Nasolabial Fillers, At A Glance
- Best ResultsImmediate
- Treatment RecoveryNil
- Procedure Time10 minutes
- Skin SpecialistDermatologist, Nurse Injector
- Duration of Results12 months to 3+ years
- AnaestheticNumbing in filler
- Back to WorkImmediately
Nasolabial fold – Cheek lines
The nasolabial folds are one of the most frequently treated areas in cosmetic dermatology. Careful and accurate placement of dermal fillers can support & diminish the nasolabial fold without adding more volume-weight to the mount area. This gives a better outcome compared to filling in laugh lines. My best advice is to look beyond the fold or line at the big picture. Filling lines is easy, however in many cases this may not be visually pleasing.
FactsFacts on nasolabial fold fillers
- Nasolabial or laugh lines are one of the most popular treatments
- These lines are also one of the most badly filled areas
- The nasolabial fold is a naturally occurring line
- Too much dermal filler will result in a heavy look
- The aim of treatment is to ‘blunt’ & not obliterate this natural line
- For mature patients it is not wise to add volume & weight below the cheek bone
Why is treating the upper cheek more important than treating the fold?
Volume should be used to lift & not only fill in lines. As we age there is downward descent of the cheeks & the mouth area. By filling down low we exaggerate the heaviness of ageing. In most cases the aesthetic appeal of just filling in lines may not be the best option as this gives what I call the Homer Simpson look (heavy around the mouth). Strategic filling above the deep nasolabial folds creates much needed support that can lessen the depth of the lines, & at the same time lift the cheeks.
How much filler is needed to treat the nasolabial folds?
Typically,1-3 mls of filler, depending on the depth of the fold & the level of correction. Remember, in most cases filling at the apex or above the fold provides lifting or blunting of the deep lines. This should be the first step prior to NL fold directed fillers.
What type of fillers do I use to treat the nasolabial fold?
I employ both hyaluronic acid as well as collagen stimulating fillers in this region. The choice largely depends on clinical examination, taking into consideration your age, volume depletion, depth of fold, associated laxity, as well as your expectations. There are pro & cons of using HA fillers compared to collagen stimulating fillers.
|Filler Type||Longevity||Costs vs Volume||Use|
|Hyaluronic Acid||Up to 2+ years||++++||Finesse & contours|
Ca OH Apatite
|3-5 years||++||Volume & bulk increase of collagen|
What is the best filler for the nasolabial fold?
An ideal filler gives a balance of support, volume & longevity. My go to fillers include Hyaluronic Acid fillers from Allergan or Merz, whilst in older patients I prefer calcium hydroxyl apatite fillers.
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How long do fillers last in this location?
12 to 36 months & beyond, depending on the type of dermal filler. Hyaluronic acid fillers typically last up to 2 years, whilst collagen stimulating fillers last upwards of 3 years. Fat transfer can last 10+ years if the original volume uptake is high.
What are the risks of dermal fillers?
Dermal fillers carry risks, much like any other procedure. In the content of the nasolabial fold area, the most common risks are overcorrection with superficial placement of filler. Other rare side effects include lumps & bumps (acute or delayed). Arterial injection with skin necrosis is a very rare side effect. The use of cannula, proper injection technique & meticulous care can reduce dermal filler side effects.
Are there any other ways to address the nasolabial fold, apart from filler?
Yes, there are surgical & non-surgical options. Non-surgical options include; Thermage, RF with Pelleve or Tempsure, HIFU with Ultherapy, & thread lifts. The success of non-surgical options is dependent on the weight of your cheek (as cheek lifting decreases the depth of the fold). Additionally, the success of non-surgical treatments is also dependent on your immune system’s ability to produce & contract collagen.
Surgical options include a short scar mini-S facelift, or a deep plane facelift. Surgical & non-surgical options address skin tone, not volume. Fat transfer can be considered in some patients if large volumes are required.
Does this treatment hurt?
Treatments are comfortable as numbing agents are mixed in with the fillers. The procedure takes 2-3 minutes to perform. I use a cannula to fill in the majority of cases.
For patients who are phobic, I do prescribe a “chill pill” to ensure your experience is a pleasant one.
Can lasers improve the nasolabial folds?
Lasers can indirectly improve the folds by tissue contraction & lifting. This is a secondary & not a primary effect. The aim of laser resurfacing is to improve the skin texture-quality, namely sun damage (elastosis), static wrinkles & pigmentation. In some cases, a lifting effect is seen secondary to collagen formation & contraction.
Does microneedling help the nasolabial fold?
Microneedling is a minimally-invasive treatment that creates microchannels deep in the dermis of the skin to stimulate the natural production of collagen, much like lasers. This treatment can soften wrinkles & fine lines. The lifting capacity of microneedling is less than lasers & other devices, hence it has very limited impact on the nasolabial fold.
Can threads address the nasolabial fold?
Threads including monofilament MINT & suspension threads can have an impact on the NL fold in the correct candidate. The ideal profile is mild to moderate laxity, with minimal background sun damage and a medium to thick dermis.
If one is risk adverse to dermal fillers, threads, in combination with energy devices such as RF – HIFU can give modest results in some.
Can diet affect laugh lines & nasolabial folds?
Unfortunately, with weight loss, the appearance of the nasolabial folds usually worsens as fat acts as a structural support for overlying skin. Soft tissue fillers & fat grafting can soften these lines.
How do I make a booking for dermal fillers?
Contact @cliniccutis to arrange an assessment with either myself or my nurse injector. We both use very similar products in our portfolio, including brands such as Juvederm, Restylane, Belotero, Redensity, Sculptra, & Radiesse. We do not use any brands from Asia, nor do we use any semi-permanent / permanent fillers such as Bellafill.
Davin’s take on nasolabial fold dermal filler injections
Nasolabial (NL) folds were the very first location we used to fill 20 years ago! Now, less than 2% of my dermal filler cases are specifically directed at reducing this line. It is important to note that NL lines are natural. Most often, blunting or decreasing this fold does not add to the overall aesthetics.
Taken in isolation, treating the fold itself can give you a great before & after photo, however it also adds volume & weight to the muzzle area- AKA the Marge Simpson look (in reality Homer has more volume in this area).
The majority of my filling in this area is aimed at the piriform fossa, the area where the NL fold meets the alar base of the nose. Strategic filler in this area reduces the shadow of the NL fold, supports the medial cheek, and in some cases provides an upper lip lift. In patients with really deep folds, I do employ both hyaluronic acid as well as non-HA collagen stimulating fillers to decrease the lines.
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