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The nasolabial folds (smile lines) are a very common area of complaint in many patients, and often the first sign of aging in younger patients. Years ago, this area was only addressed directly by linear threading of hyaluronic acid filler. “Put the filler in the line.” That’s what we learned. But then as fillers evolved and non-surgical options for facial rejuvenation expanded, we started to learn more about faces. We began looking less at lines and more so at overall facial contours and highlights. Often times, filling the line treated the symptom rather than the problem. Its like treating bacterial pneumonia with cold medication. It helps, but it doesn’t treat the source. This is why fillers like Restylane Lyft, Voluma, and Sculptra started becoming more popular to add volume to add volume to the midface. 5 years ago, I used to sound smart when I explained this concept to patients! 💁🏻‍♀️Now all of you are so savvy that you automatically come in asking for cheek injections because your smile lines are bothering you! 🤓 Typically this works pretty well, but on rare occasion, your 48 year-old, lovely patient arrives with the most beautiful, high, and full cheekbones and giving her more cheekbone would not look natural. Sculptra would be great, which she will consider for the long term, but she prefers the idea of a “quick fix” this time. This is when treating the actual line might be preferred. I treated this patient with Restylane Defyne using a combination of linear threading, subcision with a needle, and @tom.van.eijk ‘s fern technique. Defyne was my preferred filler because she is extremely dynamic in the lower face and this product settles nicely in dynamic lines. This photo was taken immediately following, so there may be some mild swelling in the dependent areas, but overall she is thrilled!
All of this being said-if I’ve ever injected your nasolabial folds, you are one of the lucky few! I am not a fan of an overfilled, widened nasolabial fold and I’m very selective about the nasolabial folds that I choose to inject. 💉 My 12 year old has smile lines-they are perfectly normal and she doesn’t look old. 😊

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