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Articles » Plasticpedia » Nasolabial folds

Nasolabial folds

07/04/2016 by Anil R. Shah, MD

  • Many methods to treat nasolabial folds
  • A nasolabial fold is part of normal anatomy
  • Typically treating the area around the nasolabial fold just as important as in treating the fold itself

Many patients who come in to see me will focus on the prominence of the nasolabial folds. There are other terms for the nasolabial folds including parenthesis lines or smile lines. There is no question as we get older these folds can change and become deeper.
The presence of a nasolabial fold does not equal an aged face. If you look at a three year old, sixteen year old, twenty year old, you will see nasolabial folds present.

So what is the goal in reducing nasolabial folds?

Most of the issues with nasolabial folds is that the surrounding tissues have deflated. When these tissues deflate, the nasolabial fold becomes more prominent. Unfortunately, 90% of plastic surgeons treat nasolabial folds by filling in the lines. Most of the time this does not make faces look younger.

The answer to nasolabial folds depends on a balanced approach to the face where volume is added in locations where it is deficient. This serves to lift up the cheek and help efface the nasolabial fold. Filling the fold itself does have some merit, but the surrounding areas are just as important.

There are instances when some surgical procedures can benefit patients with prominent nasolabial folds. Mobilization of the malar fat pad can allow for the fat pad to be lifted and help balance this area in some patients. An isolated midface lift is not effective in my opinion in treating nasolabial folds and should be combined with a traditional facelift or the surgeon can opt for a deep plane rhytidectomy. Younger patients may not be candidates for some of these techniques and would benefit from facial fillers in the office or fat transfer techniques.

Fat transfer can be useful in augmenting the areas around the nasolabial folds but are not as effective in mobile parts of the face, such as the nasolabial folds, and around the mouth. In some patients SMAS grafts (thick fascia) can help supplement the nasolabial folds after a facelift.

Other techniques may not be effective and include the use of surgiwire and threadlifts. While these procedures were embraced early on by many surgeons, Dr. Shah does not want to be the “first surgeon to use something or the last”. He believes that time is the ultimate guide to determine a procedures merit.

Why do some patients have more prominent folds then other patients? Patients with high cheek bones and projecting cheekbones often will have less prominent folds than patients with flatter malar eminences.

Filed Under: Plasticpedia

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