Why Nasolabial Fold Treatment Can Make You Look Worse
Posted: 2:30 p.m. Sunday, August 23, 2015
By Anita Mandal, M.D.
Question: I have deep smile lines extending from the nostrils to both my mouth corners. Ten years ago, Juvederm filler treatments worked well to soften them. Now my lines are deeper and need more filler, yet Juvederm injections are actually making me look worse and unnatural? Is there a better filler for my nasolabial folds?
Answer: Deepening smile lines or nasolabial folds can have different causes. Identifying the cause of nasolabial fold aging is key to a successful result and a balanced, youthful and natural looking face. Some patients have deep nasolabial smile lines due to loss of soft tissue directly in the area of the smile line itself. In such cases, deep smile lines can be treated with temporary fillers such as Juvederm, Perlane, Radiesse and Sculptra or a long-term filler like Bellafill. In other patients, nasolabial smile lines appear deep to the patient but this effect is actually due to sagging cheek tissue. Volume loss of bone and fat in the upper outer cheek causes the cheek skin to lose its support and sag, giving the illusion of a deepening smile line. Proper treatment for a natural and balanced mid-face includes volumization of the upper outer cheek area, sometimes combined with partial wedge-filling of the medial nasolabial fold. Full correction of the entire nasolabial fold without addressing the cheek volume loss can, in this instance, give an unnatural “monkey” appearance to the central face which can also look overfilled. Correction with temporary fillers such as Juvederm, Radiesse or Sculptra can last 1-2 years or with a long term filler like Bellafil can last many years. The main challenge to effective treatment of a deep nasolabial fold relates to the surgeon’s expertise in diagnosing the correct cause of deepening smile lines. Another challenge relates to the patient’s ability to understand the correct cause of their mid-facial aging – when it’s due to volume loss of the cheek vs. true deepening of the nasolabial fold. It is a misconception to think you should only seek a surgeon for surgery. Facial Plastic Surgeons have in-depth knowledge of facial anatomy and expertise in both non-surgical and surgical facial aesthetic treatments. Each time you have a non-surgical cosmetic procedure by a less qualified doctor, you increase your risk of complications and poorer results. When it comes to your face, why would you consider less than a Board Certified Facial Plastic Surgeon? Log on to ABFPRS.org.