10.1055/b-0040-177255 13 Facial Danger Zone 4 – Nasolabial RegionRod J. Rohrich and Raja Mohan Abstract This chapter summarizes how to inject soft-tissue fillers into the nasolabial region. By far the most common cause of nasolabial folds is sagging and flattening of the cheeks. However, in some patients this activity can be excessive, and some authors have described another treatment point, called the … SISU's aesthetic doctors have years of experience in achieving natural, subtle, rejuvenating results with dermal fillers along the nasolabial folds. Cannula Technique for Nasolabial Folds. Nasolabial fillers can be performed in a clinic with almost no downtime. Figure 1 (click on the image for a full-size view) shows a 52-year-old patient who was treated with 2.4 mL of JuveDerm Ultra Plus XC in the mid-face (infra-orbital, deep medial fat pad,8 nasolabial fold and oral commissure) using a combination of a 30-gauge and a 27-gauge cannula. Reversible dermal fillers are safe and well tolerated, with great results. Lip injections are now the largest application for HA fillers in the face and exceed cheeks and nasolabial fold injections within your aesthetic practice across all demographics. ... What type of filler and how much is used depends on the severity of the fold. Alternatively if treating deeper to give more structure a firmer type of filler will be used. Nasolabial Line Filler⁣ ⁣ The nasolabial fold is the deep crease running from either side of the nose down towards the corners of the mouth. The foundation or 101 when it comes to good injection technique for dermal fillers is knowing the purpose of your injection. Patients often report a prominent nasolabial fold as they age, and one option for treatment is the injection of soft-tissue filler. Answer: Nasolabial Fold Fix The retracted maxilla, can be the reason for getting deeper nasolabial folds, and you need to have some support under the skin so the folds do not get deeper. Blood vessels of the face travel in the territory of the nasolabial region. We use several different types of nasolabial fold filler. The facial artery’s anatomical location is intimately… Dermal filler treatments can have a major impact in terms of restoring volume and a youthful quality to skin. I use the ‘cross-hatching’ technique – this is when filler is injected perpendicular to the direction of the fold.6 It’s a principle borrowed from engineering, known as ‘bracing’. Everything about the muscle relaxant; Frown lines; Remove crow's feet; Skin and hair. Based on your photos, one syringe of Juvederm is not enough filler to address your nasolabial folds. You will have a chance to practice at Dermal Filler Training. The most common fillers are made from … For all of you who don’t want to experiment with cosmetic injections or plastic surgery in an intent to camouflage this concern. We’re going to augment Gill’s cheekbone using Juvederm Voluma and a needle technique. If enhancing the cheeks doesn’t do enough and the patient still wants the folds softened more, a newer and safer technique to use is with a fine, blunt-ended cannula instead of a needle. 32, 33 The author feels that periapical hypoplasia accounts for a significant proportion of prominent folds, especially toward the proximal 1/3 of the nasolabial fold. A nasolabial fold treatment will last for 9 to 12 months. Through the wrinkle injection treatment of the nasolabial fold with hyaluronic acid (filler treatment), the fold between the nostrils and the mouth corners will be replenished, so that the tired and severe facial expression may disappear from your face. Correction of these folds can be done by injection of dermal fillers or fat into the cheeks to fill the hollow and pull the cheek up. It is superficial in the upper 1/3 of the nasolabial fold and ramifies with the inferior alar artery and lateral nasal artery. The goal of nasolabial fold treatments is to even out the skin volume, leaving you with a smoother, refreshed-looking appearance. In addition to having the right amount of product, correct injection technique is also important in achieving adequate correction. The only patients whom we considered to show photographic improvement of the nasolabial fold were those who had filler placed in the transition between the lateral nasolabial fold and cheek. I think this definitely softens the blow of that initial treatment cost, and I think I’ll definitely be booking in for a top-up when my lines start to reappear. Technique for Safety in the Nasolabial Fold When injecting into the nasolabial fold, use of a cannula should be considered, given the close proximity to the facial artery and its potential loca- tion within the subcutaneous tissue. 7 . Vollure, like Volbella and Voluma, have VYCROSS™ technology. For treating nasolabial fold concerns, the filler is placed either directly into the fold to add volume, or into the upper cheek to detract from the fold’s noticeability. Too much filler in the lower face can make you look older, not younger. This post will guide you through the natural nasolabial fold … This area, usually called the nasojugal crease, frequently hollows in patients who thin as they age and visually separates the cheek from the nasolabial fold. Filler placement requires a lot of experience, skill, and expertise in facial anatomy. The amount of dermal filler needed to treat nasolabial folds depends on the severity of the folds and how deeply-set they are. Average longevity is 9-12 months. Results: These infiltration techniques are simple to perform and provide adequate anesthesia for the painless injection of filler substances in the lips and perioral, nasolabial regions. Consequently, we can see that filler injected in this region will give us attractive projection. We cannot use their names due to Australian regulations, which makes it difficult to talk about how they compare to each other and the pros and cons of each. If treating the nasolabial fold directly a softer filler will be used to allow for natural facial expression. Instead of using dermal filler only in the lower half of your face, your doctor will inject you in the upper part of your face. Lines of filler can hold and support the tissue they are injected into, reducing the amount of unwanted movement in that tissue. Improving the light and the way it shines is the goal to consider when improving the nasolabial folds and the face as a whole. Nasolabial fold correction is frequently performed by injection of hyaluronic acid fillers. The shadowing in this field breaks up the light and subtleties that you use to have when you were young. The preinjection topical anesthetic preparation, the actual infiltration techniques, and the author's experience are reviewed. The nasolabial fold is a sharp transition from the cheek to the mouth area. The black dotted line in Figure 3A illustrates the skin surface of the nasolabial fold and the white dots show the under-side of the nasolabial folds where the anesthetic is injected. Lip augmentation procedures is expected to keep growing as generations of all ages seek to enhance the look of their lips and is considered fashionable to do so. Nasolabial Fold Injection Technique | Cosmetic Medical Training Watch Dermal Filler injections in the Nasolabial Folds. It is typically used in the cheeks, nasolabial folds, marionette lines and lips among other areas. Choosing the type of dermal filler for the nasolabial fold. Dr Hill explained to me that as the quality of filler continues to improve, we can now expect slightly longer-lasting results and so my filler is likely to last for 12-18 months. A deepening nasolabial fold is one of the most difficult signs of age to treat. Hence, one of the risks of laugh line filler injections is blood vessel occlusion. Some are stiffer, some more flexible, some longer lasting, some attract water more (hydrophilic), and lastly… they slowly break down (by action of your own enzymes) at different rates. A minimum of two 1 ml syringes of dermal filler (one syringe for each fold) is usually required in order to effectively reduce the appearance of nasolabial folds. And a big concern for many people. Tip: Inject just medial to the nasolabial crease to prevent splaying of the product laterally. Putting filler too much around the front of the cheek can add to the heaviness and accentuate the nasolabial folds. It will also have the effect of lifting the cheek in this vicinity and improving the nasolabial fold. Juvederm Vollure is a medium thickness filler from Allergan. ⁣ ⁣ Fat is lost from the cheeks, reducing skin volume and making this fold appear deeper. I typically use an advanced technique with a microcannula to break down the bands at the folds while injecting the filler, which further softens the laugh lines. This may sound a little odd as surely the purpose is obvious, but is it really? Correct Nasolabial Folds and Marionette Lines in Portland, OR. In addition to making you look younger, our goal is to help you look natural. Filler - all you need to know; Lip injection; Eye circles and tear troughs; Nasolabial fold; Marionette folds; Jawline; Cheek augmentation; Rhinoplasty without surgery; Not Just for Wrinkles. Our number one treatment option is a filler cheek lift which not only reduces the nasolabial fold but also improves the overall structure of the face and prevents the fold from deepening further. This crease becomes more noticeable as part of the natural ageing process. Deeper folds will require more filler … What are nasolabial folds? However, if you’re at the nasolabial fold stage, the MD Codes technique might surprise you. Filler treatment can be performed at the nasolabial folds in order to smooth the appearance of laugh lines. The objective of this article is to describe a simple method of local anesthesia infiltration for pain control when injecting filler substances into the lips and perioral and nasolabial fold areas. Dermal filler placement is a quick, comfortable outpatient procedure. When we treat patients with excessive gummy smile or a deep nasolabial fold, if this is mild, we can treat them purely by targeting the levator labii superioris alaeque nasi, or LLSAN. 8 The concomitant injection of fillers at multiple layers, such as the supraperiosteal and subdermal layers, has been proposed for the correction of nasolabial folds. The type of filler will depend on the technique used which is differ between patients. ~0.1 cc of filler in the upper portion of the nasolabial crease; this helps to evert the upper lip. When treating this area, cheek filler is commonly required in conjunction with corrective work to the nasolabial folds. Technique for Nasolabial Fold Anesthesia This technique involves injecting local anesthesia into the oral mucosa on the underside of the nasolabial fold. One must be cautious in the region of the piriform aperture so as to not inject or externally compress the angular artery. Materials and Methods. This technology allows the filler to appear much smother and more natural looking. The filler itself for the nasolabial folds (NLF): Hyaluronic acid (HA) fillers all have different properties – all of them. The results of nasolabial filler injections can also be appreciated immediately. Vollure. Are nasolabial fold fillers very obvious?

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