Aggravation or droopiness of the nasolabial folds is in many cases the earliest sign of aging, anticipating many years to other stigmata such as wrinkling, sagging face and neck or the eyelids bags.
The anatomy of deep facial rejuvenation (excludes skin aging and wrinkles) is divided into three thirds or units, which partially overlap to each other. The upper third (excludes the eyelids) or frontal, eyebrow and orbital complex along with the cheekbones and the upper part of the cheek, the middle third or cheekbones, cheek, nasolabial region and mandibular profile, and the lower third that extends from the mandibular edge to the lowest part of the neck.
Nasolabial folds deepening is a simplified way of naming the gravitational aging of the middle third of the face, including cheekbones, cheek and jowls, which due to aging migrates inferiorly.
Although there are cases of severe nasolabial folds deepening in young or very young people due to familiar hereditary factors which may require corrective treatment, the most common scenario is patients showing a marked degree of nasolabial folds deepening from the 40s and on, often as the only remarkable sign of facial aging or associated with eyelids aging.
In most cases, the patients suffer at the same time from nasolabial folds deepening along with a greater or lesser degree of skin excess on the middle third of the face, so it is usual to simultaneously perform the treatment of both problems.
Best state of the art treatment for the deep nasolabial folds can be either the temporal fossa (temple) short incisions supraperiosteal eyebrows and forehead extended into cheeks lift with interfascial anchoring support, as much as deep face lifting with SMAS and platysma anchor and plasties.