Fix and Fill in Laugh Lines

As we age, lines begin to develop at the corners of the nose and extend down toward the mouth and beyond, often giving the appearance that we are much older than we really are. Known as nasolabial folds or marionette lines, these medium-to-deep facial creases are primarily caused by a loss of facial fat and less elastic skin, coupled with sun exposure and genetics.

Facial fillers can temporarily decrease the appearance of folds. When it comes to addressing medium to deep folds, there are a variety of different options available, including injectable fillers, in addition to fat. But which filler is right for you might be greatly influenced by your age. “In younger patients with minimal folds or creases, hyaluronic acid fillers like Juvéderm and Restylane, which plump up the area by attracting water, work very well,” says Duxbury, MA, plastic surgeon Christine A. Hamori, MD, adding that results can last up to nine months. “Patients in their 50s or older usually have some fat atrophy in their cheek fat pad, which causes a collapse of the cheek centrally in the face, exaggerating the appearance of the fold,” she says. “For this type of patient, I prefer collagen stimulators like Sculptra Aesthetic or Radiesse, because they restore the volume in the cheek while correcting the fold.”

Surgical procedures, like fat transfer or a facelift, can help get rid of nasolabial folds and other deep facial wrinkles as well. Although injectables can help fill in nasolabial folds and plump wrinkles, fat transfer provides longer-lasting results and may be the best option for those with wider, deeper folds that are heavily etched into the skin. Fat is taken from another part of the body and reinjected into the area around the folds, as well as in the folds themselves, to create support. “Surgical fat grafting can revolumize the cheeks and deep hollows, which contributes to the appearance of nasolabial folds,” says Dr. Hamori. “But patients should be aware of the risks and complications of fat grafting. Fat grafting may require multiple sessions to achieve the desired result, and downtime is longer as it involves a donor site from where the fat is harvested. It also causes more bruising and swelling.”

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Based on everyone I've seen who's had fillers, the face just doesn't look natural when moving -- particularly the undereye area when smiling. When at rest, it looks fine, but when moving, you can always tell. I know a couple of people who've had fat transfers (one with a facelift), and they've gotten far more natural looking results.
Posted November 15, 2013 3:19 PM EST

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Dr. Deirdre Leake
Facial Plastic Surgeon - St. Augustine, FL
Patients may differ greatly in their anatomy and age-related changes in this area. An individualized approach is recommended based on these factors. Some patients may get a nice improvement from fillers alone, while others may see more significant results with combination therapy including facelift and/or mid face lift with or without fat or other filler injections.
Posted October 17, 2012 10:18 AM EDT
Dissappointed there is no mention of the permanent facial filler artefill. It's my fave and have tried the others which cost alot and last only a month or so. For the high cost of fillers artefill is the only way to go and I love the lasting results!!!
Posted October 14, 2012 6:53 PM EDT
I love Juvaderm and Restalyn, took years off my face. I had deep circle under my eyes and had Juvaderm injected and i look 10 yrs younger.
Posted October 10, 2012 6:10 PM EDT
Allacen: have you considered superficial to mid depth peels and ultrasonic facials? Both of which will Gove u instant gratification, as well as prolonged results. Also look for peptides in your serums such as argireline, alpha lipoic acid, hyaluronic acids. I work in the paramedical aesthetics field and I have seen the wonders of these well as injectables. When seeking out a professional for injectables, word of mouth is of value. However, its also advisable to seek a consultation with the professional. Ask them if they consider tissue density, your skins elasticity, etc. The professional should consider these things because if you have enough elasticity and "tightness" to the skin, there isnt a need for certain fillers as this can "stretch" the skin, thereby degrading your intact collagen and elastin. Never feel rushed to do these things. Research questions, research results, research all of the injectables. Don't be afraid to ask. A professional will understand and will be willing to consult patiently. I hope I've helped you. Best of luck on your career search.
Posted October 09, 2012 3:15 PM EDT
To Heather I am interested in using Kinerase which specific kit are you refering to the c8 peptide under eye kit and the c8peptide facial cream ? Where do you purchase this?
Posted October 09, 2012 1:03 AM EDT
I am a 60 year old woman who due to the economy is now job hunting I feel great and have tremendous energy but I think my face is keeping me from being hired any one have any experience with getting injectables and looking younger without having to go the whole facelift route?
Posted October 08, 2012 11:21 PM EDT
I love juvederm. It has taken years off. I use it in the lips, upper cheek area and lines around the mouth.
Posted October 08, 2012 8:35 PM EDT
I'm 40 yrs and use Juvederm on my lips to create volume; it is great!! The result was amazing!!
Posted October 08, 2012 7:34 PM EDT
Kinerase all the way! I have been using the C8 kit eye and intensive facial cream. I love how quickly I saw a difference!
Posted October 08, 2012 6:51 PM EDT

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