Tuesday, May 17, 2022

Efficacy, Best Brands, Before & Afters, Risks, Cost

  • Nasolabial folds are lines that run between the nose and the corners of the mouth
  • They are a normal part of human anatomy and deepen with age 
  • Dermal fillers are an effective, safe solution to temporarily lessen the appearance of these folds

Nasolabial folds, also known as smile or laugh lines, are naturally occurring lines that become more prominent with age. For people who are dissatisfied with their appearance, nasolabial fold fillers are a minimally invasive, temporary treatment to fill in this area of the face for a more youthful look.

What Are Nasolabial Folds?

Nasolabial folds are lines that run between the nose and the corners of the mouth. While they are a normal part of human anatomy, they tend to become more prominent with age. Folds become deeper and longer due to decreased collagen, thinner skin, volume loss in the cheek area and repeated facial movements.

Other factors that deepen smile lines include unprotected sun exposure which damages and prematurely ages skin. Smoking and environmental pollutants also negatively impact the skin, and weight loss can cause cheeks to sag, deepening the creases.

Nasolabial folds vs. marionette lines

Nasolabial folds and marionette lines refer to two different types of lines on the face. While nasolabial folds extend from the sides of the nose to the corners of the mouth, marionette lines run from the corners of the mouth to the chin.

Can Fillers Treat Nasolabial Folds?

Dermal fillers are a temporary, but effective solution to treat nasolabial folds. These products consist of a gel-like solution injected below the skin, plumping the target area and reducing the visibility of lines and creases. The result is a natural-looking, fuller appearance.

How Long Do Nasolabial Fold Fillers Last?

The longevity of dermal fillers depends on the product used. On average, nasolabial fold fillers last between 6 and 18 months; however, some formulas can last up to 5 years.

Fillers vs. other nasolabial fold treatments

Other options for the treatment of nasolabial folds include:

  • Chemical peels: These noninvasive treatments exfoliate the topmost layers of skin to reduce the appearance of lines and creases, and encourage healthy tissue growth
  • Radio frequency and ultrasound treatments are noninvasive or minimally invasive procedures that use energy waves to tighten loose skin
  • Laser treatments are minimally invasive procedures that use laser energy to resurface and firm the skin, and promote collagen production
  • Plastic surgery includes various invasive procedures such as a cheek lift, full facelift or subcision to remove excess, loose skin for a tauter appearance

Compared to other treatments, injectable fillers are an effective, relatively inexpensive solution for nasolabial folds. They carry little risk of complications, are painless and don’t require downtime. However, unlike more invasive procedures such as surgery, their results are not permanent.

Best Fillers for Nasolabial Folds

All leading filler brands have products that address nasolabial folds and are typically made of:

  • Hyaluronic acid
  • Calcium hydroxylapatite (CaHA)
  • Polymethyl-methacrylate microspheres (PMMA)
  • Poly-L-lactic acid (PLLA)

A board-certified plastic surgeon, licensed injector or dermatologist can determine which product will work best for each patient.

Each of the following options has been FDA-approved for the correction of nasolabial folds.

Bellafill

Bellafill is a dermal filler consisting of PMMA microspheres suspended in a collagen gel. It’s FDA-approved for correcting smile lines and has demonstrated continued improvement for five years post treatment.

Belotero

Belotero Balance is approved to smooth moderate-to-severe nasolabial folds. It’s a hyaluronic acid filler that lasts from 6 months to a year, and has been proven safe and well-tolerated in long-term studies.

Juvederm

Juvederm’s hyaluronic acid-based products address moderate-to-severe nasolabial folds. One study demonstrated that Juvederm fillers lasted 6 months in 93% of patients.

Prevelle Silk

Prevelle Silk is a hyaluronic acid filler that targets moderate-to-severe folds. Results last for 3–4 months, making Prevelle a good option for first-time filler patients or anyone who doesn’t want to commit to a long-term change to their appearance.

Radiesse

Radiesse is a calcium hydroxylapatite filler that smooths moderate-to-severe wrinkles and folds. It’s been proven safe and effective for nasolabial folds, and results can last for 1 year or more. In one four-year study, 90% of patients reported very good or excellent results after receiving Radiesse injections.

Restylane

Restylane fillers plump up nasolabial folds with hyaluronic acid and water. Restylane Refyne is used to correct moderate nasolabial folds, while Restylane Defyne’s firmer formula treats severe cases. Known for allowing natural expressions, Restylane fillers last up to 18 months.

Sculptra

This PLLA filler stimulates collagen production to reduce wrinkles over several months. It’s suitable for nasolabial folds of any severity. Most people receive three Sculptra treatments scheduled about 1 month apart. Sculptra lasts for up to two years.

What to Expect From Your Filler Treatment

At your appointment, your provider will map out the injection sites on your face. They’ll cleanse the areas with an antibacterial agent and may also numb your skin with a local anesthetic if the product being administered doesn’t include a numbing agent.

They will then administer the injections and massage each site to sculpt the product and ensure it’s optimally placed. While dermal filler injections aren’t considered painful, you’ll be given a cold compress to alleviate any discomfort. The entire appointment should generally take no more than 1 hour. 

Treatment aftercare

After receiving dermal fillers, you can expect some discomfort and tenderness. To reduce bruising and swelling, regularly apply cold compresses to the treatment area and take pain medication as necessary. Until the swelling is resolved, you should refrain from:

  • Drinking alcohol
  • Extreme temperatures
  • Intense exercise
  • Unnecessarily touching your face

Otherwise, you can return to your daily routine right away. One study found that 50% of patients could return to normal social activities just 2 hours after receiving hyaluronic acid fillers.

Risks and Side Effects

Facial fillers are generally considered safe. However, like any cosmetic procedure, they do carry the risk of side effects and complications.

Immediately after your procedure, you may experience bruising, hard areas, hives, temporary numbness or swelling at the injection sites. These reactions should fade within a few hours or days.

Other risks include:

  • Asymmetry
  • Bleeding 
  • Inflammation
  • Lumps
  • Redness
  • Rash

Serious but rare potential complications include damage to facial features, infection, vision impairment, skin necrosis and stroke. To minimize your risk of possible complications, be sure to receive your facial fillers from a board-certified plastic surgeon or dermatologist.

Is filler migration a concern?

Filler migration occurs when a filler shifts away from the injection site underneath the skin. Although it isn’t dangerous, it can create an asymmetrical or misshapen appearance.

Lower your risk of filler migration by diligently following the aftercare instructions given by your provider. Do not compress the filler or try to move it under your skin. In the rare event that filler migration occurs, contact your provider immediately.

Cost of Nasolabial Fillers 

The cost of nasolabial fold fillers depends on the chosen brand and how many syringes are used. Most patients need multiple syringes to achieve their desired results.

According to recent statistics, the average prices per syringe of the most popular facial fillers are as follows:

  • CaHA fillers (Radiesse): $717
  • Hyaluronic acid fillers (Belotero, Juvederm, Prevelle, Restylane): $684
  • Polylactic acid fillers (Sculptra): $853
  • PMMA microsphere fillers (Bellafill): $1,058

These prices will vary depending on office location, the expertise and qualifications of the provider and the time and effort required to administer treatment.

Insurance does not pay for cosmetic fillers, but your surgeon may offer a financing plan to make the cost more manageable.

Takeaway 

Nasolabial folds are normal facial features that become more prominent with age. Filler treatments are an effective, minimally invasive solution to temporarily soften the appearance of these folds.

Fillers require minimal downtime, cause few side effects and produce natural-looking results. They last anywhere from several months to 5 years.

If you are interested in dermal fillers, it’s imperative to choose a board-certified plastic surgeon, dermatologist or a licensed injector for your treatment. A qualified surgeon reduces your risk of unwanted complications.

Sources

  • COHEN, S.R., BERNER, C.F., BUSSO, M., CLOPTON, P., HAMILTON, D., ROMANO, J.J., RULLAN, P.P., THALER, .M.P., UBOGY, Z. and VECCHIONE, T.R. (2007), Five-Year Safety and Efficacy of a Novel Polymethylmethacrylate Aesthetic Soft Tissue Filler for the Correction of Nasolabial Folds. Dermatologic Surgery, 33: S222-S230. https://doi.org/10.1111/j.1524-4725.2007.33365.x
  • Lorenc ZP, Fagien S, Flynn TC, Waldorf HA. Review of key Belotero Balance safety and efficacy trials. Plast Reconstr Surg. 2013 Oct;132(4 Suppl 2):33S-40S. doi:10.1097/PRS.0b013e31829a07d5
  • Monheit G, Beer K, Hardas B, Grimes PE, Weichman BM, Lin V, Murphy DK. Safety and Effectiveness of the Hyaluronic Acid Dermal Filler VYC-17.5L for Nasolabial Folds: Results of a Randomized, Controlled Study. Dermatol Surg. 2018 May;44(5):670-678. doi:10.1097/DSS.0000000000001529
  • Sadick NS, Katz BE, Roy D. A multicenter, 47-month study of safety and efficacy of calcium hydroxylapatite for soft tissue augmentation of nasolabial folds and other areas of the face. Dermatol Surg. 2007 Dec;33 Suppl 2:S122-6; discussion S126-7. doi:10.1111/j.1524-4725.2007.33351.x
  • Solish N, Bertucci V, Percec I, Wagner T, Nogueira A, Mashburn J. Dynamics of hyaluronic acid fillers formulated to maintain natural facial expression. J Cosmet Dermatol. 2019 Jun;18(3):738-746. doi:10.1111/jocd.12961
  • Brown SA, Rohrich RJ, Baumann L, Brandt FS, Fagien S, Glazer S, Kenkel JM, Lowe NJ, Monheit GD, Narins RS, Rendon MI, Werschler WP. Subject global evaluation and subject satisfaction using injectable poly-L-lactic acid versus human collagen for the correction of nasolabial fold wrinkles. Plast Reconstr Surg. 2011 Apr;127(4):1684-1692. doi:10.1097/PRS.0b013e318208d371
  • Swift A, von Grote E, Jonas B, Nogueira A. Minimal recovery time needed to return to social engagement following nasolabial fold correction with hyaluronic acid fillers produced with XpresHAn technology. Clin Cosmet Investig Dermatol. 2017 Jun 14;10:229-238. doi:10.2147/CCID.S138155
  • American Society of Plastic Surgeons. Plastic Surgery Statistics Report. 2020. https://www.plasticsurgery.org/documents/News/Statistics/2020/plastic-surgery-statistics-full-report-2020.pdf

» Show all

Latest Articles