What to do about nasolabial hollows on the sides of nose? (photos)

Question

Hi I'm 26 and ever since my late teens I had these weird almost circular hollows directly under my nose and at the sides of my philtrum. In certain lights that area looks caved in and makes my philtrum protrude oddly. I finally want to correct this issue but I don't know what is the best treatment. Is there a long lasting injectable that can take care of it? Or will I need a more permanent solution?

Nima Shemirani, MD · Answer

Hi @n6A2y07a3! I would recommend getting dermal filler in the piriform fossa. This can help with the hollowness you are noticing under your nose. My filler of choice for this area is Restylane Defyne. Best of luck to you!

Muhammad Mirza, MD (license suspended) · Answer

Thank you for your question and for providing pictures. For nasolabial lines, Juvederm is the filler of my choice. I would recommend scheduling a consultation with an experienced injector to determine which filler is the best for you.  All the best!

Philip S. Schoenfeld, MD, FACS · Answer

It appears that you have maxillary hypoplasia in the area of the pyriform aperture of the nose.  Augmentation of this area with any number of fillers will be effective.  Care should be taken as this area is highly vascular and one needs to avoid intravascular injection in this area.  A more permanent solution would be an implant but I would advise against this in this particular area and would definitely try and HA filler or Radiesse first.

Houtan Chaboki, MD · Answer

Hollows on the side of the nose and smile lines are often treated with filler. For patients with more advanced hollowing, then surgery with implants or bone advancement may be considered. If you haven't already, then you can speak with a facial plastic surgeon to review options.Best,Dr. Chaboki

Jason Emer, MD · Answer

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting,  and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Shaun Patel, MD · Answer

A small amount of an HA filler like Restylane Defyne will soften the superior aspect of your nasolabial folds.

Jo Herzog, MD · Answer

Quite honestly, if you were my patient I would try to talk you out of doing anything unless you were really obsessed and disturbed by this feature. I think that this is a normal facial feature and does not look like it needs fixing. However, if it really bothers you there is no harm in using a soft HA filler to fill and if you like it you can continue in future and if not, it will slowly disappear.

Robert L. Kraft, MD, FACS · Answer

Sometimes, less is more. I would not try to upsell you on a bunch of treatments which will probably not achieve much.   step one would be filler. The thicker fillers last longer but also can be more noticeable. I would begin with Restylane or Radiesse and let you see whether the improvement is adequate.   It can always be augmented. Your skin looks good and I do not believe that you need non-invasive treatments that offer no guarantee of improvement.

Michael L. Workman, MD (retired) · Answer

This area can be addressed with filler placed in the midface and deep onto the pyriform in the corner of the nose to help structurally lift and volumize this area. A filler such as Volume can last up to 2 years.

Gerald Wittenberg, MSc, DMD (retired) · Answer

It is always important to understand the origin of the concern. The "folds " occur at your age due to the shape of the underlying bone of the upper jaw and the support by the teeth. Short term fillers help but the long term solution is to augment the bone surface under the folds for support. Using material on the bone from  inside the mouth does work well for your situation.

What to do about nasolabial hollows on the sides of nose? (photos)

Answers (10)

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