Nasolabial folds, to fill or not to fill?
Your smile is one of the loveliest parts of your face.
The more time you spend smiling and laughing, the better life is. The natural ageing process and your years of laughing and smiling creates nasolabial folds. Also known as ‘smile lines’ or ‘laughter lines’, nasolabial folds start at the bottom of your nose and extend to the outer corners of your mouth. These indented lines become more prominent when people smile and can deepen with age. When our patients look in the mirror and see visible nasolabial folds, they often regard them as a sign that they’re ageing.
What causes nasolabial folds and why are they such an issue for people?
Nasolabial folds are a natural part of your face that lie as a gradient between your cheeks and upper lip. Your nasolabial folds are composed of dense bundles of fibrous muscle and tissue and tend to become more prominent with age. As your skin becomes thinner and succumbs to the effects of gravity, you may notice them more. Nasolabial folds become more prominent and obvious due to factors including:
Sun exposure which can prematurely age and damage your skin and create changes in skin texture
A natural loss of collagen due to the natural ageing process, resulting in your skin becoming thinner and weaker
A loss of facial fat leading to your cheeks, nasolabial folds and marionette lines appearing saggy
Smoking and exposure to environmental pollutants
Frequent weight fluctuations or rapid weight loss
When we only see ourselves in two dimensions in a mirror or in a photo, we have a ‘warped sense’ of what we look like. Since we can’t view our three-dimensional image and see our facial shape and contour, we only focus on the folds, wrinkles and lines. Your nasolabial folds are one of the major folds in your face and because they’re in the central part of the face, it’s natural that your attention is drawn to them.
Why nasolabial folds are one of the most dangerous areas to fill in your face.
When you make a booking for dermal filler treatment, you’re probably unaware of any dangers that may be involved. A major danger zone for dermal filler treatments is at the nasolabial fold, where the facial artery runs right up to it from the jawline and past the corner of the mouth through nasolabial fold. When dermal filler is injected into an artery, it is potentially disastrous.
I am passionate about an authentic consent process. Understanding risk, and understanding what we as practitioners do to reduce the risk.
I use a blunt tipped catheter to inject perpendicular to the artery direction. A cannula is a blunt tipped instrument like a needle but has a rounded blunt tip. This means there’s less likelihood of the wall of the artery being penetrated with dermal filler. Then I use a very slow method of injecting, pain is an indicator that you could be in a vessel.
Thirdly, we always have an emergency back up plan in all our treatment rooms. If dermal filler is injected into an artery and the signs of vascular occlusion become apparent, we have a reversal agent at hand to inject into that area immediately. Using hyaluronidase dermal fillers can be quickly reversed and broken down.