Skin Refine Clinic Ginza
Regular member of the Japanese Society of Plastic Surgery Certified specialist Regular member of the Japanese Society of Clinical Dermatology Regular member of the Japanese Society of Cranial Forehead Surgery
Nasolabial folds that are more noticeable in the late 30s. Nasolabial folds are one of the aging phenomena caused by changes in tissues such as skin, fat, fascia, ligaments, and bones due to aging.
As we age, our skin loses its firmness and elasticity, our fascia and ligaments lose flexibility, and our bones become thinner and lose volume. As a result, the subcutaneous tissue containing fat droops and sagging occurs, and lines such as nasolabial folds begin to appear.
In aesthetic medicine, there are several treatments that make smile lines less noticeable, but each one works on a different part . A deeper understanding of the differences in the effects of each treatment may make it easier to obtain the desired treatment results.
In addition, for those who have not obtained the expected results even after receiving cosmetic treatment to make smile lines less noticeable, changing the treatment selected may change the results.
Therefore, we will check the types of treatments and their effects and characteristics regarding cosmetic medicine that improves nasolabial folds .
Nasolabial folds are a symptom caused by “sagging” rather than just “wrinkles” .
The facial tissue is layered on top of the skull with the periosteum, muscle, fascia covering the muscle, subcutaneous tissue (mainly a layer of fat), and skin, and is supported by ligaments.
Because sagging is caused by changes in all tissues of the face, the reason is not just one but a combination of causes .
Human skin is layered with epidermis and dermis layers from the outside.
About 70% of the dermis layer is fibrous protein "collagen", which is bundled with elastic fibrous protein called "elastin". And the gap is filled with hyaluronic acid that holds water.
Collagen, elastin, and hyaluronic acid keep the skin firm and elastic, but the deterioration and loss of these components due to aging and UV stimulation leads to a decrease in skin volume .
In addition, it is said that an increase in the amount of subcutaneous tissue (fat) also reduces the elasticity of the dermis layer, which worsens sagging.
There are multiple muscles in the face, such as the frontalis, orbicularis oculi, orbicularis oris, and platysma muscles, but there is a planar fascia called the SMAS layer that covers these muscles.
The SMAS layer is also supported by supporting ligaments and is taut when young .
The face has supporting ligaments called ligaments. The role of supporting ligaments is to hold the fat-rich subcutaneous tissue to the periosteum or fascia.
When young, the subcutaneous tissue is strongly anchored to the periosteum and fascia by thick supporting ligaments. However, in the same way that a rubber band deteriorates and stretches after long-term use, the supporting ligament gradually loses its elasticity with age, and when the subcutaneous tissue that has been anchored to it droops down due to gravity, sagging occurs . will be
Bone contains cells called osteoclasts and osteoblasts.
As bone ages and is dissolved by osteoclasts, osteoblasts build bone with calcium to balance bone resorption and bone formation.
However, when bone resorption exceeds bone formation with aging, the amount of bone decreases, and as the bone becomes thinner, surplus subcutaneous tissue and skin on the bone are thought to occur, resulting in sagging .
HIFU is an abbreviation of "High lntensity Focused Ultrasound", and is a method of collecting and irradiating ultrasonic waves at one point.
Hyphen treatment is the only treatment that can approach the SMAS layer other than facelift surgery, which involves making an incision in the skin with a scalpel to pull up the loosened SMAS layer.
By replacing the cartridge (transducer) in addition to the SMAS layer, hyphen treatment can also affect the dermis layer, subcutaneous tissue (mainly the fat layer), and SMAS layer of the skin.
The cartridge is the tip of the machine. Since the irradiation depth can be changed by changing the cartridge, one machine can deliver energy to the shallow and deep layers of the dermis, the subcutaneous tissue, and the SMAS layer.
In hyphen treatment aimed at the dermis layer, fibroblasts, which are the source of collagen, elastin, and hyaluronic acid, are damaged by heat. As a result, wound healing, which tries to restore the wound to its original state, is promoted, and in the process, collagen, elastin, and hyaluronic acid can be expected to increase .
As a result, the skin is said to be firm and elastic.
Since the wound healing process progresses gradually, effects can be expected for 2 to 6 months.
When heat is applied to the subcutaneous tissue containing a lot of fat with hyphen treatment, the fat cells are destroyed or reduced . Destroyed fat cells are excreted from the body over 4 to 12 weeks by macrophages that digest bacteria and foreign substances that have entered the body.
It is effective when there is sagging due to the weight of fat .
The effect of improving sagging by destroying and shrinking fat cells appears gradually, not immediately.
The SMAS layer exists under the skin and subcutaneous fat, and in order to deliver energy to the SMAS layer, it must penetrate the skin and subcutaneous tissue. Laser and high-frequency treatments do not reach the SMAS layer, and the only way to approach the SMAS layer is hyphen treatment, other than facelift surgery.
The SMAS layer is made of collagen, a type of protein.
Proteins have the property of shrinking when heat is applied, just like meat, which is a protein, shrinks when it is cooked. Based on this principle, hyphen treatment applies heat stimulation to the SMAS layer and aims for a tightening effect .
Hyphen treatment aimed at the SMAS layer is said to tighten immediately after irradiation, and immediate effects can be expected .
Hyphen treatment tends to be painful in areas with thin skin and areas with little fat, but it is said to be tolerable without anesthesia.
The type of pain is described as a tingling pain, or a pain that resonates in the bones when irradiated near the forehead or chin .
Hyphen treatment is a treatment that aims for a tightening effect that pulls up the tissue, but it complements the volume that has disappeared due to hyaluronic acid injection and makes sagging less noticeable .
By injecting it into areas with thin bones and areas with loose supporting ligaments, we aim to compensate for the volume and correct the looseness.
Hyaluronic acid injection has been used to improve wrinkles since the late 1990s, but it has evolved as injection methods and hyaluronic acid formulations have evolved.
At first, it was simply injected along wrinkles to fill in grooves. However, in recent years, along with the detailed elucidation of the mechanism of facial anatomy and aging phenomena, various injection methods have been devised . Injection methods aimed at improving the
In addition, hyaluronic acid preparations are newly developed and sold by various manufacturers.
Hyaluronic acid is generally absorbed by the body in about 6 months to 1 year, so it is necessary to repeat the injection regularly to continue the effect. Therefore, in addition to the performance of easy lift-up, improvements have been made to ensure higher safety.
Hyaluronic acid injection is a cosmetic medical treatment that is in growing demand because it can be expected to improve sagging with a single injection, and changes can be seen immediately after injection. Due to its ease of use, people are warned against using too much.
Overfilling is caused by regular overdosing. Proper infusion is required to avoid a taut, unnatural finish .
In recent years, swelling at the injection site of hyaluronic acid has been reported after vaccination or infection with an infectious disease. This is a complication of hyaluronic acid injection called allergy/rejection.
It is known that redness and swelling occur several weeks to several months, and in some cases several years after injection of hyaluronic acid, and the incidence varies depending on the hyaluronic acid preparation.
Therefore, the selection of hyaluronic acid preparations may reduce the risk.
It has been pointed out that the molecular weight of hyaluronic acid and the cross-linking agent that binds hyaluronic acid molecules together have an effect on allergies and rejection reactions. rate is expected to increase .
Since it has been reported that hyaluronic acid has an inflammatory effect when its molecular weight is small, risk reduction can be expected with hyaluronic acid preparations with a low proportion of cross-linking agents in high-molecular hyaluronic acid.
KYSENSE®, which was launched in the EU in February 2021, has succeeded in preserving the molecular structure of high-molecular-weight hyaluronic acid through the patented OXIFREE manufacturing method.
The higher the hyaluronic acid is, the higher its viscoelasticity and cohesiveness .
Compared to other hyaluronic acid preparations, Kaisense can be effective even in small amounts, so it can be said that it is a hyaluronic acid preparation with less risk of overdosing.
In addition, hyaluronic acid formulations contain a cross-linking agent that binds the molecular structure of hyaluronic acid together in order to increase viscoelasticity and cohesiveness and prolong the injection effect. Due to its high elasticity and cohesiveness, the amount of cross-linking agent is kept low .
Kaisense is a high-molecular hyaluronic acid with a small amount of cross-linking agent, so it is said that the risk of allergy and rejection can be reduced.
Thread lift (thread lift) aims to move the drooping subcutaneous tissue and pull it up to the ideal position . It started to be performed as an alternative to facelift surgery because it is less damaging to the body compared to facelift surgery.
Multiple threads with projections like conical bio-cones or thorns are inserted, and the projections physically pull up the subcutaneous tissue to improve sagging.
Thread lift tends to be effective when the subcutaneous tissue sag is large and volume loss is small.
In addition, since the thread lift works to increase collagen and elastin around the inserted thread, it can be expected to improve the firmness and elasticity of the skin as well as lifting the subcutaneous tissue .
Thread lift for the purpose of improving sagging can be expected to improve skin quality, but there is a "shopping thread" as a thread lift for the purpose of improving firmness .
For thread lifts aimed at improving sagging, usually 3 to 4 threads are inserted on one side of the cheek. In shopping thread, on the other hand, 50 to 100 short needles are inserted into the entire face like cosmetic acupuncture in one treatment. Then, the stimulation of insertion is said to have the effect of promoting the growth of collagen and elastin.
Although the effect of lifting sagging is mild, it can be expected to have the effect of delaying the progress of sagging by supplementing firmness and elasticity, so it can be said that it is suitable for those who are starting to be a little worried about nasolabial folds caused by sagging.
As cosmetic medicine that can be expected to improve sagging , there is also a face lift surgery to remove sagging skin. Become.
Treatments with longer downtime are more suitable for severe sagging, so even if a person without large sagging wishes to undergo thread lift or face lift surgery, it may be diagnosed as inapplicable.
Conversely, even if facelift surgery is indicated, other methods should be selected for those who are reluctant to incise the skin.
In addition, if you have requests such as "I can't take downtime" or "I'm afraid of injections," we recommend that you communicate your wishes at counseling at a medical institution and consult which treatment is suitable.
It is known that facial sagging, which causes nasolabial folds, is caused by multiple tissue changes.
Even if you are concerned about nasolabial folds , the symptoms of sagging, the condition of muscles, and the way fat is deposited vary from person to person, so it is important to determine which treatment is suitable for each case .
There are several types of cosmetic medicine that can be expected to improve nasolabial folds, such as irradiation treatment using equipment such as hyphen, injection treatment using dermal fillers such as hyaluronic acid, thread lift using threads, and face lift surgery using a scalpel. , have different effects as follows.
In order to perform effective treatment, it is necessary to select an appropriate treatment menu according to the condition of the slack.
As mentioned above, each treatment that improves nasolabial folds has different effects, so a synergistic effect can be expected by combining multiple methods as follows.
Irradiation treatment such as hyphen cannot increase the reduced tissue, but it is effective in tightening the skin itself and lifting the face line. Conversely, hyaluronic acid injection can lift and lift the skin by increasing the lost volume, but it cannot tighten the skin itself.
If it is a combination treatment that combines multiple treatments, areas that cannot be treated with one treatment can be supplemented with other treatments .
The symptoms of sagging, which causes nasolabial folds, progress as changes in bones, ligaments, fat, fascia, and skin interact simultaneously and multiple times .
With daily skin care, it is difficult to approach changes due to aging of bones and ligaments, and treatments at medical institutions are effective for improving sagging.
In order to find the ideal improvement result of the smile line, the degree of sagging progress, each person's skeleton, fat distribution, skin condition, etc. must be selected.
In addition, it is safe to have a doctor who fine-tunes the image, such as how much improvement is desired and whether it can be realized.
For that reason, we recommend that you receive counseling at multiple medical institutions. By comparing the contents of the counseling, it may be possible to judge whether the doctor is an easy-to-understand explanation and answers the questions firmly.