Bad nasolabial fold filler, the lines that extend from the sides of the nose to the corners of the mouth, are among the most prominent facial features affected by aging. These folds become deeper over time due to factors like skin laxity, volume loss, and the natural movement of facial muscles. Many individuals seek cosmetic procedures, particularly dermal fillers, to minimize these lines and restore a more youthful appearance. However, when done incorrectly, nasolabial fold fillers can lead to undesirable results. In this article, we explore common issues associated with nasolabial fold fillers, the techniques involved, potential complications, and what happens when too much filler is used.
Nasolabial Fold Filler Technique
Injecting dermal fillers into the nasolabial folds requires precision and an understanding of facial anatomy. A successful filler treatment can rejuvenate the face by softening deep lines and restoring lost volume. Different types of dermal fillers can be used, including hyaluronic acid-based fillers like Juvederm or Restylane, which are preferred for their safety profile and reversibility.
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Assessment and Planning
Before any procedure, it’s essential for the practitioner to assess the patient’s face holistically. Treating nasolabial folds in isolation can sometimes result in a mismatched appearance, where the treated area looks overly smooth compared to other areas of the face. A comprehensive assessment will help the practitioner determine whether the nasolabial folds are the primary issue or if other factors like cheek volume loss are contributing to their prominence.
Injection Technique
The actual injection technique for nasolabial folds varies depending on the patient’s needs and the type of filler used. Some common techniques include:
- Linear threading: This involves inserting the needle into the fold and injecting the filler while withdrawing the needle. The filler is deposited in a linear fashion along the length of the fold.
- Cross-hatching: This technique uses multiple injection points to create a mesh-like deposition of filler, which can provide more even volume distribution and prevent lumpiness.
- Cannula technique: A blunt-tipped cannula is used instead of a needle to inject filler. This method reduces the risk of bruising and trauma and can offer more precise placement in the nasolabial folds.
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Layering Filler for Natural Results
For a natural appearance, the filler must be layered appropriately. Injecting small amounts of filler at a time allows the practitioner to build up volume gradually, avoiding the “overfilled” look. Additionally, placing the filler in deeper layers of the skin rather than superficially helps create a more subtle and longer-lasting outcome.
Nasolabial Fold Filler Complications
While dermal fillers are generally considered safe, complications can occur, especially when the injections are performed by inexperienced practitioners or when too much filler is used. Understanding the potential risks associated with nasolabial fold fillers can help both patients and practitioners take preventive measures.
Bruising and Swelling
Bruising and swelling are the most common side effects after any dermal filler injection. These occur when small blood vessels are damaged during the injection process. While these side effects are temporary, they can be minimized by using proper injection techniques and avoiding blood-thinning medications or supplements before the procedure.
Lumps and Nodules
One of the more concerning complications is the formation of lumps or nodules under the skin. These may occur due to uneven filler placement, excessive filler amounts, or the use of inappropriate filler types for the nasolabial area. In some cases, lumps may resolve on their own, but in others, they may require treatment such as massage, hyaluronidase injections (to dissolve the filler), or even surgical removal in severe cases.
Tyndall Effect
The Tyndall effect is a complication where the filler creates a bluish discoloration visible through the skin. This occurs when hyaluronic acid fillers are injected too superficially, reflecting light in a way that gives the skin a blue hue. Correcting the Tyndall effect typically involves dissolving the filler with hyaluronidase.
Infection
As with any procedure that involves breaking the skin, there’s a small risk of infection. Following proper aseptic techniques during the injection process can significantly reduce this risk. However, patients should be vigilant about signs of infection, such as redness, warmth, or pus at the injection site, and seek prompt medical attention if these occur.
Vascular Occlusion
The most serious complication of dermal filler injections is vascular occlusion, which occurs when filler is inadvertently injected into a blood vessel. This can block blood flow and lead to tissue necrosis (death of skin tissue) or even blindness if the blood vessel supplies the eye area. While vascular occlusion is rare, it is a medical emergency that requires immediate intervention with hyaluronidase to dissolve the filler and restore blood flow.
Too Much Filler in Nasolabial Folds
Overfilling the nasolabial folds can lead to unnatural results, making the face look puffy, uneven, or distorted. Understanding the consequences of using too much filler in this area is essential for both patients and practitioners.
Distorted Facial Proportions
When too much filler is injected into the nasolabial folds, it can disrupt the natural contours of the face. Instead of a soft, rejuvenated appearance, the patient may end up with exaggerated folds or unnatural fullness in the lower face. This can create an unbalanced look, as if the cheeks are too flat while the area around the mouth is overly filled.
Overfilled or “Pillow Face” Look
The overfilled look, sometimes referred to as “pillow face,” occurs when excessive filler is used not only in the nasolabial folds but also in other areas like the cheeks or lips. This results in an appearance where the face lacks natural definition and looks unnaturally plump or puffy. It’s important for practitioners to be conservative with filler amounts and ensure they are addressing volume loss in multiple areas, not just the nasolabial folds, to maintain balance and proportion.
Impact on Facial Expression
Overfilling the nasolabial folds can also affect facial expressions. Since the area around the mouth is involved in many movements, including smiling and speaking, too much filler can make these expressions look stiff or unnatural. Patients may feel self-conscious or uncomfortable when their facial movements are restricted, impacting their overall confidence.
Correcting Overfilled Nasolabial Folds
In cases where too much filler has been injected, there are fortunately options for correction. For hyaluronic acid-based fillers, hyaluronidase can be injected to dissolve the excess filler. This enzyme breaks down the hyaluronic acid, restoring the area to a more natural state. However, correction may take multiple sessions depending on the amount of filler used and how deep it was injected.
It’s also worth noting that non-hyaluronic acid fillers, such as those made from calcium hydroxylapatite (e.g., Radiesse), cannot be dissolved and may require a longer wait for the filler to naturally break down over time. In severe cases, surgery may be needed to remove the excess filler.
Conclusion
Nasolabial fold filler treatments can deliver transformative results when done correctly, softening the appearance of deep lines and giving the face a more youthful look. However, poor technique, inadequate assessment, or using too much filler can lead to complications and unsatisfactory results. It’s crucial for patients to choose experienced and qualified practitioners who understand the nuances of facial anatomy and are well-versed in safe injection techniques. Additionally, a conservative approach, focusing on natural results and maintaining overall facial balance, is key to avoiding the overfilled look and ensuring long-term satisfaction with nasolabial fold filler treatments.
For those considering nasolabial fold fillers, thorough consultations and open communication with their aesthetic provider can make all the difference in achieving a natural, rejuvenated appearance without the risk of complications.
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