Treating nasolabial folds with dermal fillers: a holistic approach

Hyaluronic acid dermal fillers are Food and Drug Administration (FDA)-approved for the correction of nasolabial folds through local dermal injections. In the past, dermal fillers were used to directly treat into the location of the desired correction. This would be through careful placement of the filler into the deep layer of the dermis and/or the subcutaneous tissue through a linear thread or fanning technique (Choi, 2015).

Despite good clinical results in the form of reduced appearances of wrinkles in the nasolabial fold, there are many pitfalls with the traditional technique. This ranges from something as simple as bruising to more sinister complications, such as vascular occlusion leading to alar necrosis and visual loss (Funt and Pavicic, 2013). This occurs due to the variability of the vasculature that runs at the subcutaneous level at the nasolabial fold (Hartstein, 2012). Furthermore, it became apparent that reduction of a nasolabial fold did not necessarily enhance the aesthetics of the patient, and in some cases treatment could look unnatural, owing to complete obliteration of the transition from the mid-cheek to perioral region. As our understanding of the facial aging process has improved, so too has our approach to treating the nasolabial fold.