I'm not sure what to do about my nasolabial folds. Any suggestions? (Photo)

Question

I'm 33 years old and I'm the last 3-4 years my nasal fold have become so prominent. It's worse on the left side of my face with some sagging. I'm looking into a doing BellaFill or fat transfer.....My laser tech has resurfaced the lines endlessly over the last year, hence the redness, and she done lots of skin tightening, however I feel the lines haven't changed a bit and I have funny looking indents above and around that nasal Lasal folds now.... Any suggestions as to what about these? Thanks

Sammy Sinno, MD · Answer

I think you would be a great candidate for filler injection into the nasolabial folds; Juvederm or Restalyne would work nicely. Fat grafting is another option that is permanent, though some of the transferred fat may not survive long-term, thereby requiring additional volume augmentation. It is hard to see the indentations on the photographs but I believe anything significantly indented could be improved with filler or fat placement

Ifeoma Ejikeme, MD · Answer

Thank you for the photos. Its great to see dynamic as well as static photos. 
I would recommend combination treatment. The nasolabial folds often do not age people in isolation. You can look at very young children and you will see they have them. When you have nasolabial folds + a prominent naso-jugular grove  (The line from medial corner of the eye to the middle of the cheek) + volume loss in the cheeks ( sagging). These 3 items together lead overall to people wanting treatment. 
My answer therefore is to treat the underlying problem (volume loss) not the symptom (nasolabial fold). I would enhance your cheekbones and lift the mid face. This can be done with hyaluronic acid filler safely. This would naturally lift up the nasolabial folds.
Above in the photo I can see you smiling and you do not seem to have a gummy smile. If when you smile fully you can see more 2mm of gum then you would benefit from botulinum toxin to the sides of your nose which would also help reduce the nasolabial fold.
Please see a doctor in your area with expert knowledge of facial anatomy and dermal filler.
best of luck.

Robert W. Sheffield, MD · Answer

Your muscles of facial expression are quite active in thesmile lines. My suggestion is to use a dermal filler to soften the shadow areasalong the smile line. Micro needling with PRP (platelet enriched plasma) willlikely help as well. I would suggest you do the latter first then after twotreatments consider the filler if any shadows remain. The other considerationis to get more active in a skin care program based on the science of Retin A.This will help with your break outs, control the pigment issues and reduce yourpore size.

Nick Masri, MD, FACS · Answer

Based on your photos, you may want to consider getting a Botox treatment. It helps decrease the appearance of dynamic wrinkles, which you get when moving your face. Your nasolabial folds are a perfect example of such.
Another option is dermal fillers, which fills up these creases and plumps up your skin, making you more younger-looking. But as you’re worried about the indentations above your nasolabial folds, I would suggest Botox to be the better option at the moment.
Still, it’s difficult to provide you with all of your options without proper consultation. Better schedule a consult with a reputable and board-certified plastic surgeon so that he can properly assess your condition. Best of luck!

P. Alexander Ataii, MD- Account Suspended · Answer

I would recommend using a dermal filler such as Juvederm XC to fill in the lines and folds around your mouth.  Dermal fillers add volume by temporarily smoothing out facial lines and wrinkles.  The benefit of using a dermal filler is an instant result with no downtime.  I recommend booking a consultation with an experienced provider to explore your options.  Best of luck!
- Dr. P. Alexander Ataii

I'm not sure what to do about my nasolabial folds. Any suggestions? (Photo)

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