Question:
I am a 52-year-old female but look like I am in my late 60’s. I have very deep nasolabial folds that I would like removed. I am not interested in surgery at this time. Would injectable fillers be used here? Is this a permanent solution?
Answer:
Facial aging manifests itself in many ways. Deep nasolabial folds are definitely a sign of aging but, fortunately, a stigmata of aging that can be relatively easily remedied. Injectable fillers can be safely placed in the nasolabial folds to reduce the depth of these folds. Several different products are FDA approved for this particular purpose. They are all extremely safe, but, none of the FDA approved products are permanent. Hyaluronic acids, such as Restylane and Juvederm are the most common fillers used and they are extremely safe and can last up to one year. Pearlane and Juvederm Ultra Plus are two other hyaluronic acid products that have slightly larger particle size and will last a few months longer than the Restylane or Juvederm. Radiesse is a product made up of the same componentsas bone. It is a powder like substance mixed in a gel matrix and is extremely safe and will last about 18 months. Autologous fat is another filler I use in the nasolabial folds and this lasts a long time but, touch ups are often times necessary. The most important thing to remember when injecting these products are that less is more. Too much product in these areas gives an unnatural appearance to the face. Some nasolabial lines are just fine but, deep ones need to be remedied. Finally, there are permanent filler alternatives but, I would caution you about using them. Firstly, they are not FDA approved and there can be potential side effects from their use that we are unaware of and may not be able to treat. Second, your face will continue to change over time. A filler that looks good now in a certain area of your face may look unnatural in 5 or ten years when your face has aged even further. Lastly, permanent fillers are just that, permanent. If you have too much filler, or do not like your appearance after placement of a permanent facial filler, you may need surgery to remove the unwanted portions and this can leave scars that are far worse than the nasolabial folds.
Posted by Dr. Philip Schoenfeld