"Injectinghyaluronic acidinto the nasolabial folds will solve it"—in fact, there are cases where that alone is insufficient.
We'll explain the causes of nasolabial folds in detail and convey the following:
- The two causes of nasolabial folds, and the difference between cases where hyaluronic acid works and doesn't
- The alternative approach of "lifting" shown by the literature
- Detailed data on procedures whose improvement effect was reported in clinical studies
- What to know about safety, downtime, and effect persistence
Once people start noticing nasolabial folds, the first thing many research ishyaluronic acid (a component that retains skin moisture) injection. Because of its image of being easy and immediate, it's one of the popular options. As a result, surprisingly few people go so far as to research the mechanism of "why nasolabial folds form"—that's the current situation. Knowing the cause may change how you choose treatment.
Why Do Nasolabial Folds Form? The Reason Hyaluronic Acid Alone Can't Cover It
The main causes of nasolabial folds can broadly be divided into two.
- Loss of skin volume: Collagen and hyaluronic acid decrease, the skin hollows, and wrinkles become conspicuous
- Sagging/descent of skin and fat: Due to gravity and tissue aging, the whole face falls downward
Hyaluronic acid injection is a procedure good at "filling" hollowed areas. Therefore, an effect can be expected for nasolabial folds whose main cause is insufficient volume.
On the other hand,when the main cause is sagging or descent,filling alone stays at superficial improvement and sometimes does not become a fundamental approach. This is a point many people tend to overlook.
For nasolabial folds caused by sagging, what options are there?
What Is the "No-Scalpel Lift" Thread Lift That the Literature Is Noting?
In recent years, what has been advancing in research even in medical papers is the procedure called thethread liftsthread lift. It passes thin absorbable threads beneath the skin to physically lift sagging tissue, a minimally invasive treatment.
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Because it involves no incision and passes the thread beneath the skin with a cannula (thin tube), scars are said to be less likely to remain and recovery is relatively fast. Therefore, it is noted as a suitable option for those who want to minimize the impact on work and daily life.
So, what about the specific clinical data?
"Improvement Effect Confirmed"—Details of Research Data Backed by 3D Image Analysis
In a clinical study conducted by Korean dermatologists and others (Kwon H, et al. Dermatologic Surgery. 2019),a thread lift using barbed (small thorn-like projections) absorbable polyglyconate thread was performed on 25 people,and the effect and safety were verified.
In this study, 84% of patients reported improvement, and 65% had marked improvement confirmed. However, these results vary by individual, and not everyone can expect the same result:
- In physician assessment,84%of patients were rated "improved or better" (using the 5-point GAIS rating scale)
- of which65%were rated "markedly improved" or above
- The patients' own self-assessment also confirmed the same tendency
- The pain score during the procedure averaged3.8 points (out of 10)—relatively mild
And what is noteworthy is the "visualization" of the effect. Through image analysis with a 3D camera,it was confirmed in numbers that the tissue of the lower face (around the facial line) moved upward after the procedure. It's not "I somehow feel it lifted" but a report based on research data.
This is ultimately research data,and the actual effect varies by individual。
Safety and Downtime—The Real Data You're Concerned About
Anxieties like "isn't putting threads in scary?" and "isn't downtime long?" are also often heard.
According to the aforementioned study, bruising (72%) and edema (swelling, 56%) were reported as side effects, butboth resolved spontaneously within 2 weeks. Not a single case of serious trouble such as nerve damage or granuloma (tissue change from a foreign-body reaction) was reported.
Furthermore, in another study (Kapicioğlu Y, et al. Dermatologic Surgery. 2019), the effect of thread lifts on collagen production was examined histologically.
It was shown that collagen is produced around the threads,and it is thought that it may positively affect not only lifting but also skin texture.
As post-procedure precautions, it is recommended to refrain from widely opening the mouth (yawning or laughing hard) and facial massage for 2 weeks. Also, the persistence of the effect varies by individual; the absorbable thread used differs by thread type and individual variation, but the thread used in this study is absorbed in about 6 months. There are also materials with a longer duration, such as PLLA and PCL.
Regarding the overall characteristics of procedures using hyaluronic acid,Explaining the Benefits and Safety of Reshaping the Nose With Hyaluronic Acidplease also refer to this.
How to Think About Whether to Choose Hyaluronic Acid or a Thread Lift
Hyaluronic acid injection and thread lifts—neither is the "correct answer." They each exert their effect through different mechanisms, sothe appropriate option changes depending on the cause of your concern。
- Cases Suited to Hyaluronic Acid Injection: When the main cause is a hollow due to insufficient volume
- Cases Suited to a Thread Lift: When the main cause is sagging or descent and you want to lift the tissue
- Cases Where Combination Is Considered: When both insufficient volume and sagging are involved
As for "which is the cause of my nasolabial folds," there are parts that are hard to judge by self-check alone. Therefore, by having a specialist check your condition once, you may be able to obtain useful reference information.
Our clinic proposes after confirming each person's condition, soyou can consult us in a consultation. Regarding the types of procedures,the procedure menu listis also available to view.
Frequently Asked Questions (FAQ)
How long does the thread lift's effect last?
It depends on the thread type and individual variation, but the thread used in this study is absorbed in about 6 months. There are also longer-duration materials such as PLLA and PCL. Therefore, the persistence of the effect varies by individual, and maintaining it with multiple procedures is common.
What kind of person is a thread lift suited to?
It is considered suited to people with mild-to-moderate sagging and skin laxity. In the study, the nasolabial folds, marionette lines (wrinkles extending from the corner of the mouth to the chin), and descent of the facial line were used as indication criteria.
How long is the downtime?
Bruising or swelling may appear, but in the research data mostsettled spontaneously within 2 weeks. Also, it is recommended to refrain from widely opening the mouth and facial massage for 2 weeks after the procedure.
How does it differ from cutting surgery (a facelift)?
It is a minimally invasive procedure that involves no incision and passes threads beneath the skin with a cannula (thin tube). Therefore, its strengths are that scars are less likely to remain and recovery is relatively fast. On the other hand, for severe sagging, a surgical procedure is sometimes considered.
Will the skin's texture and pores also improve after the procedure?
It is thought to relate to the collagen produced around the threads, but the result varies by individual.
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Summary
- The causes of nasolabial folds are of two kinds—"volume loss" and "sagging/descent"—and the appropriate approach may differ by cause
- Hyaluronic acid injection is effective for volume replenishment, while when sagging is the main cause, a "lifting" procedure is sometimes effective
- In a clinical study (Kwon et al., 2019), the thread lift confirmed a high improvement effect
- Side effects were mostly bruising and swelling, but they resolved spontaneously within 2 weeks. No serious complications were reported
- Knowing the cause of your own nasolabial folds is the first step in choosing the optimal procedure
At Zetith Beauty Clinic, we accept thread-lift consultations tailored to each person's sagging condition and wishes. Those who think "I want to sharpen my facial line without a scalpel,"please consult us in a consultation. We propose according to each person's concern.
About the Author
Hiromitsu Nakamura M.D.
Zetith Beauty Clinic Ginza, Osaka, Fukuoka
Has a track record of research presentations at domestic and international conferences, and is also involved in technical guidance and education across Zetith Beauty Clinic. Specializing in precise rhinoplasty based on anatomical evidence, he pursues natural results tailored to each person's bone structure and tissue.
References
- Kwon H, Choi S, Park G, et al. Clinical Evaluations of a Novel Thread Lifting Regimen Using Barbed Polyglyconate Suture for Facial Rejuvenation: Analysis Using a 3-Dimensional Imaging System. Dermatologic Surgery. 2019 (DOI)
- Kapicioğlu Y, Gül M, Saraç G, et al. Comparison of Antiaging Effects on Rat Skin of Cog Thread and Poly-l-Lactic Acid Thread. Dermatologic Surgery. 2019 (DOI)
- Kang S, Byun E, Kim H. Vertical Lifting: A New Optimal Thread Lifting Technique for Asians. Dermatologic Surgery. 2017 (DOI)