Many doctors who are new to cosmetic injections learn about nasolabial injections first, because in their eyes, nasolabial injections are the easiest. Some “no” black clinics or underground studios also think that there will be no problem here and just play, and some girls even buy injections from unknown sources to play for themselves. However, are nasolabial folds injections really that simple?
”The nasolabial folds are composed of the upper lip square muscle and the maxillary eminence of the zygomatic bone, which is located at the junction of the cheeks and upper lip bilaterally, from the outer edge of the nose diagonally outward to the bottom. When you are young, the nasolabial folds are only obvious when you make facial expressions such as laughing, pouting, and puffing out your cheeks; as you grow older, your facial muscles become more and more saggy, and the nasolabial folds become more and more obvious.”
Don’t think that nasolabial folds are just a line, it’s that little line that can make you look older by tens of years. The same picture with just one more line. One face looks like a teenager, while the other face becomes twenty years older.
What aggravates the nasolabial folds?
Many human expression movements are initiated by a change in the shape of the nasolabial folds. For example, smiling begins with the muscles around the nasolabial fold, and when they contract, the upper lip is pulled backward toward the nasolabial fold, which curves and deepens due to the thick subcutaneous fat of the cheek, causing the lip to meet resistance at the nasolabial fold. Similarly, expressions and movements such as crying, showing teeth, chewing, etc., are accompanied by the bending and deepening of the nasolabial fold.
In adolescents, facial expressions and resting states, as well as changes in nasolabial folds and their original state, give a natural and harmonious appearance. In addition to the frequent activity of the nasolabial folds for more than 30 years, the facial tissue accumulates on the buccal side of the nasolabial folds due to fat loss and skin sagging, etc. The deepening of the nasolabial folds is most obvious when the face is older than 30 years old. Therefore, at rest, the nasolabial folds gradually deepen, widen and elongate.
So is it enough to fill it in?
For the nasolabial folds, proper treatment is the key. Completely filling them in is not natural enough, and the ideal result is to have the proper curvature when making expressions. The treatment means still depends on the patient’s specific situation. Let’s take a look at the grading of nasolabial folds (Genzyme’s 6-grade scale): 0-5 represents the severity of nasolabial folds.
1, 0-1 degree: early changes, mainly dynamic folds that form with muscle movements.
2.2-4 degrees: caused by the sinking of the buccal fat pad at rest, which needs volume filling to improve.
3.5 degree: the tissue is atrophied and sagging, and pure filling cannot obtain satisfactory results, and needs to be combined with the uplifting of the jaw and face.
In addition, for those with problems due to bone development in the middle of the face, filling by injection is only an improvement, not a treatment or a complete solution.
How should different cases be treated?
Dynamic wrinkles can be corrected with Botox injections, which need to be carefully injected around the zygomaticus muscle, upper lip lift and orbicularis oris muscle. It can also be used to lower the orbicularis muscle to lift the corners of the mouth as a complement to simply filling in the lower nasolabial folds and perioral lines.
Volume reduction due to subcutaneous tissue atrophy can be treated with filler material. Hyaluronic acid is injected into the nasolabial fold area and filled into the dermal folds as well as the surface of the deep periosteal layer, the folds on both sides of the nose are restored to smoothness and the nasolabial ridges disappear, while hyaluronic acid also stimulates collagen production and restores the luster and elasticity of the skin on both sides of the nose, which can temporarily or permanently correct the nasolabial folds and is the primary method for nasolabial fold wrinkle removal; mid-cheek sagging With age, the soft tissues of the face are concentrated in the As the lower part of the face grows older, the soft tissues of the face will concentrate on the lower part of the face, causing the inversion of the facial contour and the obvious sagging of the apple muscle, at this time, simply relying on fillers is not able to fundamentally solve the problem, but needs to be combined with facial lifting to alleviate the sunken nasolabial folds to a certain extent.
Generally, for those who are around 40 years old, fillers can achieve certain effect. For those who are around 50 years old, the nasolabial folds are depressed due to a variety of factors, and a single filler is already ineffective. Comprehensive cosmetic surgery will be the inevitable solution to the problem, such as injectable fillers combined with buried threads, ultrasonic knife, etc. Serious cases may require surgical methods, including SMAS wrinkle removal.
Nasolabial fold wrinkle removal injection techniques
1, multi-level injection to avoid single-level injection. Multi-level injection, pay attention to the deep layer (subcutaneous layer), shallow layer (dermis) injection as little as possible as evenly as possible. Generally inject the shallow layer first and then inject the deep layer, inject the shallow layer first to fill up the skin volume, inject the deep layer and then fill up the tissue volume.
2.Injections pressed when injecting the dermis layer, because the injection is linear, so it must be rubbed open, pressed when you can pad the gauze into the mouth to press, pressed is a very important step in injecting hyaluronic acid, injections appear hard knots sometimes caused by muscle movement, so massage open.
3, to carry out comprehensive treatment should pay attention to the aging type of nasolabial communication often need to carry out comprehensive treatment. When carrying out comprehensive treatment, generally the nasolabial folds in the face are evaluated in a very backward order, such as the nasolabial folds can also be improved after the mid-facial improvement, and finally only a little amount is needed to solve the nasolabial folds.
4, must not play to the cheek to play to the cheek, nasolabial folds will be deeper and deeper, so when injecting as close as possible to the inner side of the nasolabial folds injection.
5.The nasolabial folds need to be judged accurately before injection, and the position of the nasolabial folds needs to be judged accurately when injecting.