06 Dec Cosmetic basics series: Nasolabial folds
Let’s get back to basics: Nasolabial folds
There are a few predictable changes to our faces as we age. Frown lines and crow’s feet, jowls and nasolabial folds are the most common ones. Nasolabial folds are those lines that form between the nostril and the corners of the mouth. Some people refer to these as “smile lines” or “laugh lines” but whatever they call them, people often hate them! They are probably one of the commonest areas that patients complain about but they are actually a normal facial feature and help seperate the cheek and mouth zones of our face. The issue is usually when they become too prominent and create a heaviness to the front of the face that makes us look saggy. And no-one wants to look saggy!
Dermal filler injected directly into the fold has generally been the first line of treatment. In actual fact it is usually one of the first areas to be taught when clinicians start out with injectables. My issue is that over injection of dermal filler can look very unusual and actually contribute to that forward heaviness we want to avoid. My preference is that we attempt to lift the face back up so that we avoid the sagginess. We can achieve this with dermal filler to the cheek and back of the face to add lift and shape. This pulls the attention away from the mouth area and looks a lot more flattering. If we did need some dermal filler directly into the nasolabial fold, we can then use a lot less. This technique avoids adding more weight to the front of the face and avoids adding to the problem!
There are other options too. Instead of using regular dermal filler, collagen stimulating filler can be used too. This slow-growing filler adds fresh collagen in to the skin to achieve more lift and tightening. This is a more advanced technique but MUSE Clinic is one of the biggest users of collagen-stimulating filler in Australia, so we have lots of experience with it. If patients prefer to avoid injectables, we can use Ultherapy and Exilis to gradually tighten the skin. These are heat based treatments which stimulate collagen and elastin production to lift and firm the skin. Some doctors also offer threads which mechanically lift the skin and pull up the nasolabial fold. Threads are a surgical procedure and can potentially carry more risks.
The best results always come when the injector and the patient are on the same page. Setting realistic goals, outcomes, timeframes and costs is also a really important step to achieving a great outcome.
Dr Stephen Lowe