This is the area that patients mostly describe as deep wrinkles on both sides of my mouth.
Nasolabial means "from nose to lip" in Latin. The nasolabial fold is the anatomical transition line that extends from the edge of the nose to the edge of the mouth and separates the lip and cheek.
It gradually deepens as you get older, and often merges with the "marionette fold" that runs from the lower lip to the chin. It is one of the characteristic features of older faces, and its deepening can become an eyesore even for the most self-satisfied individuals.
Nasolabial fold is a deformation that occurs under the influence of many factors.
For example, it is affected by facial movements. When the laughing muscles are activated, they compress the cheek fat mass like an accordion. As a result of this compression, the skin and subcutaneous fat tissue at the border of the mouth and cheeks become thinner due to repeated pressure, and a wrinkle occurs here.
Another important factor in the formation of the nasolabial fold is the sagging of the cheek mass as a whole. As the cheek droops, it moves not only downward but also towards the center of the face. When you move the cheek mass up and out with your hand, you can observe that the nasolabial fold is improving. Face lift surgery is the way to permanently achieve what you do with your hands.
The nasolabial fold is also greatly affected by the bone skeletal anatomy. In individuals whose upper jawbone is backward, this fold becomes evident at a very early age and in a very deep way. Tooth loss, especially during the aging process, can cause the nasolabial fold to suddenly become extremely prominent. If you have a relative with a removable denture, observe the face while the denture is in place and when the denture is removed. When the prosthesis comes out, you can suddenly observe that the nasolabial fold deepens, the upper jaw recedes, and the face looks 5-10 years older within seconds. Supporting the upper jaw with a prosthetic tooth or surgically placing a paranasal implant on the bone surface here can significantly correct the nasolabial fold in accordance with the anatomy. An underlying scaffold of the nasolabial fold In cases where it is caused by a nasolabial fold, you cannot achieve an effective improvement in the nasolabial fold no matter how much you try with face lift surgery.
Another important factor in the formation of the nasolabial fold is the volume changes in the subcutaneous fat tissue. Especially in individuals who gain weight significantly from the cheeks and then lose this weight quickly, the skin that stretches and expands during the overweight period becomes empty and sags when it loses weight. In a group of patients with severe weight loss, the nasolabial fold may not be effectively removed even by face lift surgery, and in these cases, it may be necessary to excise the fold leaving a scar on the skin.
At this point, the subcutaneous fat tissue volume of the cheek must be reduced. It should be emphasized that all reducing methods may cause the nasolabial fold to become more pronounced/deepened. I also mentioned in my other articles; Bichectomy, facial liposuction, mesotherapy that melts fat, and energy-based applications that cause heat damage under the skin and melt fat tissue can deepen the nasolabial fold in the months following the procedure.
The simplest method to treat the nasolabial fold is to fill the triangular area on the inner side of the fold with a filler, the upper edge of which is formed by the nose wing and the outer edge of which is formed by the nasolabial fold, and which remains relatively hollow. However, the point that should be known is that filling the nasolabial fold may create an amorphous facial structure devoid of aesthetic angulation and contour transitions in individuals whose face is truly sagging. Access to the nasolabial fold near the center of the face is limited. “Extended subcutaneous” approaches, which separate the skin from the ground up to the nasolabial fold, are effective in correcting the nasolabial fold, but (1) they risk the blood circulation of the skin (2) and when the skin loses its tension and stretches in the postoperative period, the first recurrent symptom is the nasolabial fold that is furthest away from the pulling force.
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