The Nasolabial Fold: how to reduce shadowing
The crease running between each side of your nose to each corner of your mouth is called the nasolabial fold. Shadowing and/or creasing in this area tends to bother many people, and also tends to become more prominent with increasing birthdays.
Let us begin with setting expectations. Even babies have a nasolabial fold. It is a normal human facial feature independent of age, and it's a mistake to try and get rid of it completely. Trying to obliterate a nasolabial fold with filler makes a puffy-faced appearance like a monkey, so the best goal is to soften but not eliminate creasing and shadowing at the nasolabial fold.
Why does this area become more shadowed over time? There are several factors that play into it. Fat volume loss in the upper face, especially in the cheeks and temples occurs as age increases, and as we lose support in the upper face, the skin hangs slightly lower in the lower face. Think of the fat you have in your upper cheeks when you're young (the "apple" of the cheek) as a tent pole holding up the skin and other structures of the face. When you begin to lose the tent pole, the overlying structures fall a little lower. Skin laxity or looseness increases over time, and plays a role in shadowing at the nasolabial fold. Additionally, the muscle movement of smiling creases the nasolabial fold area, but we're not going to stop smiling!
Can you treat the nasolabial fold with Tox (Botox or Dysport)? No. With the neurotoxins being muscle relaxers, their mechanism doesn't address the root causes of shadowing at the nasolabial fold. Adding volume with dermal filler or Sculptra, and skin tightening therapies like Sculptra or some machine-based therapies will treat the area better.
Dermal filler is a good treatment for nasolabial folds, and it can be used in several ways to reduce shadowing and creasing in the area. The most natural way to begin to address nasolabial folds is to start with optimizing cheek volume with filler or Sculptra. This is because you're putting volume back where it occurs naturally, where you probably had more cheek fat when you were younger. It's true that it only indirectly treats the nasolabial fold, but if you're looking for natural full face rejuvenation, this is the best way to start.
Once cheek volume is optimized, there are two injection points in the nasolabial fold to consider. The first is the pyriform fossae (beside the nose) to treat shadowing. Secondly, the creases in the skin at the nasolabial fold may also be injected in a "fern" pattern with a very light-bodied filler to smooth out the skin crease that your smile makes because you can't stop smiling! Yay!
Biostimulants like Sculptra have a double benefit: they add volume and they tighten/firm skin, both via collagen stimulation. Sculptra helps increase your growth of your own collagen and elastin. It's much more powerful than oral collagen supplementation, and it produces a lovely, gradual, natural result. Sculptra may be injected into the temples, cheeks and pyriform fossae to gradually build volume. In the preauricular area (in front of the ears) it helps to tighten skin and create a subtle pull-back effect in the lower face. Sculptra is also effective for cheek lines which may occur to the side of the nasolabial fold.
It's important to note that dermal filler is visible on the day of treatment whereas Sculptra requires about 3 months to begin to show results due to its collagen stimulation mechanism. Sculptra does tend to have longer lasting results than dermal filler.
Every face is unique, and during an in-person consultation, we can talk more specifically about the best treatment plan for you!
