How to Get Rid Of Those Facial Parentheses (Nasolabial Folds)

Lip Injections - How to Get Rid Of Those Facial Parentheses (Nasolabial Folds)

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One of the most base facial areas that bothers many patients is the improvement of the nasolabial folds, also referred to as the lip-cheek groove, or in a up-to-date television industrial known as the parentheses. You can argue either it is a fold or a groove but it is probably closer to a fold. It develops as the cheek tissue from above ages and begins to sag....falling over its border with the upper lip. The upper lip is 'fixed' so the overhanging cheek tissue creates the appearance of a deepening fold. With time, aging, and the anatomy of one's face, this nasolabial fold extends south past the corner of the mouth and sometimes nearing the lower border of the jaw in ultimate cases of skin laxity.This area is commonly treated by injectable fillers and in my custom as many patients wants their nasolabial folds treated as they want their lips enlarged.

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Lip Injections

The most base method for nasolabial fold reduction is with injectable fillers. Like all filling procedures by injection, the results from nasolabial fold reduction is quick, easy to do, and the results are immediate. I usually accomplish them under a local anesthetic block so the medicine is as comfortable as possible. While all of the injectable fillers will work, I think some are great for this area than others. And the ones that I think are best are those that last the longest and have the many 'push'.

While all of the hyaluronic acid fillers such as Restylane or Juvaderm will work, they do not last as long as any of the particulated injectable fillers. Currently Radiesse (ceramic beads) and Artefill (plastic beads) are the only two particulated fillers currently available. The evidence is clear, not surprisingly because of their solid bead component, that they consistently last longer than any of the hyaluronic acid fillers. While beaded injections can cause lumpiness and irregularities, this is not a considerable cosmetic issue (nor can it usually be seen) in the forgiving area of the nasolabial fold. Conversely, in the lips this is a different matter. Also, because the bead blend makes the injectable material more thick and viscous, I think it provides more push as it goes in resulting in a great cosmetic result and having to use less injectable filler. Because of particulated fillers longevity and thicker volume, it is my preferred injectable arrival to the nasolabial folds. This injectable medicine will give a 9 to 12 month result.

There are other medicine options for the nasolabial fold as well. The best way to eliminate them is the one way which is almost never done....cut them out. That gets rid of the fold immediately but also leaves a fine line scar which may only be thorough in an older patient. The other more commonly done alternative is to use an implant. I specifically use an Advanta implant for those patients that want a permanent volume solution. A very small incision is made in the nose crease and at the end of the lower fold line. The implant is slide into place from one end to the other. This is a procedure that can be done in the office under local anesthesia. An implant arrival to the nasolabial fold is a good explication for someone who no longer wants to do injections, doesn't mind the notion of an implant in their face, or has very deep nasolabial folds which would take a lot of injectable filler volume. My palpate with an implant in this area has been quite good but it is not a first line arrival for most patients.

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