21, male - What can I do to reduce my nasolabial folds? (Photos)

Question

Im 21 and ive had these extremely obvious and annoying smile lines for years now, I know its genetic probably but i dont want that to stop me. I cant stop thinking about them they look so obvious and its all i see and probably the first thing someone notices on my face. i try to find the reason why they're genetically there, Maxilla retrusion? Skin elasticity? Dehydration? Poor zygomatic support? Malar fatpads? I havent figured it out, everyday i look at peoples faces wondering why i have them and no one else ive seen so far has the kind i do. I dont know what would work for me and at this point im desperate and willing to do everythint from implants to le fort just for a chance of reducing them. But I first want to know what the best options for me are. I have a good skincare routine, and i have tried profhilo none of these have helped, ive been leaner before and fatter/more bloated, that also does not help maybe slight differences but nothing relevant. Some details about them, they're completely non existent in lighting that strikes my face directly from the front atleast such as a ring light. Or looking up at a light source, they're only reduced slightly when i artificially lift my face up from the sides, yet completely dissapear when i suck in my lips tightening the skin. day to day they dont change much in prominence but dehydration and bad skin can make it somewhat worse. I was thinking pyriform fossa deep injected filler, with maybe some at the cheek or malar.

Anna Chacon, MD, FAAD · Answer

I can tell you've spent a lot of time trying to understand why your nasolabial folds are so noticeable, and you've clearly done your research. The important thing to recognize is that when these folds are present at 21 years old and have been there for years, they're much more likely to reflect your natural facial anatomy than premature aging.

From your description, several possibilities could be contributing. Facial bone structure, the way your cheeks are supported, the position of the malar fat pad, and the shape of the tissues around the mouth can all create deeper folds in someone who has otherwise healthy skin. The fact that they almost disappear with direct frontal lighting and become more noticeable with side lighting suggests that the issue is largely one of facial contour and shadowing rather than poor skin quality.

You also mentioned that they disappear when you tighten your lips. That tells me skin laxity is probably not the primary problem. Likewise, since you've noticed very little change with weight fluctuations, hydration, and Profhilo, those are probably not the main drivers either.

Regarding treatment options:

Deep pyriform fossa filler can be an excellent choice in carefully selected patients because it provides structural support at the base of the nose, which may soften the upper portion of the fold without overfilling the fold itself.
Conservative cheek or midface filler may also help if there is subtle volume deficiency or inadequate support in that region. The key is restoring support rather than simply adding volume.
Injecting filler directly into the nasolabial folds should be done cautiously in a young patient. Overfilling the fold itself can create an unnatural appearance without addressing the underlying anatomy.
Procedures such as subcision are more appropriate if the fold is tethered beneath the skin, but not every patient has this type of attachment.
More invasive procedures such as facial implants or Le Fort osteotomy are generally reserved for patients with significant skeletal abnormalities causing functional or major aesthetic concerns. Based on your description alone, I would be very hesitant to consider those solely for nasolabial folds.

One thing I would also encourage you to keep in mind is that we naturally notice our own features far more than other people do. When we spend a lot of time examining ourselves in mirrors, photos, or different lighting conditions, it's easy for one feature to become the focus of our attention. Others usually perceive the face as a whole rather than concentrating on a single line or fold.

At your age, the most successful approach is usually a conservative, anatomy-based treatment plan that supports the facial structure without chasing complete elimination of the folds. Because these folds appear to be part of your natural facial anatomy, the goal should be to soften them while preserving a balanced, natural appearance rather than trying to erase them completely.

21, male - What can I do to reduce my nasolabial folds? (Photos)

Answers (1)

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