Hi, I'm Dr.
Johnny.
Thanks for joining me today.
I'm talking smile lines, nasal labial folds, still a top driver to
practices of patients complaining of an aged look because of those folds.
This is where fillers and products were approved for over 30 years now
because people look in the mirror.
They see the folds of aging and I get it.
I can understand why part of the problem I see is people are sending.
People watching YouTube down the very wrong road by saying certain treatments
are going to fix that problem today.
I'm going to tell you six treatments that do not work for nasal labial poles.
Then I'm going to show you.
Three that do.
And at the end, I'll give you a bonus little tip of something you
can do at home as well to help remove the appearance of those lines.
Now, to understand it fully, you have to understand the complexity.
And I'll tell you why they occur.
Number one is bone there's, bone loss in the Mugzilla or the bone
here that when it resorbs, it makes that a little bit deeper.
Number two bustle pole.
A lot of times young people, they have them when they smile.
But not at rest.
As we age the muscle pulls a little bit more.
In fact, there's evidence that the muscle in the face actually
pulls on the bone and create some of the bony changes that we see.
I'll talk about facial exercises.
If you guys want, let me know in the comments below, because they think
that's important, but there I did sit through an hour lecture just recently.
Very fascinating how the muscles pull the ball bone, but they play a role.
For those Naval nasal Linville bowls, for sure.
Third is the fat pad.
So we have a male or fat pad.
A lot of people know that name because it creates a problem in
the mid face, but the fact pad we know now hypertrophy, so it grows.
And it grows right at the edge where you don't want it to, and
it almost creates a fold there.
And when I talk about some treatments that don't work, this'll make a lot of sense.
So that's, uh, the fat pad plays an important role in the growth of that.
Along with the muscle pole, I said the muscle pulls for the younger
person, but they don't see it.
College and loss.
As we age, the muscle pulls, you get the bone loss.
You get the college and loss and the fat pad growth, and that
all adds up to an aging feature.
So now let's go through the six things that will not fix your
falls that you've led to believe.
Maybe they will.
If you liked the videos, click like subscribe and definitely comment.
Let me know what you want to see coming up.
But I want to make sure that you get the education so that you do the
treatments that are ripe for you to save you time, money, and energy.
Number one treatment.
That's not going to work.
Are facial exercises for this fold.
So you can do all the exercises you want.
I'd love to see them before and after picture of one, three,
four, or five months, whatever it takes of basal exercises,
that's going to get rid of that.
Fold.
Number two is microneedling.
Microneedling.
Whether you're putting in a retinol, a hyaluronic acid platelet, rich fibrin,
like I do, it will not remove that full.
They won't get enough college and building.
And to create that lift, create bone or reduce the fat that's creating it.
Number three Kybella or fat dissolving PCDC phosphatidylcholine
or deoxycholic injections.
The reason we don't use them, you might think we would because
there's a fat who reduce the fat.
Well, everything will be good.
The problem is it also gets rid of the myelin or the covering around the nerve.
You'll end up with little palsy or a stroke, like look too often than not.
So we don't use it.
Number four, retinol, you can use all the retinol you want in the world.
It's not going to get rid of a nasal labial fold for you.
It's not its function.
It can help build college and give me a better skin, but it's
not going to get rid of that.
Fold.
Number five is led mask.
I did a whole review on them.
I liked them a lot, but they're not going to get rid of a fold.
They do other things as mentioned in that video, it may help with
skin and possibly some college and production and they give a nice look
and they have positive benefits.
But they will not get rid of a fold.
The last one can help a little bit, depending on what you're using, but
I was talking more towards Gelman occurrence or microcurrents, some
people might use it RF at home and that college and building can do something.
So that's a soft call, depends on the device you're using or the type.
Energy of microcurrent, if it produces heat and how strong it is, there are
so many devices out there, but a lot of the ones that people are buying, aren't
strong enough to stop that full let's go into the three things that will work.
And then my bonus tip that you can do at home as well.
Number three.
Is moving the tissues or repurposing the tissues.
This is probably the most aggressive one, but a lot of people want to know about
it now because it's accessible to them.
And it's PDO threads and thread lifting, not the smooth threads, although you could
put them in the fold and that will help get rid of the fold, but the Barb or the
lifting threads that you can see here.
That I put in with a large gauge cannula.
And again, this is very accessible to so many people.
Now it's probably the most or the fastest growing, uh, minimally
invasive procedure around the globe.
Certainly in North America that I'm seeing today.
One of the hottest trending topics, you put the thread in, you set the thread,
you reapply pose those fat layers.
So you actually do get a lifting.
Effect.
And now with the molded threads that we're using, the lift is pretty amazing.
And you can put several threads in a face to get the lift that you want.
If the fat pad is deeper, my number three treatment.
Is deep heating, whether you're using RF radio frequency devices,
high-frequency ultrasound.
Those are the two most common and there's various devices that one can
use to denature the college ins and get more structured support, deeper
down a high-frequency ultrasound.
A lot of people know Olvera radio-frequency Thermage.
I use a VR device.
Um, there are many on the market.
The key is.
The depth of the heating, the oven amount of heating,
meaning the time and the energy.
I have to heat the temperature at the correct amount for the
correct time with each device.
And they'll all be a little bit different depending on how much heat they produce,
because if you can get rid of fat, which of course we want in this region,
so you can target it to remove fat.
And to build college and to lift and tighten the tissues above it.
So the providers, one of the most important factors for these type
of treatments, because they will adjust the device in the area to do
what you want to remove and tighten.
Where appropriate, because it could go wrong.
You could remove the fat where you don't want it to.
And I know many of you have had that experience on my
channel, many subscribers.
Um, and that's unfortunate because it does.
Shrink the fat cell often doesn't permanently get rid of it such
as RF microneedling will with 67 degree temperatures, uh, or, um,
desolving fat with the injections, like the PCDC valid type.
Those are permanent fat reduction.
So the heating usually.
Makes the fat cells leaky as opposed to, um, permanently get rid of them.
So often that bat does return use correctly.
That's a solid option.
Number two, especially for those that don't want anything aggressive
like threads, um, or fillers placed in, which is my number one most
common, which is filling the folds.
Uh, when that is by using hi Allie orotic acid filler, I
will often use plasma sculpt.
Or sculptor type biostimulators cause it's nice and smooth, but filling
the folds directly a high-alert chronic acid is a really good
choice because it's long lasting it.
Doesn't migrate here so much.
If done appropriately, you can use a micro cannular.
So it's safer in some instances.
And now we have nice flexible products that integrate with the
tissues and move with the face.
A bonus little tip here.
If you're filling these folds, most people need.
Mid face fillers as well.
The high cheek won't lift here as much, but the midface filler will
help lift that nasal full and it can be placed in different layers in the
fat and on the bone to reproduce.
What's the bone loss and what the fat loss is.
If you're interested in learning more in injections, certainly
consider your professional.
Joining my monthly membership@theaestheticmonthlyinsidertrainingataesthetictrainingcenter.com.
Um, but I wanted to give the concept.
To most people about the fillers.
Now what's my bonus tip that you can do at home that I actually think works
really well for those who aren't ready for more aggressive treatments, or if
you've had more aggressive treatments done and you want to maintain, and
it's really important to do so because the less you can get injected, the
less invasive treatments you have done, the happier Vern is the better
it is and the safer it is for you.
So I believe hydrating the area.
Hydrating the area hydrating.
The skin actually does work by using a skincare product such as hyaluronic acid,
which has small and larger molecules.
So you can get the penetration and by hydrating that fold and
attracting water, it plumps the area a step further from that.
Would be using Mesotherapy or an injection technique, or he put little non cross-link
tie on erotic acid blebs, uh, in the skin.
So that can hydrate, help build college.
And of course, hyaluronic acid, not only attracts water, but has.
Antioxidant properties, but in a topical form for those who wish to,
if you do that on a regular basis, I think it actually works well prior.
I said, yeah, retinol doesn't work.
That's something absolutely different in terms of building
collagen, but plumping the area.
Can have a nice effect.
And if it's a minimal to moderate fold, that's a great
option to treat a topically.
Do your nasal labial folds bother you.
What's your best solution.
I put a complete playlist up here of things you can do at home to
help your skin, bone, and fat pads to maintain your skin, to keep it
beautiful, healthy, and vibrant.