THE NASOLABIAL FOLD
What is a nasolabial fold ?
The nasolabial fold is a wrinkle on either side of the face that runs from the bridge of the nose to the corner of the mouth. Like any wrinkle that runs downwards, it gives a sad, tired look.
Effective aesthetic medicine treatments exist to treat this unsightly appearance.
Why nasolabial folds ?
The nasolabial fold itself is a wrinkle that appears with age, although this line can be present in young people at rest and/or when smiling.
This unsightliness can be:
♦ Constitutional: this is a false nasolabial fold. It is simply due to the morphology of the face, and is found in particular in the case of a protruding, low cheekbone (additional information about the 5 types of cheekbone). It can be reduced, but its disappearance should not be considered, which would give a round appearance to the face.
♦ Linked to ageing: it appears around the age of thirty in both men and women.
As the years go by, the fat in the cheekbone melts and gradually descends to the oval, the bone resorbs and its supporting role is lost. The skin becomes thinner and less elastic.
Extrinsic factors aggravate the development of the nasolabial fold: smoking, weight changes, sun exposure, lack of sleep and hydration.
More or less pronounced nasolabial fold : stages of severity
The Metz laboratory has created a nasolabial fold severity scale. There are several stages of development:
With ageing, other changes often affect the lips:
♦ Stage 0: absence of furrow (observed in young people under the age of 30).
♦ Stage 1: slight nasolabial folds.
♦ Stage 2: moderate nasolabial folds.
♦ Stage 3: severe nasolabial folds.
♦ Stage 4: very severe nasolabial folds.
How do you get rid of nasolabial folds ?
Treatment of the nasolabial fold
Treatment of the nasolabial fold is a frequent reason for consultation in aesthetic medicine. Women seek treatment from their thirties onwards; men consult us from their forties onwards because they are able to hide it under their beards and consider it a charming asset.
Hyaluronic acid-based creams cannot make it disappear and make-up cannot camouflage it.
It’s important to understand that:
♦ This wrinkle must be softened and not erased to avoid rounding out the face.
♦ The two sides are not symmetrical and never will be, perfect symmetry is not achievable and moreover is not physiological.
Hyaluronic acid injections in the nasolabial fold
Hyaluronic acid is a biocompatible gel used to treat wrinkles. My approach to the face is natural and physiological, and any treatment must aim to correct the causes of age-related changes and bring the face closer to perfect beauty proportions (beautiPHIcation technique).
Treatment of the nasolabial fold is personalised and depends on the patient’s anatomy.
There are several techniques:
♦ The lift technique: the nasolabial fold is almost always due to the loss of superficial malar fat. The 8-point lift technique, one of the variations of the MD Codes invented by Brazilian plastic surgeon Mauricio di Maio, lifts the tissues via the injection of strategic points to be adapted to each face. The injection is carried out with a needle, the product is placed deep against the bone, the hyaluronic acid used is firm and has lifting properties.
♦ Wrinkle injection: a wrinkle filler is often combined with the lift technique for optimal results. In the treatment hierarchy, tissue lift must precede wrinkle injection , so as not to round off the face. The only exception is the constitutional furrow found in young people, in which case it is preferable to inject only the furrow.
♦ The injection is carried out with a cannula (a needle with a round tip) for vascular safety reasons, the product is placed in the skin at different depths.
♦ If the wrinkle is very superficial, the acid used will be injected very superficially and its particles will be very small, I use a hyaluronic acid such as restylane or skinbooster. If there is a reduction in fat at this level, the acid used will be volumising and injected more deeply.
The two techniques can be combined if necessary, known as a sandwich technique.
♦ Bolus injection at the level of the canine fossa: sometimes an injection of hyaluronic acid is performed at the level of the perineal triangle. The product is dense and placed against the bone.
These techniques can be combined. Injection of the nasolabial fold, like all facial injections, is complex and requires an experienced eye, medical know-how and a perfectly mastered technique.
→ Find out more about hyaluronic acid
→ Find out more about sculptra injections
Smoothing out the nasolabial fold with Sculptra injections
Sculptra stimulates collagen synthesis.
This product is indicated for improving the nasolabial fold if the patient has a significant reduction in skin thickness and a reduction in cheek fat (very hollow cheeks).
This is a preventive treatment that I offer to all patients over the age of thirty, working synergistically with hyaluronic acid injections to slow down the ageing of the face.
The number of sessions and the areas to be injected are adapted to each patient’s anatomy.
Results and side-effects
Results are immediate and improve within three weeks of treatment. It lasts approximately one year.
The lift technique restores the youthful triangle and refines the oval of the face.
The face appears rested, and the furrows will be reduced in a physiological way or completely erased depending on the patient’s request (which will be respected).
The immediate after-effects are marked by slight swelling, small haematomas are rare and do not last more than a few days. Normal activities can be resumed immediately after the injections.
Prices
Type of consultation
Prices
Hyaluronic acid
600 CHF per syringe
Sculptra
800 CHF per bottle