Where to fill: cheeks to lift nasolabial folds or just nasolabial folds? (Photo)

Question

Where to fill: cheeks to lift nasolabial folds or just nasolabial folds? Best filler for a natural look. Or non filler treatment? or cream suggestions to rebuild collagen and get rid of sun spots.

Nelson Lee Novick, MD · Answer

From the photos, there appears to be flattening of the central and midfacial cheek region with reasonable volume prominence over the cheekbones themselves. For this reason, a nonsurgical mid-face rejuvenation with a volumizing filler would not only restore the more youthful and feminine roundness to the central face, but secondarily improve the smile (nasolabial) lines likely without any need for the direct injection of a filler into the folds themselves. In my NY practice, I would choose Juvederm Ultra Plus XC for this purpose and in my Israel satellite facility, where a far greater number of regulatory agency approved volumizing fillers are available, I would opt for Princess Volume. Treatment in this fashion typically engenders an immediate "Wow!" reaction. For "sunspots" and other pigmentary irregularities, you might consider starting with the nightly application of an OTC retinoid, such as Differin Gel. If additional treatment is necessary, a series of superficial peels using high concentration glycolic or salicylic acid, Jessner's solution or low strength TCA are in order. You would be wise to seek treatment by a board certified aesthetic physician and to be especially cautious for claims for this or that fraxel laser or other light or energy-based devices, as, despite the heavy marketing, the hard science for the true benefits for these relatively expensive treatments is unfortunately still lacking. Best of luck.

Nima Shemirani, MD · Answer

Hi @Is.3187! You would be a great candidate for PDO threads and cheek fillers. Restylane Lyft and Juvederm Voluma work great for lifting the cheeks and to help soften the nasolabial folds. Best of luck, Dr. Nima!

Jason Emer, MD · Answer

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

Arezou Yaghoubian, MD · Answer

To best answer your question we would need to see a picture of your whole face or at least your entire cheeks to see  what would work best. Usually a combined approach works best in patients with a thicker filler like volume in your cheeks and moderate thickness filler in your nasolabial folds. Please see a board certified plastic surgeon or dermatologist for the best results.

Lawrence Janowski, MD · Answer

The best results would be from a combination of fillers in the nasolabial folds and anterior cheeks, combined with threadlifting to lift the jowl and lower face area.  I prefer MINT threads, Restylane Lyft for the cheeks and Restylane Defyne for nasolabial folds.

Center for Aesthetics and Plastic Surgery - Grand Rapids · Answer

Hello there! I would prefer to examine the whole face to give the best recommendations, but with what I can see, I think combining treatments would be your best option. 
Firstly, I would start by addressing these beginning signs of laxity with Ultherapy. This is a procedure that addresses deep collagen and elastin to lift and tighten the face. By starting to target these issues now, you are investing in the future health of your skin, and are preventing more laxity from setting in. Treating the lower face and neck should help to decrease some of the nasolabial fold depth. I would recommend this prior to injections, since this procedure can potentially affect filler. 
In regards to filler, you have beautiful cheek volume already, so I would be hesitant to add any more volume there. I would inject a small amount of filler in the residual nasolabial fold and below the mouth. This would address the visible shadowing in this area, and would really help to give a more youthful look.
Lastly, medical-grade skincare is ALWAYS the best for your skin. Medical-grade products penetrate deeper, and are always more effective. Every patient should be using this type of skincare, because the consistent use will greatly slow the aging process. 
Good luck! Sarah RN BSN

Carmen A. Traywick, MD, FAAD · Answer

Thank you for your question. To get some lift on the nasolabial fold, placing filler into the cheeks will help lift. You can also consider injecting both but focus on the cheeks first. All fillers tend to appear natural if doing subtle amounts. Resylane and Juvederm lines are great injectables to use. Topical creams and fillers do separate things for facial rejuvenation, it just depends on what you would like to target or treat. Next step for you is to schedule a consultation with a board certified dermatologist or plastic surgeon. Hope this helps.

Josie L. Tenore, MD · Answer

In looking at these photos, and depending on the "look" you are after I would start with cheek augmentation. 
If you want the most natural, sculpted and restored look, I start with placing Juvederm Voluma along the lateral aspects [sides of the cheeks]. I would then re-evaulate how you like that look and then add some volume in the cheeks moving towards the nose, and possibly  putting some filler in the tear trough [under eye area]. The best filler for those areas are either Juvederm Volbella or Restylane's Refyne. I would let all of that settle down and take some after photos before deciding on whether the nasolabial folds need to be treated.

Where to fill: cheeks to lift nasolabial folds or just nasolabial folds? (Photo)

Answers (9)

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