How many syringes of Juvederm to treat the nasolabial smile lines or would something else yield better results? Laser? (Photo)

Hi @jsherman101. I would recommend ~1.5 syringes for your nasolabial folds. In addition, 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. Best of luck, Dr. Nima.

Thank you for your question and photos. It does appear you would need more than one syringe to treat your nasolabial folds. You might also consider augmenting the cheeks with additional filler, which would further enhance the appearance of your lines. 
Filler is the most common option for treating nasolabial folds. While lasers might offer a myriad of skin rejuvenation benefits, these creases are usually too deep to respond well. To ensure an optimal outcome, make sure you are working with a board-certified dermatologist with ample experience and expertise in dermal fillers. 

Based on your photos, I would say it is likely you would need more than one syringe of Juvederm to treat your nasolabial folds. I recommend you schedule an in-person assessment with a board-certified plastic surgeon that will have the experience and expertise to customize your treatment to your precise needs and goals. This doctor should be able to choose a dermal filler for your treatment that will produce the best possible results. There are many different fillers on the market today and the right filler for you will depend on a variety of factors. The experience of your injector is the most important element in ensuring a successful procedure. 

Finding a permanent solution for lines around the mouth is challenging. There are many options such as filler injections, chemical peels, laser treatments (Nonablative as well as resurfacing) and of course mid face lifting and short scar face lifting.  It really depends on what you're specifically interested in and they're all sorts of combinations.
I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of facelift surgery but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.I hope my answer helps and if it does, please take a moment to up vote this answer on the “respond” button on the top right.  Have a great day.

My next to last patient this afternoon in my Israel satellite facility literally presented with the exact same problem. Since a far greater number of regulatory agency approved injectable fillers and skin boosters are available there, I chose to treat her with Profhillo--a bioremodeling filler--in selected locations around the mouth region to promote a natural lift for the smile folds followed by the use of Viscoderm Hydroboosters for directly elevating and smoothing the fine, etched in lines that had developed.  In my NY office, I would choose Belotero Balance for both lifting the fold and smoothing the more superficial etched in lines. Belotero possesses little to no tendency to give rise to the unwanted bluish-gray Tyndall Effect that may occur when hyaluronic acid-based fillers are injected very superficially as needs to be done in order to smooth very fine etched in lines. You would be wise to seek consultation with a board certified aesthetic physician and avoid non-core and non-physician providers and medspas that sell fillers by the syringe, rather than simply quoting, as any surgeon would for a surgical procedure, a total fee for getting the job done. Whomever you choose, you should make sure to ask to see his/her before and after photos before agreeing to proceed. Best of luck to you. 

Thank you for sharing your question and photographs.  I agree that you would need more than a single syringe and would focus attention on both your cheeks and smile lines.  By adding subtle volume to your cheeks it will help lift the skin creating the shadowing in your smile lines.  With your cheeks rejuvenated then place additional product in the smile lines to refine your results.  The smile lines often take more filler than anticipated, typically at least a full syringe per side.  Hope this helps.

The amount of fillers that are necessary per treatment area depends on how much volume is necessary. Your doctor would know just how much to inject and which type of filler to inject so that the effect is natural-looking. Do visit a trusted practitioner in your area to see if this treatment is suited for you.

Fillers are a very good option for treatment of nasolabial folds. Many patients require multiple syringes to achieve optimal results but it's important not to overdo it. Placing too much filler can lead to an unnatural appearance. I would recommend treatment by an experienced injector who can show you photos of their work.
An alternative to off-the-shelf fillers is fat grafting. Your own fat can be placed as a permanent filler and the stem cells in the fat improve skin quality. A fat grafting procedure is typically more costly than fillers but in the long run it may be more economical because repeated treatments over your lifetime are not necessary.

Thanks for your question and photos.  I understand your concerns about the depth of the folds around the mouth, but sometimes filling them with too much filler looks very unnatural and "simian" or monkey-like.  Your dermatologist should help you figure out what will make you happiest, perhaps a syringe of Voluma in the upper cheeks to lift the cheeks a bit off the folds, and a syringe of Juvederm to soften the lines around the mouth.  Be sure to take into consideration the way the mouth moves and looks while you are talking and smiling.  Sometimes filling folds to capacity "at rest" can result in nodules or an odd outpouching of the filler when you are in a full smile.  CO2 laser would be a great start also, and soften the lines a bit, but that does come with some downtime. Start conservatively, and you can always add more later.  See an expert and best of luck!

Thank you for your message! The nice thing about dermal fillers is that you can start small and continue to add more filler if your budget and schedule allow! Dermal fillers, such as Juvederm or Vollure, are a great option for the nasolabial folds. Often more than one syringe is needed to fully treat the area, though every patient has a different preference. Laser resurfacing would help to address fine lines and wrinkles, though would not erase deep hollows such as the nasolabial folds. Voluma, a thicker filler, can be placed into the cheeks to help lift the lower face as well! I would recommend a consultation with a provider in your area so they are able to fully assess you in person.