Nasolabial Folds and Weight Loss: Shocking Truths & Top Treatments Revealed!

When considering the aesthetic signs of aging, many people immediately think of crow's feet or forehead wrinkles. But the deepening of nasolabial folds, the lines that run from the nose to the corners of the mouth, is another visible marker of time. While a normal part of human anatomy, these folds can become more pronounced with age and are influenced by various factors, including weight fluctuations.

What are Nasolabial Folds?

Nasolabial folds are the creases in your skin that extend from both sides of your nose to the corners of your mouth. Often referred to as "smile lines" or "laugh lines," they are a common feature in both men and women of all ethnicities and tend to become more noticeable with age. Everyone has them, though how distinctive and noticeable they are can vary from person to person. In some individuals they look more like lines, while in others they appear as deep wrinkles. Nasolabial folds consist of fibrous tissue and muscles densely bundled together.

Causes of Nasolabial Folds

The prominence of nasolabial folds is influenced by a combination of factors:

Aging: As we age, our skin naturally loses collagen and elastin, the proteins responsible for its elasticity, resilience, and ability to retain its shape. The cheekbones can also flatten, and gravity can pull down loose skin in the area. When collagen and elastin fibers break down, nasolabial folds can deepen. In addition to the decrease in collagen and elastin fibers, aging can cause the flattening out of the cheekbones. This can lead to sagging or drooping skin.
Weight loss or gain: Weight loss can cause loose skin, while weight gain can make the cheeks rounder and the nasolabial folds more noticeable.
Sun Damage: Exposure to the sun's ultraviolet (UV) rays can accelerate aging and wrinkles. The sun’s rays also break down collagen and elastin.
Smoking: Smoking destroys collagen and elastin in your skin. Cigarettes and other types of pollutants can also accelerate the aging process.
Genetics: Genetics are the primary factor that decides how your skin will age.

The Link Between Weight Loss and Nasolabial Folds

Changes in weight, particularly massive weight loss, can significantly impact facial aesthetics, including the prominence of nasolabial folds. Bariatric interventions, both surgical and medical, such as the use of glucagon-like peptide 1 (GLP-1) agonists like semaglutide (Ozempic®), are increasingly employed for weight reduction. However, these interventions can lead to notable facial changes.

Massive Weight Loss and Facial Aging

Research indicates a correlation between massive weight loss and accelerated facial aging. Studies have shown that significant fat loss in the mid-cheek region and increased skin laxity in the central neck are common outcomes of bariatric interventions. This fat regional devolumization was observed along the mid-cheek region and with central neck skin laxity. The apparent age of patients was higher among those with massive weight loss. Individuals who have undergone bariatric surgery may be perceived as looking older postoperatively, even though they may be more attractive overall.

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Following bariatric intervention, the majority of studies concluded massive weight loss results in significant facial volumetric changes that resemble facial aging. “We observed accelerated facial aging due to fat devolumization and increased skin laxity,” the investigators concluded.

"Ozempic Faces" and GLP-1 Agonists

The rise in popularity of GLP-1 agonists like Ozempic has led to concerns about facial soft tissue changes. The term "Ozempic faces" has emerged to describe the hollowed-out appearance, accentuated wrinkles, and sagging skin that can result from rapid fat loss in key facial areas such as the cheeks, temples, chin, and periorbital region. Loss of facial fat leads to the loss of volume and fullness in the cheeks, temples, chins, and periorbital area, resulting in a hollowed-out appearance that accentuates wrinkles and sagging skin.

Facial Rejuvenation After Massive Weight Loss

Patients with massive weight loss may require earlier and more frequent facelift revisions due to excess skin. They may also need approximately twice as much fat augmentation compared to patients without massive weight loss.

Prevention Strategies

While nasolabial folds are a natural part of aging, certain measures can help to minimize their appearance and delay their development:

Sun Protection: Wear sunscreen with an SPF of at least 30 every day, even on cloudy days. Reapply every two hours, especially if sweating or swimming.
Healthy Lifestyle: Eat a balanced diet, exercise regularly, and get sufficient sleep.
Avoid Irritants: Refrain from using skincare products that cause stinging or burning, unless prescribed by a healthcare provider.
Quit Smoking: Smoking accelerates aging and wrinkles.
Sleep Position: Sleep on your back to minimize the effects of gravity on the face.
Skincare Routine: Use a gentle cleanser and moisturizer at least twice daily. Understand the ingredients in your skincare products and consult a dermatologist for recommendations.

Treatment Options

If you are bothered by the appearance of nasolabial folds, various treatment options are available:

Dermal Fillers: Injected into the skin around the cheeks, fillers add volume and lift the skin, reducing the appearance of folds. The substance plumps the area, restoring volume and fullness. They can also help encourage the growth of collagen. Popular fillers include hyaluronic acid, polylactic acid, calcium hydroxylapatite and polymethyl-methacrylate microspheres (PMMA). The effects can last six months to a year.
Botulinum Toxin Injections (Botox®): While primarily known for treating frown lines, Botox can also be used to weaken and relax specific muscles that contribute to nasolabial folds, reducing their appearance for several months.
Retinoids: Topical application of retinoids (a chemical form of vitamin A) can promote collagen production and reduce smile lines over time.
Skin-Tightening Procedures: Treatments using lasers, ultrasound, or radio waves can stimulate collagen production and tighten loose skin.
Surgery: Cosmetic surgery options include cheek lifts or facelifts to reposition and reshape the skin and underlying tissues.
Skin Resurfacing: These treatments include laser resurfacing and chemical peels. So, when your skin looks youthful, you can easily hide these folds.
Microneedling: This process leads to the formation of the skin tissues, which emits the skin's natural glowing hormones and other elements that promote healing and repair. The sink's naturally occurring process initiates the development of the elastic fibers and new collagen, making the skin tighter, thicker, and more youthful.
Fat Transfer: Your surgeon will remove the fat from any part of your body, usually thighs or stomach using liposuction. Then, they will process it in a centrifuge to clean it from all the impurities. In the end, they will inject it in your upper cheek or below your laugh line to reduce the nasolabial fold's noticeable appearance.
Subcision Surgery: This procedure includes the usage of the needle to make tiny punctures in your skin. It will help the skin to release the underlying tissues and encourage collagen production. Subcision surgery has the ability to reduce the depth of the deepest smile lines.

Choosing the Right Treatment

The best treatment approach depends on individual factors such as facial structure, the severity of the folds, skin characteristics, and desired outcomes. Consulting with a dermatologist or cosmetic surgeon is essential to determine the most suitable treatment plan. Your plastic surgeon will recommend you the best procedure based on your facial structure, nasolabial fold severity, characteristics of your skin, and your preferred result. To make the best choice, consult with a plastic surgeon or dermatologist who will guide you about the best method for the laugh line correction.

Home Exercise

Try this daily exercise at home to reduce the appearance of lines around your mouth:

Separate your lips a little.
Use your fingers to pull the corners of the mouth backward toward your neck.
Pull back, keeping the lips parallel.
Hold for 10 seconds.
Relax and release your skin.
Repeat this 10 to 25 times.

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