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The real deal on nasolabial folds

nasolabial folds

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#1 CalumJones

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Posted 19 July 2019 - 12:58 PM


Nasolabial folds are mainly caused by fat ABOVE the fold thus causing a deepened appearance, rather than actual loss of volume along the line. You will notice this because they will get worse if you get fat or if you eat LOADS of salt and get a bloated moonface. Being very low body fat will make them disappear for most people.

I have surgical pictures of older patients I could show which should show you the excess fat buildup above the nasolabial position but of course these are a little graphic. These are diagrammed so you can see what each part is (because otherwise it's difficult sometimes to understand what you're seeing in surgical images).
 
Beyond this, for actual volume loss something like microneedling would be a good idea as it induces collagen production. I use the Derminator 2 device as it does not cause microtearing. Microneedling is also effective for acne scars and minor wrinkles, but scarring is best done at a high depth using a dermastamp. I do not trust lasers whatsoever due to some of the disastrous results I have seen. I am not a gambler, if I deformed myself my life would be over, so I do things incrementally in risk. If the least risky option does not work, I try the next least, etc.
 
After this, you want to look into dermal fillers. They don't hurt. You will bite down but the pain is very bearable and I'm not trying to sound tough, I am serious that it is VERY bearable. LIP injections hurt a lot I will admit that much. Nowhere else hurts... Even under the eyes. Cannulas can kind of hurt I think it's because it can be tricky to get the needle into the cannula hole properly and there's sometimes a lot of fiddling which can be a bit uncomfy - but again - it's not like you're going to be in real pain.

Now ideally with filler (in a perfect world) you want to create a lifting effect rather than filling into the lines, although filling the lines directly with Restylane can work well. Overfilling the lines can give your face either a bloofy look or a "Bugs Bunny" smile, this is because by filling the line you are raising the tissue to the level of the excess fat above. There is another point that can be injected with a thicker dermal filler like Juvederm Voluma which is the point where the fold meets the nose, just underneath that.
 
So ultimately:
 
1) Lose body fat until you are in very good shape.
 
2) Use microneedling techniques, you may choose to combine this with one of the Matrixyl iterations and supplementation with substances shown to increase collagen such as Altrient C. But there are many others too which create firmness etc. etc. including Pycnogenal.
 
3) Dermal fillers to create a lifting effect IDEALLY if you can get away with this placed in a "hidden" spot where it won't show it will look better. BUT often the results from this are less satisfying.
 
4) Injection of something like Voluma into the point where the crease meets the nose, again this is a more "hidden" stealth option.
 
5) Direct injection of a light-medium filler along the line itself. Restylane fillers are good here.
 
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In some rarer cases muscle tension can cause the appearance of folds which can be alleviated by botox injection. See a doctor for this. I cannot give much information on it as I do not know much about it except that it's possible.
 
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It is also possible to treat nasolabial folds with careful injection of kybella into the excess fat accumulation, or even liposuction. But this of course comes with risks as you don't want to remove the wrong fat etc. So consider this a very last resort if you absolutely MUST rid them and nothing else works, but it is done and does work.

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