Today’s post is on the treatment methods for nasolabial line.
One thing that the patients must know about the nasolabial line is that, no one method can solve or improve on its related problems.
Also, one should have some knowledge on the nasolabial line.


How does nasolabial line form?
If you think that the nasolabial line is formed due to age, then you would not be able to explain why the young people have nasolabial line.
There are multiple reasons to why the nasolabial line is formed, therefore, it is important to have multiple approaches to solve this problem.

1. Influence of the upper jaw and tooth
Upper jaw includes the bottom of the nose to the upper lips. It also includes upper mouth gum bone where the teeth are located.  There are cases where this gum bone slides outwards. The tooth also slides out in this case and we call this, buck tooth. We usually call this problem, protruded mouth. For all those who have protruded mouth, you cannot avoid having nasolabial line on the face. The nasolabial line does not make you look older in such case, but the face might look dull and less sophisticated and this is why you want to have the face treated.
Such treatment for the bone-mouth structure is not covered by antiaging treatment but by facial contour surgery. Usually, surgery with implant is conducted, but another simple method can be the usage of the filler.

2. The skin on the midface, above the wrinkle, hangs down



Nasolabial line refers to the groove, and this groove means that the surrounding area is rather tall or high. If you have much fat on the midface, ie from the apple line to the side of the nose and to the nasolabial line, and your face hangs down even by a little, your nasolabial line would look severe. In this case, facial contour surgery is necessary rather than antiaging. Usually accusculpt / mini sculpt is applied, but nowadays, facial contour injection or hpl methods are applied. Also, the hanging skin means that the skin has lost elasticity therefore tightening methods such as ultraformer / ulthera are used.

3. Facial expression, lip movement, smiling habit
Aging mean that you have used something for a long time. If you do not make many expression then you would not have severe case of nasolabial line. But, if you move your mouth a lot, make it big, and make many expressions with the mouth, you would naturally have severe case of nasolabial line.
Take a lot at how much the nasolabial line moves when you frown or smile. Also, in most cases, both sides of the face would not make the same expression therefore your nasolabial line would be asymmetric.
The most representative methods to solve this are using the Botox or the filler.


As shown in the image, the filler is applied at the deep area where the pressure is high. But the filler disperses to the area with less pressure resulting in no improvement. This is why filler cannot be the solution to nasolabial line problem.

4. Low elasticity of the skin
Most people would suffer low elasticity of the skin. Only the degree is different. No one can avoid this problem. As the skin loses elasticity, the skin starts to hang down and the wrinkle becomes worse.



Nasolabial thread lifting ... i.e cog thread – the skin starting from the front part of the ear to the nasolabial line is lifted and the filler is used. This is the most commonly used method for most patients.

Today, I have share about the nasolabial line and how to treat it. Hope you had a great off-days. It’s a start of a new week from tomorrow. Thank you for reading. Have a great day.

Today, I will be putting up a post regarding wrinkles under the eyes.
There are many who are curious about this matter and this is something that is very complicated. The reason for such complication is because the wrinkles under the eyes not only include the influence on the skin but also, the fat, muscle around the eyes, lower eyelid, bone structure, and other parts on the center of the face.


Let’s look at some common problems that may arise under the eyes.

1. Wrinkles under the eyes; The reason why many wrinkles are cause under the eyes is that the skin under the eyes is very thin, and there is much movement. When we think about the eyelid, we mostly refer to the top eyelid, but the lower eyelid moves as much as the upper one all day.

Also, the muscles around this area makes minor small expressions. A small frown or a smile can end up in many wrinkles. Also, the aging of a person starts from the eyes and therefore it is difficult to hide the wrinkles under the eyes even for those young ladies.
There are many solution to this. The simplest method is the skin Botox.

The part at bottom of the eyes make the facial expressions therefore if this part becomes stiff due to the Botox, one would look weird. Therefore, it is better to mix the Botox with saline solution and anesthetic drugs so that it does not penetrate deeply into the muscles targeting just the wrinkles.
Tornado threads are used for thread lifting under the eyes. Normally, one would put about 3 to 5 threads parallel to the direction of the lower eyelid. The thread put tension on the thin skin under the eyes making the skin tighter so that this part does not stretch. The thread stimulates the collagen that causes the tightening.
If you are one with severe case of wrinkles and old aged, then removing lower eyelid through surgery is recommended for positive results. The invasive methods recommended above are those from mid-20s to late 40s.



2. Fat under the eyes: There are those who want to get rid of the fat under the eyes to solve the problems that arise below the eyes. This fat is different from the subcutaneous fat that we usually talk about. The eyeball is covered by tissues and muscles that act as a padding for protection. One of the most important cushioning factor is the eye socket fat.

The eye socket fat is located both above and below the eyelids. The eye socket fat below the eyelid loses elasticity and strength as the person gets older and starts to hang downwards. This is a totally different problem compared to the wrinkles.
If the fat under the eyes start to stick out, then one must remove the fat or move the fat to the lower tear trough. There are some who ask if the eyes look fat and whether the dark circle becomes worse or not, when the fat is removed. This is not true.



3. Tear trough ; Tear trough is formed because of the lower margin of the orbital rim, which acts as a container for the eye. The bone acts as a shelf and the eye is placed on it. When the skin surrounding the orbital rim lose elasticity, wrinkle is formed. This is the case of nasolabial line and Indian band. Also, the fat below the eye sticks outwards making the tear trough look deeper.



For the swelling of the eye or worsened case of tear trough, one can consider fat transplantation. But if you want to avoid a surgery and rather find noninvasive method, a tornado thread can be used to make the tear trough look less severe. Threading is normally used for lifting or tightening, but in this case, it can be used as a supporting measure. Filler can be used simultaneously.


4. Dark circle ; Dark circle is casued due to the melanin coloring from the ultraviolet rays or because the blood vessels are too close to the skin. Allergy or not enough blood circulation can also make the surrounding of the eyes look darker. Dark circle cannot disappear with one surgery, it needs continuous care. If the dark circle is caused by pigmentation, then whitening treatment (whitening laser, whitening injection) can be applied. If there is a problem with blood circulation then one should take care of his/her body by getting enough sleep and drinking much water. If a person has a severe case of dark circle with aging effect on the eyes, the he/she would need to get both dark circle and wrinkle treatments.




5. Lower eyelid(aegyo sal); There are some who take care of the lower eyelid for antiaging, but one must be careful of this. Making the lower eyelid smaller does not make one look younger. If you have many small wrinkles below the eyes, then you can put filler into the lower eyelid therefore removing the small wrinkles. But if you are aged with less elastic skin under the eyes and use the filler, the filler would make the skin hang down. Therefore, it is important to consider how elastic the skin around the eyes are when using the lower eyelid filler.

Today, we looked at the wrinkles formed under the eyes and the antiaging method for these wrinkles.
Thank you very much for reading.

Today, I would like to share about how to make a V-line.
V-line means sharp looking chin line. There are mainly two reasons on why such chin line is wanted by many.

The first reason is because as your lower face look bigger, it feels unsophisticated and blunt. If the lower part of your face is small, it would look sleek and sophisticated.
The other reason is that as you get older the lower part of your face become more square-like. Sharp looking chin line would make you look much younger.
The main objectives are V-line lifting are sophisticate look and anti-aging affect. Both these two objectives can be satisfied.

There might be those who question the difference between V-line and marionette line lifting.
V-line lifting is a broader term and it includes marionette line lifting. Marionette line lifting is used to improve on the marionette line around your mouth but pulling it upwards. V-line includes the bone, skin, fat, muscle, etc therefore it can also include marionette line in some aspect.



First, we need to improve on the square looking face that is caused by the hanging down cheek skin. I would recommend invasive thread lifting to solve this.
The method used here would be almost identical with the marionette line lifting method. One added step is using the screw lifting thread at the lower chin bone.



Second, if there is obese or thickening effect on the cheek muscle, this would result in square looking face. This can be improved with the usage of Botox.
Botox is put at the lower part of the face making the muscle smaller during the masticatory movement, and makes the square looking part of the face thinner.
The actual objective of this method is not antiaging but face contouring but such improvement on the face also leads to positive antiaging effect.

Thirdly, tightening method such ultraformer/ulcera that use ultrasound head is also included as v-line lifting method. The cheek line is located at the lower part of the face therefore there is much pulling down power on it. Therefore using ultrasound tightening method such as ultraformer / ulcera helps maintain elasticity of the skin.

Most of the time, such tightening method is applied on to the whole face. This is help avoid hanging down effect at the bottom of the face.

Fourth, is the tightening of the lower cheek line. This is one part that people usually do not consider in v-line lifting but this is medically very important.


As a person gets older, the sharp lines of the face become dull. The line from the chin to the neck is very important when you compare that of an older person to that of a younger one. The skin on the neck hangs down and the line at the chin and the neck becomes dull.


I will cover more about this in the future when sharing about how to correct a double chin, but this too is a core element of v-line.
We usually combine screw lifting and Botox, but we can also apply fat transplantation for a sever case.
Today, I shared about v-line lifting. Thank you for reading.

Hello, everyone. Today, I would like to share about marionette line and fixing this sagging cheek skin. The focus will be on the invasive method of thread lifting.
We call this part marionette line.



There are many reasons on why this marionette line is formed but the first reason is that there is a ligament in the face that holds the cheek skin. This can be looked as a dam. These ligaments on the face act as a dam by holding together the fat so that the fat does not drop down. However, as you age, the skin not only lose elasticity but the ligament tissue also weakens therefore the skin drops down and start looking like the marionette line. The water is supposed to flow downwards but remains collected because of the dam.



Nasolabial fold, Indian band are all the same. The dam holding the skin weakens, making it look like a furrow instead and the skin collects above it, making the cave look bumpy.

Then how can we improve on this weakened skin and the fat collected? The best solution would be to pull it back to the original place. This improvement is difficult when conducted with a surgery.

We would need something to pull up the skin and maintain that pull. We call these two point, anchoring point and suspension point.

The anchoring point is normally at the side of the head. This is like nailing on the wall therefore the wall must be strong and hard. A good spot would be somewhere higher than the ear.

The suspension point is one where we want to pull up the skin. For this case, it would be where the marionette line is.

Usually, we would use thread with lumps but if we have Indian wrinkle, nasolabial line, or dense skin around the marionette line, such parts would be pulled first therefore there would not be much strength to hold onto the marionette line. This would not have any effect.

So, at times tunneling is necessary to destroy the ligament of the Indian band or those that are near the cheekbone.



The most commonly used thread for lifting is the one with bumps. We call this Cog thread.

We need about 3 to 6 cog threads to lift marionette line on one side of the face.
However, there are many cases where this cog thread lifting is not enough to maintain long lasting effect. If these threads are to have long lasting effect, we need another source of power that would pull the threads to different directions. So we use another thread in parallel called PDO. About 10 threads are necessary.





This is how we correct the marionette line. At times, we would need to remove the fat around the marionette line, if the cheek is too chubby. We apply fat transplantation as well.

Today, we looked at the details of marionette line.
I hope that the information has helped you.
Thank you and have a great one.