Hi! I have a question on nasolabial folds. Are there any products that can help in making them less pronounced? Or are there any ingredients that we should look for in creams/serums etc. that can maybe help in “lifting” these folds? Thank you so much! -Francesca
There are three “tiers” of treatment in dermatology for nasolabial folds, tiered according to price and availability. They are:
Top Tier: Surgical correction
Not surprisingly, the most long-lasting and effective treatment for nasolabial folds is plastic surgery. The three procedures conducted most often to correct nasolabial folds are the mid-facelift, cheek implants, and nasolabial fold excision:
- If your cheeks are sagging, a mid-facelift will likely be recommended, as this procedure lifts nose-to-mouth nasolabial folds as well as drooping cheeks.
- If you would like more facial contouring, a small cheek implant often softens the upper part of the nasolabial folds, while giving more definition to the face.
- If you have severe nasolabial folds, a nasolabial fold excision may be your best bet. The nasolabial folds are literally removed from your face and the area is sutured afterwards.
Middle Tier: Fillers and/or Botox
By far, the most common treatment for nasolabial folds is a hyaluronic acid filler. There are three main classes:
- Temporary hyaluronic acid fillers, such as Restylane, Juvéderm, and Perlane, are typically injected into the mid-to-deep layers of the skin to plump up nasolabial folds. Results typically last 9-12 months. While price varies by region, expect to pay upwards of $900 for this option (typically about $450 per syringe, and two will usually be needed).
- Collagen stimulators, such as Radiesse and Sculptra Aesthetic, are for patients with less severe nasolabial folds. Think of Radiesse and Sculptra as best for gently rounding out an aging face that has been gradually losing volume for years. Results will last 6 to twelve months, and expect to pay a bit more, upwards of $1000, for this option.
- Permanent fillers, such as Artefill, have the advantage of being, well, permanent. In addition, Artefill in particular has been FDA approved for use in the nasolabial folds. So why am I mentioning it last? The truth of the matter is, it is hard to correct potential complications as a result of using Artefill, so be careful in selecting your doctor or aesthetician. Make sure he or she has done the procedure before, particularly in the nasolabial folds, a region in which it is difficult to get the right symmetry. Ask to see photos of before and after photos. Another caveat: Artefill costs over twice as much as the other options, about $2100 and over for the average.
Bottom Tier: Retinoids and peptides, Silicones
Even if you can’t afford more than $100, don’t fret: Scientifically-backed solutions are available in skin care products. Granted, these products will not typically produce the same results as the surgical procedures, but they also come with a far lower price tag — and far less risk.
Consider Retin-A or topical over-the-counter retinol creams: According to research by Fisher et. al, retinoids are effective in preventing and treating the collagen loss caused by years of cumulative sun damage. Fisher et. al also demonstrated that application of tretinoin (a form of retinoid found in prescription Retin-A) stops matrix metalloproteinase (MMP) genes from starting their collagen-degrading activities. So I highly recommend Retin-A. If, however, you are interested in over-the-counter retinol treatments, I (of course) love our retinol FutureDerm Time-Release Retinol 0.5 ($54.95) with 0.5%; and I’m also a fan of Neutrogena Healthy Skin with <0.025% retinol, Skinceuticals Retinol 0.5 or Skinceuticals Retinol 1.0 with 0.5% and 1.0% retinol, respectively, and Green Cream Level 3, Green Cream Level 6, and Green Cream Level 9 with 0.3%, 0.6%, and 0.9% retinol, respectively.
You may also want to consider glycolic acid treatments in the area. According to a 1998 study in Dermatological Surgery, glycolic acid treatments increase skin cells’ production of collagen better than other alpha hydroxy acids, including lactic acid or malic acid. However, if you’re deciding between prescription-strength retinoids and over-the-counter glycolic acid peels, you may want to choose the prescription retinoid: According to a randomized, placebo-controlled double-blind study, it was found that 0.05% all-trans-retinoic acid was more effective than 10% glycolic acid (a concentration found in at-home treatments) in treating signs of aging.
Finally, no matter what, look for skin care products that contain silicones for use in the nasolabial area. These products temporary “fill” the area, making it look more cosmetically appealing. I like Too Faced Cosmetic Wrinkle Injection ($26.95, Amazon.com). Though its ingredients aren’t going to make you start producing collagen like the injectables Radiesse or Sculptra Aesthetic, the product’s high concentration of silicones will still temporarily “fill in” your wrinkles, and also provide a more firm, solid canvas on which to apply your concealer and foundation. Always a plus!
The “right” treatment for your nasolabial folds comes down to your penchant for spending money and risk-taking. Those high in both categories are likely to get surgery, whereas those on the opposite end of the spectrum should use Retin-A, get regular glycolic acid peels, and use a cosmetic product designed to be a filler with silicones as well.
That said, most people choose the hyaluronic acid fillers right now, as these procedures have a high degree of satisfaction with a relatively low risk if you choose an experienced physician or aesthetician.
What are your thoughts on nasolabial fold treatments, and wrinkle treatments in general? Let us know in Comments!
- 35Wrinkled forehead, a photo by iamsin on Flickr. Oh, forehead wrinkles. Even if you're amongst the least vain of people, they're still a concern, as they make you look angry and frustrated. And if you are somewhat vain, well, they're a nightmare! - aging, visible, hard to disguise. Forehead wrinkles can occur at any age,…
- 34Last week, I briefly discussed some of the more popular hyaluronic acid (HA) fillers, including Juvéderm®, Restylane®, and Perlane®. What I didn’t include were non-HA dermal fillers, which can be synthetically created in a lab or created from your body's own cells. Like hyaluronic acid fillers, other types of dermal fillers are great for replacing…