Botox injections into nasolabial folds

In cosmetology, Botox injections into the nasolabial folds are considered rare. These folds, in fact, are not wrinkles and are not formed due to frequent muscle contraction. Therefore, the inactivation of certain muscles will not lead to their disappearance, even if temporary.

However, in many cases, patients have such features of facial expressions in which the contraction of certain facial muscles can increase the severity of nasolabial folds. It is in such situations that injections of botulinum toxin into the target muscles make nasolabies less noticeable and therefore are sometimes used in addition to filler injections and other cosmetic procedures.

For example, the photo below shows the result of using Botox alone (before the introduction of fillers) specifically for the complex treatment of nasolabial folds:

As you can see, there is a positive effect, although wrinkles on the face are preserved. Further, after the following basic procedures, it is possible either to completely remove the nasolabies, or to hide them to the maximum.

Here, the final result of the complex treatment of nasolabial folds is already visible in the photo:

It is impossible to achieve such an effect only with Botox on any face. However, in some cases (though not all), Botox is needed as an additional tool to obtain such a result.

What is the reason for this feature of nasolabial treatment and in what cases is it necessary to inject botulinum toxin for this purpose?

 

Can Botox help with nasolabial folds?

It is well known that Botox and other botulinum toxin preparations are intended to eliminate wrinkles caused by too frequent or permanent contraction of certain facial muscles. The principle of action of botulinum toxin does not allow its other uses: getting into the tissue, it violates the mechanism of transmission of impulses from nerve endings to the muscles, which is why neither arbitrary nor involuntary contractions of these muscles already occur. And due to the fact that the muscles do not contract, wrinkles do not appear.

The specificity of the nasolabial folds is due to the fact that in most cases their formation is not associated with muscle activity.

So, the main causes of the appearance of nasolabs are:

• Skin aging, loss of elasticity and tone, sagging under a load of fat on the cheeks;

• Heredity - in people with certain facial features, nasolabial folds can appear even in youth, even on young and supple skin;
• Decrease in the tone of the muscles supporting the cheeks from above - in this case, the cheeks actually slide to the corners of the lips.

In addition to these reasons, nasolabial folds can form due to too frequent contractions of the circular muscle of the mouth, the muscle that lifts the corners of the lips, and some other muscles. Moreover, the degree of influence of such contractions on the severity of nasolabies depends not only on the patient’s emotionality and expressiveness, but also on the features of his face, the specifics of facial expressions and the interaction of different muscles.

As a result, there is no muscle that is enough to immobilize with botulinum toxin to achieve complete disappearance of the nasolabial folds. But the presence of muscles, the contraction of which affects the severity of the nasolabies, determines the appropriateness of using Botox to eliminate them in some cases.

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“I started my cosmetological epic with a nasolabial. Then Restylane pricked, there was a very good result, I didn’t notice a fold for half a year. Then the beautician advised me to make Botox between the eyebrows, and when I did, I hinted that small dynamic wrinkles appeared near the former nasolabs, sort of like above the lips, at the level of the nose.So they are almost invisible, but with a smile they are striking. Here, he says, Botox is better, because these are dynamic wrinkles. In general, I agreed, she injected. Indeed, it has become better, although it seems to me that my smile after that has become not so deep. ”

Olga, from correspondence on the forum

 

Results of botulinum toxin injections: “before” and “after”

Just give a few examples for clarification.

Below in the photo are typical gradient nasolabial wrinkles before and after botulinum toxin injections:

As you can see, the folds, although less pronounced, did not disappear completely. The reason here is the features of the patient's cheeks and lips: they are quite voluminous, and due to this, the fold between them is formed just like a place with the least amount of soft tissue. The contribution to the severity of the nasolabies, which was precisely the activity of the muscles when smiling, was eliminated by injections of the drug botulinum toxin. Everything that was caused by other reasons has been preserved.

Another good example is Botox-free nasolabial treatment:

Here, in the place of the folds, it was precisely the dynamic wrinkles that were formed by the smile. After the previous procedures, it will be enough to correctly select the injection site of botulinum toxin and eliminate these residual defects.

Finally, a separate specific case is the nasolabial folds, the severity of which decreases with the correction of the so-called gingival smile. For example, the patient’s face looks like this before and after therapy:

As you can see, due to the deactivation of the muscles that raise the upper lip, the severity of the nasolabies decreased.

Here, however, everything is rather ambiguous. In some cases, treating a gingival smile can, on the contrary, make nasolabial wrinkles more visible. In the photo - an example of such a situation:

In fact, the depth of the nasolabies remained the same, but due to the disappearance of the dominant defect, they became more striking.

Finally, an example from a star worthy of textbooks on cosmetology:

Here we see both the adjusted gingival smile and its reduced strength. Ronaldo, of course, did not admit what procedures he underwent, but for the specialist everything was written on his face ...

All this means that the decision to inject or not to inject Botox in order to eliminate nasolabial folds is made by the doctor after examining the patient’s face and facial expressions, as well as diagnosing the causes of nasolabial appearance. There are almost always unambiguous reasons for injecting, as well as it may be obvious that you do not need to put it.

 

When Botox definitely does not need to be pricked to eliminate nasolabial folds

An indisputable reason to abandon botulinum toxin injections when removing nasolabies is an accurate understanding that the reduction of any muscles in the face does not affect the severity of these wrinkles. As a rule, diagnosing the complete absence of such an effect is difficult and not always possible. However, in most situations, Botox to eliminate nasolabial folds definitely does not need to be applied to young people with elastic smooth skin, especially if they do not have other wrinkles that are uniquely caused by muscle hyperdynamics. The likelihood that, for example, there is still no wrinkle between the eyebrows, but the nasolabial was formed partly due to facial expressions, is minimal.

Botulinum toxin also does not eliminate the nasolabac caused by:

• Reducing the normal tone of the muscles of the cheekbones - because of this, the cheeks sag under their own weight, and even compensation of the antagonist muscles will not prevent their downward movement;
• Sagging skin due to age-related changes in its structure - in this case, revitalization of the skin is required;
• Sagging cheeks with sudden weight loss - in this case, a decrease in the volume of soft tissues occurs faster than normal skin adaptation to it and its excess also shifts down.If this happens at a young age, the defect itself goes away with time. If this happens with a parallel decrease in skin elasticity, additional procedures are required - tightening, biorevitalization, filling with permanent fillers;

• Features of the face on which the cheeks are clearly expressed. In such a situation, the defect can only be corrected by surgical methods, but the expediency of this step is very doubtful.

As a rule, in the treatment of nasolabies, the doctor first conducts the main therapy and only then uses Botox if defects remain that are clearly caused by muscle contractions. If such defects do not remain, botulinum toxin preparations are not used. And it rarely happens when a doctor initially sees that botulinum toxin is needed to eliminate nasolabial folds. Then he can first inject Botox or its analogues, and then apply other methods on the face without muscle contractions.

 

Botulinum toxin as an adjunct to filler injections in nasal sponges

More often, botulinum toxin preparations against nasolabial folds are used in addition to filler injections. Moreover, the fillers themselves can perform several tasks:

• Restoring the normal structure and tone of the skin, due to which the drooping cheeks are “pulled”;
• Filling the wrinkles themselves, reducing their depth and severity.

Various means are used to obtain these results. In the first case, biorevitalization of the skin in the region of the nasolabial triangle is carried out using hyaluronic acid, in the second case, fillers based on collagen, autologous fat, or other volume-creating preparations are used.

When after these procedures (usually after a certain period of time necessary for the effect to manifest), obvious dynamic wrinkles remain in the place of the nasolabial folds, the doctor will eliminate them with botulinum toxin injections.

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“I had a similar situation. I thought of uploading only filler, because, apart from the nasolabial, nothing bothers me, and only fillers do it. But my beautician tells me: your facial expressions are pronounced, the smile is very wide, because of it the folds turn out to be deep. Here Botox will solve the half of the problem. Did either one or two injections on each side. And really, I guessed. Then it was from him that the skin was smoothed out well. But after Botox I came to put a filler, it took half as much, I injected a half of the syringe into my lips, so now I’m really beautiful. And everything costs 1300 rubles more precisely due to Botox. I think that this is a perfectly reasonable investment in beauty. ”

Ksenia, Moscow

In some cases, it is possible to use botulinum toxin before other procedures. If the doctor initially correctly assesses the effect of facial muscles on the severity of nasolabs, it is more rational to first immobilize these muscles and eliminate the severity of dynamic wrinkles, and then eliminate defects caused by other causes.

However, the second option is more complicated due to the fact that it is not always possible to correctly assess the contribution of various factors to the total defect. Therefore, in practice, filler therapy and, possibly, other procedures are often carried out first, and only when obvious dynamic wrinkles appear, botulinum toxin is used.

On a note

According to statistics provided in some reputable American magazines, the use of botulinum toxin is required in about 8% of cases of nasolabial correction.In most situations, to remove these folds completely or to achieve the maximum possible result is possible without Botox or its analogues.

In general, fillers are more effective in eliminating nasolabial folds than botulinum toxin preparations.

 

Amounts of drug and points of administration

Since botulinum toxin injections are only an auxiliary component of the procedure for eliminating nasolabial folds, it is administered in small amounts at several points.

Most often, Botox or its analogues, as part of the fight against nasolabels, are injected into the muscle that lifts the upper lip and the wing of the nose. She is very thin, but quite long, while her contractions lead to the lifting of the corners of the lips and stretching them with a smile. At this point, there is a strong deepening of the nasolabial fold in the central part, and in some people, the exposure of the upper gum.

In these cases, the injection is carried out in the apical triangle of the upper lip or in the pear-shaped opening of the nose on each side. 1-2.5 Botox units or 3-6 units of Dysport are introduced at one point. Given the small diameter of this muscle, this amount of drug is enough to completely immobilize it.

After the procedure, the deepening of the fold with a smile becomes less noticeable, and on the face without a smile the nasolabine is smoothed out a little.

Less commonly, botulinum toxin is injected into a muscle that lowers the angle of the mouth. This may be justified by reducing either the tone of the zygomatic muscle or the elasticity of the skin on the cheeks. In both cases, the muscle pulls the corner of the lip and cheek down, increasing the severity of the nasolabial, and when it is injected, the cheek rises and the crease decreases.

As in the previous case, a small amount of the drug is injected into the muscle that lowers the angle of the mouth - 1-2 Botox units or the equivalent dose of Dysport. If after the procedure the effect is insufficient, it is enhanced by the introduction of additional doses.

After such injections, the severity of the so-called dashed folds - thin surface wrinkles stretching from the edges of the nose to the lips weakens.

Given the small amount of the drug, the price of such procedures is relatively low. So, with the cost of introducing a Botox unit of 300-320 rubles, such a nasolabial therapy will cost 1200-1400 rubles. But at the same time, the result will be very weak, and for a more pronounced correction, other methods, more expensive, will be required.

Also, in some cases, with complex correction of the nasolabels, injections are made into the zygomatic muscles, the circular muscle of the mouth, and even into the muscle of laughter. Here, however, the highest caution and the use of minimal amounts of the drug is required to avoid side cosmetic defects.

Moreover, to eliminate or reduce the severity of nasolabial folds, botulinum toxin is never injected directly into the folds. The fold itself is formed at the places of muscle attachment to other fibers, and their contraction does not occur here.

 

Possible unwanted effects of such injections

Injections of botulinum toxin into the nasolabial triangle are fraught with a noticeable, conspicuous violation of facial expressions. Moreover, in order to be noticeable, these violations do not need to be significant. For example, critical for many patients are:

• Insufficient lip extension when smiling, caused by weakening of the muscle of laughter or the muscle that lifts the upper lip. In this case, a visual feeling is created that a person cannot fully smile;
• Omitting or, conversely, raising the corners of the lips. In the first case, the face acquires a dull expression, in the second, an evil smile appears on it (an analogue of the smile from clowns from horror films);
• Total lip extension in length, leading to a change in the face as a whole;
• Sagging the middle of the upper lip with a smile, creating the impression that a person intentionally covers his upper teeth and is afraid to smile at full strength;
• Violation of the symmetry of the face - omission of one corner of the lips, the curvature of a smile.

Since such side effects significantly affect facial expressions, they attract attention even if the observer does not realize exactly what changes have occurred with the face of the person who has undergone botulinum therapy. In this case, people around tell the patient that something is wrong with him, but they cannot explain what exactly.

Other side effects are already pathological and not only affect the appearance of the patient, but also cause him some inconvenience. These include, for example:

• Dysphagia - complexity and even inability to take a sip;
• The development of dysfunction of the muscle blocking the mouth;
• Flu-like syndrome (very rare due to small amounts of botulinum toxin administered).

At the same time, side effects typical of botulinum therapy in the form of edema and bruising at the injection site with injections into the nasolabial triangle and rarely develop around it. This is due to the small amount of the drug administered and the softness of the injected tissues.

 

What methods more effectively remove these folds?

As you can see, botulinum therapy is only an auxiliary method for combating nasolabial folds, which allows only to strengthen the results obtained using other procedures. As the main correction method, the following are usually used:

• Injections of hyaluronic acid - in cases where restoration of skin tone, intensification of metabolic processes and increase in the amount of water in it, regeneration of the cell matrix, creation of volume and smoothness are required. Due to these effects, the use of hyaluronic acid is called biorevitalization;
• The introduction of autologous fibroblasts, providing an effect similar to the effect of hyaluronic acid, but not accompanied by an increase in volume due to the retention of additional quantities of fluid;
• The introduction of fillers into the skin, providing additional volume and smoothing the surface of the skin. Such excipients include special biodegradable gels, bovine and human collagen, autologous fat taken from other parts of the body, polymethyl methacrylate;
• Thread braces indicated for age-related sagging cheeks;

• Hardware lifting, by itself, is ineffective, but well enhancing the effect of contouring.

If the patient has other, more serious defects that require surgical correction, he may simultaneously undergo an operation cheek lift. However, in practice this happens very rarely due to the complexity and high cost of such operations.

Finally, in some cases, it is not so much therapeutic as preventive measures that can significantly weaken the severity of nasolabial folds.

For example, the photo below shows the girl’s nasolips before a course of special yoga for the face and after the corresponding set of exercises:

It can be seen that the result is superior to that even for filler injections. And although this effect can only be achieved before the appearance of senile wrinkles, for many women aged 30-40 years this method is a real magic wand.

It is also extremely useful to use various scrubs and peels, moisturizers, mesotherapy, to control the time of your exposure to the sun. All these methods will at least help not to aggravate the severity of the nasolabies, and with a competent approach, they will weaken them until they disappear completely.

 

Nasolabial folds: causes, exercises for prevention and methods of dealing with the problem

 

An interesting video about facial correction with Botox, including nasolabial folds

 

Tips and tricks from a specialist on how to get rid of nasolabs