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This is Primi Clinic, a premier skin beauty clinic in Seoul.

As we age, the most common concern regarding facial wrinkles seems to be the nasolabial folds, which are centrally located on the face.

For this reason, consultations about nasolabial folds are more frequent than for other areas. However, the area around the nasolabial folds is not entirely safe, as it contains critical blood vessels near the nose. Additionally, this area is highly mobile, making filler migration more likely.

Let’s explore the appropriate amount of filler for your face by reviewing examples of nasolabial fold filler treatments before and after.


Types and Causes of Nasolabial Folds

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(Source: Why Do Nasolabial Folds Appear? Exploring the Anatomical Perspectives and the Role of Thread-Based Interventions, Gi-Woong Hong, 2024)

Nasolabial folds can be classified into three main causes, each with distinct characteristics:

  1. Difference in fat layer thickness between the mouth area and the cheeks

    • Solution: Thread lifting
  2. Development of the muscles around the mouth

    • Solution: Botox
  3. Depression near the sides of the nose (protruding mouth)

    • Solution: Nasolabial fold hyaluronic acid filler

Key Point: For cases 1 and 2, fillers should not be used. Proper diagnosis and differentiation are essential.
(This article focuses on case 3.)


How Fillers Reduce Nasolabial Folds

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The fundamental principle of using fillers to reduce nasolabial folds is filling the Deep Pyriform Space (Ristow’s Space) near the sides of the nose. This can be achieved either by injecting fillers or through a surgical procedure, commonly known as “aristocrat surgery,” where an implant is inserted to elevate the area.

When this area is depressed, wrinkles appear deeper. Correctly augmenting this space is a key skill of the practitioner and the most critical factor for success.

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(出典:The Youthful Cheek and the Deep Medial Fat Compartment, Rohrich, Rod J. M.D, 2008)


Hello,

This is Primi Clinic, a premier skin beauty clinic in Seoul.

As we age, the most common concern regarding facial wrinkles seems to be the nasolabial folds, which are centrally located on the face.

For this reason, consultations about nasolabial folds are more frequent than for other areas. However, the area around the nasolabial folds is not entirely safe, as it contains critical blood vessels near the nose. Additionally, this area is highly mobile, making filler migration more likely.

Let’s explore the appropriate amount of filler for your face by reviewing examples of nasolabial fold filler treatments before and after.


Types and Causes of Nasolabial Folds

(Source: Why Do Nasolabial Folds Appear? Exploring the Anatomical Perspectives and the Role of Thread-Based Interventions, Gi-Woong Hong, 2024)

Nasolabial folds can be classified into three main causes, each with distinct characteristics:

  1. Difference in fat layer thickness between the mouth area and the cheeks

    • Solution: Thread lifting
  2. Development of the muscles around the mouth

    • Solution: Botox
  3. Depression near the sides of the nose (protruding mouth)

    • Solution: Nasolabial fold hyaluronic acid filler

Key Point: For cases 1 and 2, fillers should not be used. Proper diagnosis and differentiation are essential.
(This article focuses on case 3.)


How Fillers Reduce Nasolabial Folds

The fundamental principle of using fillers to reduce nasolabial folds is filling the Deep Pyriform Space (Ristow’s Space) near the sides of the nose. This can be achieved either by injecting fillers or through a surgical procedure, commonly known as “aristocrat surgery,” where an implant is inserted to elevate the area.

When this area is depressed, wrinkles appear deeper. Correctly augmenting this space is a key skill of the practitioner and the most critical factor for success.

(Source: The Youthful Cheek and the Deep Medial Fat Compartment, Rohrich, Rod J. M.D, 2008)


Recommended Amount of Filler for Nasolabial Folds

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The appropriate amount of filler varies depending on its properties, but as a general guideline, it’s recommended to use no more than 2cc in total.

Case 1: Medium-density filler, 1.2cc

This patient exhibited a combination of several types of wrinkles. Filler was combined with Botox to avoid overcorrection, with only 1.2cc used.

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Case 2: Medium-density filler, 1.6cc

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Case 3: Medium-density filler, 1cc

These two cases involved typical depressions near the sides of the nose, requiring a relatively larger amount of filler. However, excessive correction increases the risk of complications, so minimal filler was used in these cases

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Case 4: Medium-density filler, 0.6cc

This patient’s wrinkles were not deep, but they expressed concern. A small amount of filler was injected to address their worries.

Using the appropriate amount ensures a natural look while preventing filler migration and side effects.


What Happens If Too Much Filler Is Used?

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  1. Upward Filler Migration
    The muscle vector direction around the nasolabial folds tends to pull upwards towards the cheeks. Excessive filler or shallow injections may cause the filler to migrate upward, exacerbating the appearance of nasolabial folds.

  2. Vascular Compression and Skin Necrosis
    Important facial arteries run near the sides of the nose. If filler compresses these arteries, it can lead to skin necrosis on the forehead, nose, or cheeks. If sudden pain or discoloration occurs after treatment, it is crucial to dissolve the filler immediately to prevent further damage.


3 Key Points to Summarize

  1. Nasolabial folds require different treatment methods depending on their type.
  2. To prevent side effects, the filler amount should not exceed 2cc.
  3. Excess filler can lead to migration and vascular complications.

 

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