NASOLABIAL FOLDS
Nasolabial fold filler can be used to lift and treat the folds which occur with ageing and volume loss in the cheek area. Clients that have had lip filler will also find they will benefit from nasolabial fold filler.
Nasolabial folds are the lines from the lower nose corner to the corner of the mouth which make the face appear more aged. Filler injections will help the area look smoother, younger, with less of a demarcation between the cheeks and the lower face helping the face look more fresh.
Many clients are concerned about the appearance of their nasolabial folds, even from a very early age, and this concern intensifies over time. They can be concerned about the fold, or the wrinkle or both. Dermal filler can be used to address these issues.
THE NASOLABIAL FOLD DEBATE
There is debate about whether nasolabial folds should be filled. Those against filling the nasolabial fold argue that the nasolabial is mostly caused by volume loss in the cheeks, causing loss of structural support for the cheek, causing it to “fall down”, creating the nasolabial fold. So they see the nasolabial as a symptom of volume loss and believe that volume in the cheeks should be replaced, which is treating the cause, rather than treating the symptom, which is the deepening appearance of the nasolabial fold.
Where we sit on the debate: At Dani Louise Aesthetics, we believe it is very easy to fill a nasolabial fold and the client does appear younger after this treatment is performed. BUT if that person has volume loss (which they invariably do) then filling the nasolabial fold is not rectifying the problem, it is just filling in a fold.
The other point is that it takes significantly more product to fill a cheek than it does to fill a nasolabial fold. So there are budgetary issues to consider as well. Also, too much product may be required in the cheek to reverse a nasolabial fold, and this can create an unnatural pillow-face appearance. Our recommendation is to treat both the cheek and the nasolabial fold to obtain the best appearance, in these circumstances, if it fits into the client’s budget. If the budget doesn’t allow for all treatments then cases should be assessed individually to see whether treating volume loss or the fold will make the biggest or best and most natural change to the person’s appearance.
TREATMENT OF NASOLABIAL FOLDS WITH DERMAL FILLERS
Choosing the type of dermal filler for the nasolabial fold
We use several different types of filler for the nasolabial folds at our clinic in Sidcup . Reversible dermal fillers are safe and well tolerated, with great results. For nasolabial folds dermal filler with a larger particle size, or lifting capability is useful, but in older clients with thinner skin, a smoother filler may be required.
Dose of nasolabial fillers
The dose required for nasolabial fold filler is variable, it depends on the client’s anatomy, and where the client wants to get to in terms of results.
The practitioner will assess the nasolabial folds and decide on the best dose after taking a history and examining the client. If a client has a history of complications with dermal fillers, or if their budget is small or if they want a more subtle result, then a smaller dose might be chosen to start with.
We may use a standard protocol for first line dermal filler treatment of the nasolabial fold (when treated on its own), which is:
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Treatment - Initial treatment of 1ml dermal filler.
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Review - One month after treatment. If nasolabial fold adequately filled then next treatment should be at 6 months and then yearly. If at one month review results not adequate another 1ml of dermal filler will be injected, with another review at one month.
DURING TREATMENT
The area will be cleaned with alcohol. A numbing cream such as EMLA or LMX will be applied to ease any discomfort.
The practitioner will inject using a very fine needle. Sometimes a cannula may be better, if so a fine needle pierces the skin to make an entry point for the blunt cannula.
AFTER TREATMENT
The effect of the nasolabial fold filler will be obvious immediately. There may be redness, swelling, and red dots at the injection sites. Bruising may occur. If cannula is used, bruising is less common
Most of the swelling from the dermal filler will have resolved by 2-3 days after the procedure.
AFTERCARE
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No makeup for 24 hours
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No heavy exercise for that day
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No face products for 24 hours
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No sunbeds spas or saunas for 7 days
SIDE EFFECTS / RISKS
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Bruising occurs in a significant number of cases.
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Swelling in the injection area will occur. This will last for approximately 48 hours
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Asymmetry. Sometimes one side is better treated than the other, this is usually because the client is asymmetrical to start with. Nasolabial folds are notoriously asymmetrical. Most clients will have different doses to each side of the nasolabial folds
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Infection is a very rare complication, but always a possibility when a needle penetrates into the skin.
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Necrosis is caused by a blood vessel being blocked, interfering with blood supply to the skin. This is very rare. This could lead to scarring. We are complications trained at Dani Louise Aesthetics and fully equipped to deal with emergencies.
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Need for further treatment. It may take more than one syringe of product to get to where the client wants to be with nasolabial fold filler.
