Dear Dr. Maria,

I am a 47-year-old mother of two. I recently started noticing deep grooves lines around my mouth, so I went online and discovered that these lines have a name: nasolabial folds

With so many different brands, I’m confused. In your opinion, which is the best filler for my nasolabial folds? I want something safe, natural and long lasting. The marketing info online is driving me crazy!

Please advise.

Jasmine Davidian, 47, Abu Dhabi

Dr. Khattar Answers: 

Aging with grace is everyone’s goal and deepening grooves around your mouth (Nasolabial folds) indicate that you live well and laugh too. Nasolabial folds are one of the earlier manifestations of facial aging and result generally due to the sum total of changes in facial anatomy that occur in all of the layers of the face: the skin, facial fat , facial muscles and facial skeleton.

I will shed light on the topic in general so that you can make your own informed decision. For physicians reading this column, these messages are relevant for your patients too.

When selecting dermal fillers, substance safety is key 

Always opt for fillers that are biodegradable and its recommended that these be administered by physicians who are board certified in aesthetic medicine. Always be sure you know the name of the filler you have been injected with. Always ask both the trade name and the generic name (chemical name) of the filler and discuss its safety and efficacy with your physician.

Going Against Gravity

Judging from your age, your nasolabial depressions are probably a consequence of mid-face fat loss. Rather than directly injecting into the folds themselves, you would achieve a more natural correction by addressing areas of volume loss in the upper face (cheek and zygomatic arch) with a soft tissue contouring agent, which would lift your face and consequently alleviate your nasolabial folds.

Did You Know?

There are numerous dermal filler substances on the market but they can be divided into two categories: the Replacement fillers and the Collagen stimulating fillers.

Replacement Fillers

These have an immediate effect in filling out lines and folds but do not regenerate the skin. The most commonly used replacement filler substance is Hyaluronic Acid , which is a natural skin component and is marketed under several trade names including Restylane, Juvederm , Neauvia and Z-fill.

Filler Longevity

The cosmetic correction obtained with these substances is relatively short-lived ranging from six to eight months and regular re-injection is required to maintain the desired effect.

Collagen-Stimulating Fillers

These help to replenish your own collagen and restore lost volume, collagen stimulating fillers made from Polylactic acid, Calcium Hydroxylapetite and Polycaprolactone. All three compounds are totally biodegradable and eliminated in time from the body. However not all of the products in this group lead to the same extent of collagen stimulation.

Contour Me Beautiful

Soft tissue fillers are ideal facial contouring agents that are used to create the appearance of high cheekbones, one of the main determinants of facial beauty. They are excellent in enhancing weak chins and giving a total face lifting effect by strategically placing the product near the ears, in the temples and along the jawline. For Total Facial Contouring, the collagen stimulating substances afford long term results due to the fact that they induce the formation of the body’s own soft tissue.

Are you a Physician looking to get trained in Dermal Filler? Make Sure You’re In Safe Hands with IMA

As a physician looking to expand their knowledge of the anatomy for facial aesthetics, you probably already know that fillers should only be administered under a strict medical setting by physicians who are highly trained, to manage anaphylactic allergic reactions in case they occur.  Unprofessional dermal filling by untrained physicians or nurses could result in side effects and complications such as:

  • Bruising

  • Oedema

  • Skin discoloration: telengiactasia, erythema and hyperpigmentation

  • Infection

  • Vascular occlusion, which may result in necrosis and blindness

  • Paraesthesia (direct nerve damage)

To know more about Hands-on Training in aesthetic certification courses offered by leading experts, please contact