Treating Nose-to-Mouth Lines

The Ageing Mid-Face

​The sides of the nose down to the mouth corners (the nasolabial folds) is an area of the face which tends to develop a deeper crease over time and can be the site of the first noticeable sign of ageing. In our Oxfordshire and Warwickshire clinics we find that even younger women and men can start to see this change and therefore seek dermal fillers as a treatment option.

In the case of older women and men, this deepening groove can be accompanied with jowls, showing as saggy skin on the jawline. Closer inspection often reveals a flatter mid face with depressions at the side of the nose just under the inner eye area. The eye area itself may have hollowed and created a ‘tear trough’; a cavernous shady appearance under the eye. Further examination may reveal a hollow a little further down below the tear trough. Below the mouth, a gap appears on the jawline and this can develop into sagging at the corners of the mouth - the base of those oral commissures, as they are called, or more commonly known as 'marionette lines'.

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As we all know, no two faces are the same and they really vary enormously according to shape, weight and racial type, which all affect signs of ageing. Thin white women and men appear to hollow around the nose to mouth area more than fatter rounder faced people. Black skinned men may present with deeper nose to mouth hollows at an earlier age as part of a racial normal type.

Our faces are rarely symmetrical and so we find that the two sides of the face frequently age differently; meaning that most people find hollowing shows more on the sleep side, or on the dominantly used side. Such differences have to be pointed out to ensure this is explained from the outset so that patients understand their own unique features before treatment commences. Since the different sides of the face are different, they may need to be treated slightly differently.

Treating the Nasolabial Folds with Dermal Filler

At Oxford & Leamington Facial Aesthetics, we are asked to fill the nose to mouth lines (nasolabial folds) more often than any other dermal filler procedure, as it is a bothersome area for many people.

Treatment options for the nasolabial folds vary and may involve injecting small amounts of filler into the crease itself in order to ‘lift’ the depression where the depth is slight. In the case where the mid-face has become flatter because of decreased roundness of the inner cheek (due to a combination of loss of fat, skin elasticity and density); mid-face lifting can be achieved by targeting a few crucial anatomical points to restore the sphere of the inner cheek.

Increasingly we opt to use a cannula to fill the mid face. This is a hollow, smooth silicone tube which is designed to glide under the skin creating minimal trauma, pain and vascular damage. It is not a painful procedure at all. A little discomfort at the insertion point may be felt but we always use good topical anaesthetic on the skin and apply cold packs to optimise our clients' comfort and relaxation during the procedure.

What's the Best Filler for Nose-to-Mouth Lines?

Teosyal RHA 4

While we are constantly reviewing the best options to make sure we offer our clients the most innovative products, our current dermal filler of choice for treating nose-to-mouth lines is Teoxane’s Teosyal RHA 4. It is an award-winning hyaluronic acid filler, which does not contain additional chemicals to stabilise the gel. This purity helps make it much more tolerable and natural for the skin. 

Teosyal RHA 4 also has the appropriate lifting capacity for this area of the mid-face. Importantly, the product has an excellent safety profile; we have used it in our clinics for a number of years now and have not encountered any side effects from its use in any patient to date.

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How Often Is Treatment Needed?

We usually advise patients to come back for a treatment review at least twice a year so that a personal treatment plan can be made for them.

Whilst the products we use can last up to a year, the  face undergoes seemingly imperceptible changes for example, due to weight gain or loss, and the ageing process seems to have gear changes sometimes. Women can experience more marked ageing around the menopause, or post-childbirth, for example. Men seem to experience increased facial ageing with changes of circumstances such as with getting fitter or the traumas associated with job loss and separation or loss of a partner.

​For more information about dermal filler procedures please visit our dedicated treatment page available here or don't hesitate to contact us directly at the clinic to discuss your situation.