39 years old, Restylane, microneedling. Is it possible that Restylane will not fill the creases?

Microneedling does not affect the effect of filler. The procedures should work well together, although they should be spaced at least a few days apart. For stubborn or deep nasolabial folds I would suggest a filler with larger molecules such as Perlane, Voluma, Radiesse or perhaps Juvederm Plus. Since Restylane® contains smaller particle sizes, it is typically used to treat more delicate lines and folds such as smoker lines and dark circles under the eyes. Microneedling on its own works well for fine lines, wrinkles, and scars. However, those deep lines would be filled most effectively with a filler. You should always see a board certified dermatologist or plastic surgeon for best results with your injections.

There is no problem of having both procedures, although the two should not be performed on the same day. It is best to space them out by at least a few days if not more. For the treatment of superficial fine lines, deeper microneedling can go down to the Restylane which can extrude (come out). This is uncommon, but is possible. There are different depths of needles available and whomever is treating you should be aware of this.

There should be no diminished effect of Restylane in a patient receiving micro needling on a separate day. These treatments though should be spaced out. Restylane typically is only required every 6 months or so. Restylane silk is a great new product indicated for the perioral rhytides and lip area only . Not indicated for the nasolablial folds. Would recommend you discuss with a board certified dermatologist.