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Secrets of a Beverly Hills Cosmetic Surgeon

with Robert Kotler, MD, FACS

Dr. Kotler's blog has now been retired. We appreciate all the wisdom and support he has brought to the WebMD community throughout the years.


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Thursday, December 9, 2010

Filling in the Parentheses on Your Face

mature woman with parentheses

The nasolabial creases, also known as the “parentheses” because their shape mimics parentheses, are the curve-like grooves that begin where the nose meets the cheeks and typically end below the corners of the mouth.  Sometimes the muscle action in smiling can accentuate them.

How do we get these?  The answer is simple, one word: aging.  As we age, nature spontaneously shrinks the fat layer in the face.  The first area for the shrinkage to show is around the mouth because, in fact, it is the area where nature originally deposited the thinnest layer of fat.  So as the fat diminishes, the nasolabial groove becomes more prominent.  Expect this to begin even in the 40s.

The good news is that we now have many products that can “fill” the grooves and make them look better.  And by the way, that is a far better answer than any mid-face or surgical facelift that claims to be able to “pull out” the nasolabial crease.  That won’t happen satisfactorily. What will happen is you’ll have that over-tight, over-pulled look. We’ve all seen some unfortunate people who made a bad decision by having the procedure done, and they look like the “Joker” in the Batman movie.  It’s a bad look and it cannot be easily reversed.

Artefill® is a long-lasting, non-resorbable filler that works because within it are little spheres of purified collagen.  The collagen acts as a base upon which the body can increase its own collage production and therefore fill the groove.

Not everyone is familiar with Artefill®.  Over 20,000 patients have been treated with it since the launch of the product nearly three years ago.  The manufacturer states there have been “no product recalls.”

Artefill® is not the only substance that fills the nasolabial crease, but it should be considered because of its long presence in the tissue.  As you know, some of the fillers last four to six months.

As with all fillers, when done by a skilled injector, whether it be an MD or an RN, it’s very difficult to tell that the filler material has been injected.  It looks natural and feels natural.

- Robert Kotler, MD, FACS

Posted by: Robert Kotler, MD, FACS at 8:45 am

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