Dr. Sam Lam Plastic Surgery Forum

I have been plagued with nasolabial folds for as long as I remember. But I believe they are due to facial structure and not aging as I am still very young. I am really bothered by them. Is there anything permanent I can do? Picture included.


I'm also getting rhinoplasty in the future. PLEASE help. I can't find answers for this anywhere.

first, i don't think they make you look bad so i would probably tell you not to spend any money doing so. however, if they really bother you the only safe thing for an 18 year old face in my opinion is a temporary product like perlane or restylane. i would go with perlane because although it is firmer it lasts much longer. in general, the products don't last more than a few months so it can get expensive. i use artefill which is a permanent filler but i would not in you because you are too young in my opinion. i want to make sure a permanent filler ages well for you. you could go with a surgical implant but i am opposed to these because i think they don't look natural, shrink over time, feel hard, and require incisions that oftentimes do not heal well. as you can see, i do not perform that procedure any more. it is a nightmare in my opinion. i think the two best points of advice for you are 1) forget treating them they are probably not worth it, and 2) if you do only go with a temporary solution.
best,
sml

I understand and appreciate your rational and am glad you are concerned with your patients well-being. They really really do bother me though and I feel like I'd rather get them fixed while I'm young and can enjoy having a mostly flawless face rather than do an over-haul on my face in my forties. They are a hereditary problem and one of the only things that aged very noticeably on my mother. That being said, is fat grafting an option? From what I've read it's safe, natural, and about 50% gets absorbed into the body which is better than it disappearing completely after a few months. Thank you.

My opinion is fat grafting is really an unacceptable option. I know that many docs who do it don't believe me but isolated fat grafting to a young woman has the following problems:
1. fat is a live graft and if done well will persist and fluctuate with weight and metabolism. to me for someone as young as you, that may not be a great idea.
2. a permanent injectable in someone young like you may have problems with how it will age down the road and it may not look good over time. that would be something uncorrectable.
3. fat actually does not work well for the folds. i find the failure rate to be close to 95%. that is why when i do fat transfer i tell them to be prepared for it to fail there. why? the movement is too great to retain the fat. plus, fat is too soft to lift the fold up well. it simply does not work well.

in summary, if it works, then you can have a problem in the future. if it doesn't, then you will have a problem now. i personally believe it is a terrible option for you. i am really one of the world's authority on fat grafting who has written a textbook on the subject. i would honestly say that given your age, you really should be looking at temporary options for your safety. even if you don't care about your future safety, hopefully the doctor will.
best,
sml