The nasolabial fold or laugh line is a very specific area of the face. It frames the upper lip extending from the junction of the rim of the nose downward. It can extend beyond the upper lip into the chin area and become what is referred to as marionette lines.
This area of the face has a very specific cellular composition. With a facelift these deep furrows can be reduced. But it is a challenge to remove them completely. Therefore fillers have been used either by themselves or in conjunction with other facial rejuvenation procedures to lessen the depth of this area.
I prefer hyaluronic acid as the main filler because it can be reversed. There are other semipermanent and more permanent fillers also available to treat this area. I have great success with 1 to 2 syringes to fill these areas producing a noticeable reduction in depth of the nasolabial fold. These fillers are a great tool to address this area.
Nasolabial Fold
Fat transfer has also been used to fill the nasolabial fold. Every one of these mechanisms to treat this area have their own limitations. This is discussed thoroughly with the patient prior to procedure. In extreme cases I have performed direct excision of the nasal labial fold with the patient understanding that a scar will then be present. This must be thoroughly discussed prior to procedure.
The gold standard for cheek, neck, and total fullness and laxity is the face and neck lift. Fillers alone will not give the absolute best most long lasting result. But used properly fillers can be a great tool for facial rejuvenation.
THOMAS TREVISANI, MD
BOARD CERTIFIED PLASTIC SURGEON
MEMBER AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY
