The nasolabial folds, also known as marionette lines or smile lines, run from the nose to the corner of the mouth. They separate the cheeks from the upper lip. As we grow older, the creases formed in the nasolabial folds can become more prominent due to several factors, such as excess skin, thinning of skin, and ptosis or drooping of cheek fat.

Will a facelift help?

No perfect method exists to treat this problem. A Facelift alone will not remove the creases. Other treatments must be used either alone or in conjunction with a facelift.

During a facelift it is common to tighten the underlying muscle layer called the sub muscular aponeurotic system (SMAS). However, for tightening to have any benefit this muscle layer must first be released from some of the structures to which it is attached, especially the muscles around the eyes. Unfortunately this increases the risk of this surgery and creates an unnatural appearance. Although a facelift may reduce the appearance of the nasolabial fold, it will also flatten much of the facial curvature, thereby “aging” the face.

Another effective method is to surgically remove the creases; however, this leaves scars that may be worse than the original creases.

Is there a safer method?

A safer, simpler method to reduce the appearance of the nasolabial fold is to use Liposculpture to remove the excess fat that lies in the area of the folds. The scarring that is created beneath the sculpted areas may also have a beneficial effect. To smooth the transition between the fatty cheek and the lip, Fat Grafts or artificial prosthetic material have been placed beneath the creases. The fat is either injected into the areas or surgically grafted.

At this time no surgical method can completely remove the nasolabial folds and produce a good cosmetic result in every patient. A new treatment that is gaining popularity is actually an old surgical technique modified using new, more-powerful instruments. This method, known as Subcision Surgeryreleases the fibrous bands under the skin without any incisions.

Will treatment rejuvenate the whole face?

Releasing or tightening the nasolabial folds are reasonable treatment strategies; however, they do not restore the volume that inevitably occurs with aging. Tissue fillers such as Restylane® provide a means to restore volume. Several other fillers are currently available in the US market. Read the Pros and Cons about these fillers to gain a better understanding of which one is best for you.

Fillers will most certainly improve the appearance of the nasolabial fold, but often the cheeks and lips also require treatment. Elevating the cheek with a Midface Lift or augmenting the lips with Restylane® will greatly enhance the appearance of the nasolabial folds by rejuvenating these adjacent structures.