We saw a patient today who has been treated elsewhere and is displeased with the firmness in the nasolabial fold region (the depression from the side of the nose to the corner of the mouth), and she did not feel that the area was adequately treated. We discussed the fact that some patients’ soft tissue anatomy makes it difficult to fill that area optimally to get a fully smooth appearance, as it remains somewhat tethered to the deeper structures. Also, some patients have an overactive muscle that raises the upper lip and this contributes to the deepening of the nasolabial fold. Most of the time, when it occurs, the patients benefit from filling of the cheek to help lift the skin away from the nasolabial fold and therefore make the fold more shallow, but we also occasionally have to suggest a very small amount of Botox in the muscles that pull up the upper lip if the patient has an overactive muscle in this area.
Blog » Dissatisfaction with Fillers.