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Written by Dr. Russo

Mouth and Lips

Nasolabial Folds (Parentheses)

Permanent nasolabial folds are often one of the first signs of facial aging. In fact, they can show up when you’re only in your twenties! Although smiling a lot may bring them on faster, there really isn’t any way to prevent them. The major cause of nasolabial folds isn’t really smiling anyway, it’s aging.

As we age, we lose collagen and with it, skin elasticity. When skin elasticity is lost, we get sagging. Another contributor to the problem is the descent of the fat pad in the upper part of the cheek. With aging, the fat’s attachment to the underlying cheekbone loosens and weakens. As a result, the fat pad drops, which causes a hollowing in the lower eyelid area and a prominence of the nasolabial fold. In addition, we naturally lose fat from our faces with age. The fat serves a valuable purpose: its volume supports the skin and stretches it taut. Without it, the skin sags like a deflated balloon. 
As volume is lost in the face, the skin sags, forming marionette lines, the lines running from the mouth to the chin, and nasolabial folds. Depending on your needs, Dr. Russo may recommend a mid-face lift and/or replacing lost fat with injectable filler or an autologous fat transfer.