Nasolabial Folds / Laugh Lines Correction
Remove unsightly laugh lines now! For a more youthful look.
Laugh lines are nasolabial folds that run from both sides of your nose to the corners of your mouth. They come with aging, when facial fat pads are lost and cause the skin to sag downwards and form prominent folds.
Correction by Filler
These are easily reversed with hyaluronic acid filler injections into the lines, volumising the area and minimizing the appearance of such lines. Hyaluronic acid filler is a proteoglycan similar to what is also found in our skin, eyes and joints. It is highly reversible, either by dissolution or natural breakdown by the body over months, and has been found to be very safe for facial contouring.
This procedure takes up to 30 minutes, with 2-3 injections per side from the corners of the nose to a little way down the nasolabial lines. Some massage over the area after the procedure minimises side effects. There is no downtime.
For better result, some may also require a treatment of cheek fillers to restore the facial fat pads that were lost. (You may read more about it here.)
As nasolabial folds are a part of normal facial expressions and are present during smiling even in little babies, elimination may be possible but it is not the aim. Rather, treatment aims at reducing sunkeness and severity of these lines, especially when the face is at rest and without expression, for a less aged look.
Correction by B'tx
Some lightening of these lines with b'tx is also possible and is more often used in conjunction with filler augmentation to enhance the correction and improve results.
Possible side effects
Numbness of the upper lip during the procedure is common due to the presence of anaesthetic in the filler; it disappears in hours. This area hardly sees any bruising at all.
Sometimes, lumpiness may be felt just after the procedure but it quickly resolves within 2 weeks or so.* A very rare complication is where the side of the nose gets less blood supply after the procedure, resulting in some skin changes – medical attention should be sought immediately if this happens.
Correction by Threadlift
If you find fillers not suitable for you, you can also consider facial threadlift to improve the laugh lines.
Short PDO threads are inserted just beneath the skin of the laugh lines to improve firmness of the skin and reduce superficial wrinkles. These threads improve the quality of your skin through the first 6-8 months of treatment. Long PDO threads may also be inserted to lift the skin of the laugh lines so that they look lesser when the droop of the skin is corrected.
Threads are a safe option and are highly reversible, as they dissolve completely after 6-8 months.
Dermal Fillers FAQ & Myths
What are fillers? How many types of fillers are there?
In a nutshell, fillers can be classified into temporary, semi-permanent and permanent fillers.
Our favourite is the hyaluronic acid (HA), which is a temporary filler lasting between 9-12 months. It’s made of glycosaminoglycan polysaccharide and is not just found to be naturally occurring in the body as universal extracellular matrix– it’s also chemically identical across species and therefore, is very low on antigenicity, i.e. less likely to cause bad immune reactions.
In other words, it’s very safe. There are many other brands in the market that are also similarly good in quality. Be sure to check with your doctor on this.
There are also other type of fillers that are non-hyaluronic acid based, such as poly-L-lactic acid, calcium hydroxyapatite and poly-caprolactone. They essentially work by having an initial bulking effect plus an additional benefit of stimulating collagen synthesis wherever they are placed.
This enhances their volume enhancing effect in the mid-term, so you may have to wait a little for the full effect. However, they may not necessarily last longer than current, newer type hyaluronic acid fillers. An alternative would be to choose a more viscous hyaluronic acid product, which your doctor can recommend to you.
Semi-permanent fillers last the longest. Examples include polyacrylamide gel (i.e. plastic), and liquid silicone, which is the longest lasting of all fillers. These can last for years. However, the longer lasting the filler, the more likely it can cause complications such as lumps and scarring.
Why did the facial filler seem to decrease so quickly in the first 2 days after injection?
Hyaluronic acid (HA) occurs naturally without cross linkages. In this form, it is easily broken down in the body in 1-2 days. The HA that remains are those that are still cross-linked, which prevents its breakdown, and this is the form that lasts. Therefore, your facial filler with HA can seem to decrease quickly in the first 2 days before it plateaus into a steady state. The rest decreases slowly. Therefore, the more cross-linked the HA, the longer it lasts.*
There is also a part of the filler procedure that causes a little swelling, such as the local anaesthetic and the inflammation of local trauma. This quickly subsides in a few days, leading to a reduction of up to 20-30% in the final result.
Should I always choose the brand of HA that lasts the longest to save cost?
The longer HA lasts, the more viscous it must be and therefore, the harder its feel may be or its chance of leaving residual lumps. Harder HA may not be suitable for all areas of facial correction, even though they last longer, because they may not be suitable for all areas or feel all that natural in others.
Why does my nose have a bluish tinge after filler injection with hyaluronic acid?
If it isn’t a bruise, it can be due to the Tyndall effect, which occurs after injection of hyaluronic acid is done too superficially so that it shows through the skin, making it take on a bluish tint that is not easily hidden by makeup. It doesn’t happen often, though, and can be avoided by placing the filler in the correct plane. Newer improved fillers seldom give the Tyndall effect these days.
After a facial filler injection, can I go for massage or wash my face?
Temporary fillers are moldable in the first 4 hours or so and they settle in approximately 2 days. In the first 4 hours, you shouldn’t apply firm pressure on the area of the filler or massage too hard. Gentle washing of the face is permitted. For the first 2 days, it is advisable not to apply prolonged pressure on the area of the facial filler e.g. sleeping on that side of the face– there is a slight chance it may shift. Thereafter, once it has set, you can do whatever you want and it should not change in shape.
Myths about dermal fillers– busted.
Myth: Fillers are permanent.
Truth: There are many different types of fillers. Some are permanent, some are semi-permanent and the rest are temporary fillers. Temporary fillers are mostly made of hyaluronic acid nowadays. It is a substance that is also naturally found in the body and is absolutely safe for use. It is gradually broken down by the body and absorbed, usually lasting from 6-12 months.*
Myth: Fillers are harmful for the body since they are absorbed by the body.
Truth: Absolutely not. Hyaluronic acid, which is used as temporary filler, is a natural substance found in the skin, joints and eyes of the body. It is gradually broken down by the body and not harmful to health. In fact, some brands of fillers have obtained FDA’s approval for clinical use.*
Myth: Surgery is required to place fillers into the body.
Truth: Not at all. Facial fillers for the nose, nasolabial folds, cheeks, chin, etc. are easily placed into the respective parts via a few simple injections. There is no need to undergo the knife– hence the wonder of minimally invasive procedures. Even breast fillers only require 1 or 2 injection sites under the breasts. Minimal pain and minimal scarring, in just under 15min!*
Myth: You need to keep coming back for frequent top-ups once you do fillers.
Truth: Top-ups are required only because temporary fillers are naturally broken down by the body and absorbed, so its effect diminishes over time. They are not in the least bit addictive and you can choose not to top up again if you’d like. The filler will simply disappear and the part of the body will return to its original state as before filler was done.*
There can be incidences where the fillers last longer than expected in some people, especially after 1 or 2 top ups. This eliminates the need for frequent top ups over time.*
Myth: When the filler disappears, you’ll look worse than before.
Truth: Fillers do not change the original state of the body part it is placed into. When it is absorbed, that part of the body simply returns to how it was supposed to be. Of course, temporary fillers last up to a year or more and in that time, the body is still undergoing its own aging process.*
Myth: Fillers are harmful to the body when used in the long term.
Truth: Hyaluronic acid is a natural substance found in the skin, eyes and joints. It is gradually broken down by the body’s natural metabolism and is not known to be harmful in the long term or short term. Newer studies have also showed that it may actually boost natural collagen in the skin for a more longer term effect, which can be considered desirable in many cases.*
Myth: Fillers change the shape of the body part permanently.
Truth: Not all fillers. Temporary fillers are made up of hyaluronic acid which are absorbed by the body over months and gradually, the body returns to its original state, as it was before. Of course, as part of aging and change, the body does sometimes alter from its natural state but it is not usually affected by temporary fillers like these.
Permanent fillers are not absorbed, though, and they can stay for a long long time. In that sense, they change the shape of the body part permanently.*
Myth: Doing something to your face with fillers makes it look fake.
Truth: Amazingly, it is rather difficult to look fake with facial fillers. They can give dramatic natural results and yet escape others’ eyes unnoticed. Too many have told me how they wished people had noticed– even though in their own eyes, it was a great difference!*
Myth: Fillers are very painful.
Truth: Some pain is to be expected but it is usually minimal and quickly forgotten after the procedure. The pain is usually only of the injections and subsequently, a vague dull ache during filler injection. After the procedure, the dull ache may remain for a couple of days but it isn’t particularly noticeable and resolves quickly. In other words, it definitely isn’t something you’ll remember for too long.*