave itself than where it is going to crash. It is true that the beach (where the fold is headed towards (the lip) , does have depletion of hyaluronic sugars and deflate a little over time. So here is the issue: There is this snow that came off the mountain and is now piled up on the side of the road. And yes, the road did sink down a little, but not much. So what do we do? Shall we only build the road up with asphalt until it is as tall as the snow. Or shall we try to blow the snow off the side of the road and back up on to the mountain where it came from? I suggest we try to improve both of the issues. Whatever will help the skin get off the fold and back up onto the cheeks where it came from will help. What could be recommended would depend on age, sun damage, weight as a function of IBW, etc. Choices might include fillers over the zygomatic arch, in the infraorbital periosteum, at the back jawline, etc. Tightening devices such as RF (e.g. Thermage), highly focused ultrasound (e.g. Ulthera), lasers and more may be considered and give additional different benefit such as tightening and building of collagen. Too often people doing injections put filler in the NLF up and down as if it were a worm under the skin. And then that is what it can look like. There are different concepts of how to make a bridge between the wave coming down from the cheek and the slightly deficient volume in the peri-oral area in other words the NLF and more medially (towards the center of the lip). I think that most things are better viewed and treated as a together complex rather than as separate things. So the NLF can be viewed as the cheek plus the fold plus the lip... You should have a physician who is very experienced with fillers, facial contours and aging see you and give advice. The physician may suggest having your NLF filler partially dissolved and then after waiting some weeks having someone different treatment in the area that is to say something done in a different way. To have a different result, something will need to be changed and be different. This is all art work and not merely injecting. A key thing with all of this cosmetic "work" and treatment is to be patient. You can definitely have a different result and one that you really like. Good luck!
