Nasolabial folds remaining even after aristocratic surgery—what surgery can help? (Before and after photos)

hello, Director Baek In-soo of Garnet Plastic Surgery no see.
“I had a facelift, but why are my nasolabial folds still the same?” This is a question frequently heard in the consultation room.

Nasolabial folds It deepens not only due to hollowness next to the nose but also due to the combined effects of sagging cheek tissue and changes in fat and bone structure. Therefore, even for the same nasolabial folds, the appropriate surgery varies depending on the cause.

Today, I will explain the reasons why nasolabial folds remain even after aristocratic surgery and what surgeries can be helpful, addressing five frequently asked questions.

🔹 What are the reasons why nasolabial folds remain even after undergoing aristocratic surgery?

Noble surgery is a procedure to add volume to sunken areas, not to lift sagging tissue.

Noble surgery is a procedure that adds volume to sunken areas next to the nose by inserting implants or similar materials. Since it is not a surgery to lift sagging cheek tissue, If sagging is the main cause, nasolabial folds may remain.

🔸 When power failure is the main cause
This is a case where shadows form due to the hollowing of the bone structure next to the nose. In this situation, wrinkles can be alleviated through a "noble surgery" that adds volume.

🔸 When sagging is the main cause
This is a case where the cheek tissue sags downward, creating a fold next to the nose. Simply adding volume will not return the sagging tissue to its original position.

In addition, wrinkles may become prominent again as aging progresses even after surgery. Just because wrinkles remain after aristocratic surgery does not necessarily mean the surgery was performed incorrectly or that the implants were insufficient.

🔹 What surgery do you recommend for improving nasolabial folds?

Rather than making a decision based solely on the depth of the nasolabial folds, you should first evaluate the proportion of hollowness and sagging.

If the primary cause is a skeletal depression next to the nose, a "noblesse" (aristocratic) surgery may be considered; if the sagging of the cheek tissue is pronounced, a mid-face lift or a full facelift can be taken into account. If volume loss is also present, supplementary procedures such as fat grafting may be necessary.

✔ We do not decide on surgery based solely on the depth of the nasolabial folds. It is important to first assess where the area has sunken and which tissues have sagged, as well as the extent of the problem, before selecting the appropriate surgery based on the cause.

🔹 Can I get a facelift after aristocratic surgery?

If there are no issues with the existing implants and surrounding tissues, it may be considered depending on the condition.

Even those who have undergone aristocratic surgery may consider a facelift depending on their condition, provided there are no issues with the existing implants or surrounding tissues. However, Position and size of the implant, presence of inflammation, adhesions due to previous surgery You must check this first.

Deep-plane facelift is a method that repositions sagging tissues by manipulating deep-layered tissues and retaining ligaments. However, since the same approach is not suitable for all patients, the surgical method is determined based on previous surgical history and tissue condition.

📌 This is a case of a patient who agreed to the disclosure of before and after photos of a facelift.

🔹 What are the side effects I should know before surgery?

Since the risk varies depending on the scope of the surgery, surgical history, and health condition, a thorough pre-operative evaluation is necessary.

For any surgery, it is important to be aware of the potential side effects along with the changes you can expect.

✔ Noble surgery — Infection, implant displacement, foreign body sensation, asymmetry, etc. may occur.
✔ Facelift — There is a risk of bleeding and hematoma, infection, scarring, changes in sensation, impaired blood flow to the skin, nerve damage, etc.
✔ Factors that increase risk — The risk varies depending on the scope of the surgery, past surgical history, smoking status, and health condition.

Therefore, before surgery, please thoroughly evaluate your past surgical history and health condition, and confirm any questions you may have during the consultation.

🔹 Does a facelift completely eliminate nasolabial folds?

This is a surgery that alleviates wrinkles by repositioning sagging tissue, and complete disappearance cannot be guaranteed.

A facelift is a surgical procedure that alleviates wrinkles by repositioning sagging tissues. It cannot resolve all deeply etched lines on the skin or skeletal depressions, Aging continues even after surgery.

In addition, since two weeks post-surgery is the early stage where swelling remains, it is too early to judge the final results and maintenance effects. It is recommended to monitor the changes while observing the swelling subsides.

🔹 Frequently Asked Questions (FAQ)

Q1. If nasolabial folds remain after aristocratic surgery, was there insufficient implant material?

That is not necessarily the case. Since aristocratic surgery is designed to restore volume to sunken areas, wrinkles may remain regardless of the implant if the primary cause is sagging of the cheek tissue.

Q2. Can nasolabial folds be improved with fat grafting alone?

If volume loss is present, supplementary procedures such as fat grafting may be helpful. However, if sagging is the primary cause, surgery to reposition the sagging tissues should also be considered.

Q3. Can I have a facelift while keeping the implants from the aristocratic surgery?

If there are no issues with the existing implants or surrounding tissues, it may be considered depending on the condition. The decision is made after first checking the implant's location and size, the presence of inflammation, and adhesions.

Q4. It has been two weeks since my facelift, but wrinkles remain. Is it a failure?

It is too early to judge the final results as two weeks post-surgery is the early stage where swelling still remains. Additionally, a facelift cannot resolve all deeply etched lines or skeletal depressions.

🔹 Conclusion

🔹 Key Points
The starting point for improving nasolabial folds is Distinguishing between sinking and sagging Just because wrinkles remain after aristocratic surgery does not necessarily mean the surgery was performed incorrectly or that there was insufficient implant.

🔹 Verification points
Evaluate the skeletal structure, volume, tissue sagging, and the condition of existing implants together, and Expected changes and limitations of the surgery You should decide on treatment after fully understanding it.

🔹 Reasons why specialist consultation is necessary
When consulting about nasolabial folds, I first examine where the area is sunken and which tissues are sagging. I select the appropriate surgery based on the cause, and Providing a thorough explanation of the changes you can expect and even the wrinkles that may remain. This is because it is important.

If you are still concerned about nasolabial folds even after aristocratic surgery, please first check whether hollowness or sagging remains.

Garnet Plastic Surgery Clinic

Director Baek In-soo

- Graduated from Korea University College of Medicine
- Graduated from Korea University Graduate School (Major in Plastic Surgery)
- Plastic surgeon at the National Medical Center
- (Former) Chief Director of Jewelry Plastic Surgery Clinic
- Regular member of the Korean Society of Plastic and Reconstructive Surgeons
- Regular member of the Korean Society of Aesthetic Plastic Surgery
- Regular member of the Korean Craniofacial Society
- Regular member of the Facial Contouring Research Group of the Korean Society of Plastic and Reconstructive Surgeons
- Regular member of the Oculoplastic Surgery Research Group of the Korean Society of Plastic and Reconstructive Surgeons
- Regular member of the Rhinoplasty Research Group of the Korean Society of Plastic and Reconstructive Surgeons