Laugh lines/smile lines is one of the most requested filler procedures.
What are laugh lines?
Also known as nasolabial folds, laugh lines start from the corner of the nose and extends down towards the corner of the mouth.
Deep laugh/smile lines can make one look older, and happens due to the loss of volume in the nasolabial compartment of the face. In older patients, sagging skin can also cause droopiness of the cheeks, creating deeper laugh lines.
Should I get laugh line fillers?
The loss of volume around the laugh lines can be replenished and filled up with fillers. The fillers directly plump up the area and the laugh lines will be significantly reduced.
Patients with droopiness of the cheeks that cause a fold above the laugh lines might benefit from a combination of procedures. Fillers alone might not provide the best results – fillers replaces lost volume but does not help tighten the skin.
An Ultraformer HIFU (link) or a Ultherapy procedure can help lift and tighten the skin around the cheek areas. Some patients also can choose for a thread lift procedure to help lift and tighten the area.
What can I expect?
Laugh lines due to volume loss can be effectively plumped up with fillers to look immediately younger.
Downtime is minimal, and as with all injectables, there is a tiny chance of bruising.
How much filler do I need?
On average, 1.5 – 2ml (1.5-2 syringes) of fillers will be required in total for laugh lines. Younger patients will less volume loss can sometimes only require 1-1.5ml (1-1.5 syringes) of filler.
Choice of laugh line fillers
The laugh lines is an area where more than 1 type of filler is used on some occasions. This is because the depth of injection along the laugh line varies due to the amount of tissue and space around the area.
Restylane Lyft is the filler of choice for the deepest part of the laugh lines. The area we are filling up is called the pyriform fossa (Ristow’s Space). It is usually the area where the laugh lines are deepest, situated right beside the sides of the nose.
Being deep and usually with the most loss of volume, this area is most effectively plumped up with Restylane Lyft. This means using the least amount of filler and thus saving cost for the patient. Other softer fillers will tend to require more filler in this area.
As the laugh lines extends downwards towards the corner of the mouth, the tissue around the area becomes thinner. A softer filler is usually used here to avoid lumpiness and for a more natural effect.
Restylane Defyn, Restylane Volyme, and Juvederm XC are all good hyaluronic acid fillers with natural-looking results.
Frequently Asked Questions about Fillers
How long do fillers last?
Fillers typically last for 12 months. Different type of fillers are designed for different areas of the face and have different longevity due to the filler material.
Does it completely dissolve away?
Most fillers will dissolve away and gets broken down by the body into water. However, there are cases that we have seen before with fillers that last much longer that it was intended to. For these cases, the filler had to be dissolved by injecting a dissolver call hyalase which breaks down the filler into water.
Is it painful?
Most filler injections are not painful with numbing cream applied. There are some areas which are more sensitive, such as the lips, and can be more uncomfortable.
The skill and hands of a doctor also directly contributes to the amount of discomfort. An experienced and gentle doctor can mean much lesser discomfort during the procedure.
What are the side effects?
Like all medical procedures, there are always potential side effects during injectable procedures.
The more common side effects associated with injections are bruising and swelling. Bruising and swelling happens when a larger blood vessel under the skin gets injured during an injection. If present, bruising and swelling typically goes away after 4-7 days.
The most serious side effect associated with filler injections is vessel occlusion. Vessel occlusion is when the filler is directly injected into an important blood vessel and blocks blood flow, potentially resulting in skin necrosis and even blindness.
Some patients have heard about fillers causing blindness, in particular nose fillers. In actual fact, fillers performed at any part of the face can potentially lead to blindness. Blindness happens when the filler material travels up the blood vessel and blocks the blood flow to the optic nerve in the eye. Blindness is more often associated with nose fillers due to the blood vessels supplying the eye being close to the nose. Skin necrosis, which is the dying of skin cells, happens when the blood vessels supplying the area of skin affected gets occluded and blocked.
The risks of skin necrosis and blindness can be greatly reduced with a clear knowledge of the blood vessels in the face. Therefore, it is very important to go to an experienced doctor for filler injections. More than 90% of filler complications happen at illegal salons or beauty parlours which are not authorised to perform such procedures.
How doctors reduce the risk of vessel occlusion?
- Use the appropriate equipment and filler for each area. The type of needle and needle size makes a difference in reducing the risk of vessel damage and occlusion.
- Specific techniques such as performing a drawback to ensure that the needle is not in a vessel, slow precise injections, and the depth of injections all help ensure that the filler is not being injected into a vessel.
- Most importantly, a good knowledge of the facial anatomy will allow the doctor to identify the areas where the major blood vessels are. Knowing which area to avoid and which areas are generally safe helps to greatly reduce the risk of injecting the filler into a vessel.
What should I avoid after fillers?
Avoid strenuous exercise and alcohol for at least 24 hours. Avoid any facial massage for at least 2 weeks.