As we age, many changes take place in our faces, including the development of the NL fold. The reasons for most NL folds are threefold: one, the malar (cheek) fat pads tend to move downward and inward, some say under the influence of gravity, and others blame the general breakdown of supporting structures such as collagen and elastin. Contraction of the facial bones may also be a factor. In women whose upper palate is small and therefore does not “push out” the soft tissues that cover it, they may also have deeper creases. Breakdown of the supporting structures of the skin, whether one’s malar pads have descended or not, results in NL folds that resemble lines of parentheses (as opposed to deeper clefts). Sleeping on your stomach or side, with your face squashed into the pillow, or just leaning against it, can also make folds worse. That is why one fold is usually deeper than the other, depending on which side we sleep on.
Cosmetic surgeons will tell you that even a medium facelift will do little to improve the NL area, at least in the long run. There may be a slight and temporary lifting of the area, but the malar fat pad will soon move down and in again. Some surgeons inject fat into the area during a facelift, but again, this fat tends to be reabsorbed in a matter of weeks. Another option is an ePTFE (non-reactive) implant. They are tubular and are generally inserted through two small cuts made in the NL area.
How we treat the NL fold to improve its appearance depends a lot on what has caused the fold. In the case of a deep fissure, dermal fillers are a guaranteed way to see improvement, along with facial exercises that raise the zygomatic muscles, raising the malar cheek pad. (Some women have reported a worsening of the crease after doing facial exercises, but this effect usually reverses soon after they stop. If you have NL creases, I would also avoid exercises that involve the orbicularis oris muscle, as this can build up quickly , in doing so, making the outer area of the upper lip stand out in a monkey-like fashion).
Women with more lines or wrinkles in the NL area (bracket lines) are in some luck, as using a skin cream with specific active ingredients can reduce early-stage lines. Active ingredients that work include peptides and Retin-A. Don’t be afraid to really work the product into the crease by massaging upwards with a firm touch. Despite what many dermatologists may tell you, facial massage does not make wrinkles or parentheses lines worse.
Some women have reported that using a skin roller (a device that resembles a miniature paint roller with short needles protruding from it) on the NL area has helped reduce the crease. This is quite likely because if the spikes penetrate deep enough, the device behaves like a fractional laser, causing channels of damage that fill in with fresh collagen. The attraction of the lymph to the damaged area will also cause a temporary improvement in the folds.
Recently, threads on unsponsored skincare forums have promoted the use of “green foods” to reduce nasolabial folds. While the evidence is purely anecdotal, enough women have seen a difference to warrant further investigation. It is possible that a change in internal pH caused by the ingestion of alkaline green drinks helps reduce flab in general. The weight loss that often accompanies the intake of green drinks may also contribute to the “shrinkage” of the malar fat pad and thus its impact on the deeper slit-like folds.
Here are the most effective ways to reduce nasolabial folds:
1. If you have indentations instead of parenthesis lines, try facial exercise. There are a number of reputable programs available for download.
2. Don’t over-exfoliate. Each layer of the epidermis has its function. Excessive exfoliation can cause a thinned epidermis that provides less of a “girdle” effect, that is, less tightness.
3. Use a skin cream that contains actives like peptides (to increase cell communication) and collagen boosters. Be careful with drugstore creams as they rarely contain enough active ingredient to really impact the skin.
4. Consider a dermal filler (injectable) Start with a temporary filler, as you want to make sure you like the result before you have a semi-permanent or permanent filler.
5. If you’re on board with the idea of ePFTE in your body and have done your “due diligence,” consider a tubular implant.
6. If your creases aren’t of the deep line variety, use a lighter concealer within them, covered with light-reflecting makeup. (Not a shimmery foundation, as this will emphasize them.) A department store cosmetics consultant from any of the major brands will be able to recommend light-reflective makeup.
7. Some women claim that a facial exercise/muscle stimulation works to diminish wrinkles. Also, some report that an amber light device has helped.