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Nasolabial Folds

Nasolabial folds, commonly known as "smile or laugh lines" are the deep lines or the indented skin between the corner of the nose and corner of the mouth.

The cause of nasolabial folds includes:

  • Age
  • Excessive exposure to the sun
  • Hereditary factors

With age and excessive exposure to sunlight, the loss of skin elasticity and firmness is related to the breakdown of collagen (protein responsible for skin tightness). This causes the skin to become loose, appear saggy, and to form folds.

The treatment options for nasolabial folds include

  • Non-invasive procedures such as fillers
  • Surgical procedures such as a mid-face lift

Fillers

Injectable fillers, also known as soft tissue fillers, are products that are injected into specific areas of the face to correct any textural irregularities by plumping and smoothing out the skin depression. Injectable fillers work by restoring facial volume and filling out wrinkled or uneven areas of the face, thereby bringing an immediate vibrant and youthful appearance to one’s face without surgery.

With aging, the skin becomes more susceptible to wrinkles and sagging. The injectable fillers do not stop the aging process but restore the age related volume loss in the face providing a significant facial rejuvenation.

Injectable fillers are used to correct cosmetic concerns including smoothing wrinkles, lines and folds.

There are several types of injectable fillers available to treat nasolabial folds based on the patient’s requirement. Injectable filters are either temporary or permanent.

Temporary – are made up of absorbable materials (those are absorbed by the body over time). These include:

  • Hyaluronic acid (HA) – Hyaluronic acid is a natural substance found in the body, especially in the soft connective tissues. Hyaluronic Acid products are the most popular and commonly used injectable fillers that are often used to fill the nasolabial folds. They are very safe fillers and the effect of the filler usually lasts up to 12 months depending on the type of HA filler used. These fillers also have the added benefit of reversibility as they can be dissolved away in cases where the desired result is not achieved. They also offer the opportunity of customizing the required effect when repeat injection is performed. This allows the volumising effect of the filler to constantly adapt to the changes in the ageing face ensuring a consistently natural and aesthetically pleasing result. Examples of such fillers are Restylane, Juvederm, Sub-Q.
  • Hydroxylapatite – Hydroxylapatite is a natural substance that forms the major component of the human bones. It is the heaviest of the injectable fillers composed in a gel base and provides a longer lasting effect (6-18 months). The most common brand of this filler is called Radiesse.
  • Polylactic acid – Polylactic acid is synthetic filler that stimulates the production of collagen within the body. The effects of polylactic acid fillers can last up to two years.

Permanent (made up of non-absorbable materials)

  • PMMA (polymethylmethacrylate) – PMMA is a permanent type of filler that is used to fill the nasolabial folds. PMMA microspheres (microscopic granular substances) or beads are tiny, round, smooth particles that are composed in a collagen based gel to fill the wrinkles. PMMAs are found to provide a long-lasting correction. However fat grafting is preferred to PMMA when such long-lasting effect is desired.

The Procedure

The procedure is performed on an outpatient basis and involves the following steps:

  • The areas to be treated on your face are identified and cleaned with an antibacterial agent.
  • Topical anesthetic agents may be used to numb the areas to be treated or sometimes the filler itself may contain a local anesthetic that makes the injection more comfortable. Your surgeon then injects the filler through a fine needle beneath the surface of the skin. The discomfort is usually minimal as our experts have special techniques to ensure that the filler is given in a smooth and comfortable manner.
  • The doctor will show you the immediate result using a mirror and you can also guide the process to ensure that your desired result is achieved under expert guidance.
  • Gentle pressure is applied immediately to the area for a few minutes.
  • Make-up may be applied that allows you to resume your daily activities immediately.

The best filler for treatment is selected based on your age, condition of your skin, amount of sun damage and genetics.

Risks and complications

Though injectable fillers are very safe to use, Hyaluronic acid fillers as associated with lowest incidence of any risks or complications as compared with hydroxyl
Injectable fillers that contain materials from non-human sources require a pre-treatment allergy test.

Recovery

  • The procedure provides immediate results and requires very minimal downtime, allowing you to return to normal activities and work, directly following the treatment.

Treatment Outcome

Mid-Face lift Surgery

Mid-face lift is a surgical procedure that tightens and removes drooping facial skin. This surgical tightening of the facial muscles improves the tone of the skin. These procedures also may involve the removal and repositioning of excessive fat present beneath the skin.

Mid-Face lifts are more commonly performed in the age group between 40-65 years, but people who are younger or older may opt for this surgery as well.

Purpose of mid-face lift surgery

The objective of face lift surgery is as follows:

  • Reduces the signs of ageing
  • Reduce nasolabial folds
  • Improves the contours of the cheek and mid-face
  • Make the skin younger and smoother
  • May be combined with other cosmetic surgical procedures such as brow lift, eyelid surgery or skin reconstruction
  • May be undertaken along with non-surgical treatments such as chemical skin peel, dermabrasion or skin resurfacing

Mid-Face lift surgery does not involve the alteration of the bone structure of the face.

Procedure

Face lift surgery is performed under general anesthesia or local anesthesia. The type of mid-face lift surgery depends upon the age, type of skin (dry, thick etc.), condition and requirement of the individual person. It is quite often performed through the lower lid thereby avoiding any visible scar in order to achieve excellent cosmetic outcomes.

Post-operative care

The basic post-operative instructions following mid-face lift surgery include:

  • You can have a light meal and can drink fluids 2-3 hours after the surgery
  • Elevate your head while sleeping to reduce swelling
  • Take prescribed medications for pain and swelling
  • Rest for a few weeks as recommended
  • Avoid heavy lifting, strenuous exercise, swimming and strenuous sports