Paranasal Augmentation – A Permanent Solution to Smile Lines and Sunken Midface
Restore Volume. Rejuvenate Your Smile. Trust Bangkok’s Leading Experts in Facial Harmony.
The face tells your story—and for many, it’s a story of joy, laughter, and a life well-lived. But over time, those smiles can leave behind something less desirable: deepened laugh lines (also called smile lines or nasolabial folds), shadowed under-eyes, and a sunken midface appearance. This is where paranasal augmentation offers a scientifically advanced and long-lasting solution.
At HERS Clinic Bangkok, we specialize in paranasal augmentation using surgical techniques designed for natural, permanent correction of facial grooves, helping you look refreshed—never overdone.
This comprehensive guide will walk you through what paranasal augmentation is, how it compares to filler injections, and why HERS Clinic is among the best clinics to treat smile lines for patients from around the world.
What Is Paranasal Augmentation?
Paranasal augmentation is a surgical procedure that corrects midfacial hollowness—especially around the sides of the nose (paranasal area). This area often contributes to the development of nasolabial folds, also known as laugh lines or smile lines.
This treatment is ideal for people who have:
Deep nasolabial folds or smile lines
A flat or depressed midface (sunken area beside the nose)
Under-eye grooves that seem exaggerated
Tired, aged facial appearance despite a healthy lifestyle
Unlike temporary solutions like fillers, paranasal augmentation reshapes the underlying bone structure or soft tissue volume to deliver permanent correction.
Why Do Smile Lines and Midface Hollowing Occur?
Several anatomical and age-related factors lead to the formation of smile lines and facial grooves:
Facial bone structure: Some individuals naturally have a recessed midface or flatter paranasal bone area.
Fat and soft tissue loss: Aging leads to volume loss in the midface, which accentuates grooves and folds.
Ligament weakening: The tissue holding the skin and fat begins to sag, creating shadow lines and depressions.
Frequent facial expressions: Repeated smiling or facial movements deepen lines over time.
These signs are commonly visible in your 30s and progress with age. But for some, especially those with a flat midface genetically, these features can appear much earlier—even in their 20s.
How Is Paranasal Augmentation Performed?
At HERS Clinic, we tailor each paranasal augmentation based on the patient’s facial anatomy and aesthetic goals. The procedure is typically performed under local anesthesia with sedation and takes about 40 minutes to 1 hour.
We use a custom-shaped medical-grade paranasal silicone implant inserted to gently project and fill the midface hollowness.
Paranasal Surgical Procedure
A small incision is made inside the upper gum (no visible/external scarring).
The implant is inserted into the precise anatomical pocket.
The area is adjusted to ensure symmetry and natural contour.
The incision is closed with dissolvable sutures.
Dr.Joe usually do paranasal augmentation with local anesthesia.
Paranasal Augmentation VS Filler Injection
One of the most common questions we receive is:
“How to treat laugh lines? Should I get paranasal augmentation or fillers?”
Both treatments aim to restore midface volume and reduce smile lines—but they are fundamentally different.
Filler or Paranasal augmentation ?
| Feature | Filler Injection | Paranasal Augmentation |
|---|---|---|
| Material | Hyaluronic acid (temporary) | Silicone implant (permanent) |
| Downtime | Minimal | Minimal |
| Longevity | 6–12 months | Years to lifetime |
| Cost | Lower upfront | More cost-effective long term |
| Risk of Migration | Possible | None |
| Precision | Moderate | High (surgically placed) |
Advantages of Paranasal Augmentation
✅ Permanent correction of midface hollowness
✅ Natural look, no risk of overfilling like with some fillers
✅ Improves overall facial proportions, especially when viewed in profile
✅ Helps soften nasolabial folds and under-eye shadows
✅ Enhances balance for rhinoplasty or cheekbone procedures
✅ Performed through hidden incision—no visible scarring
Whether done alone or in combination with other procedures (like buccal fat removal, rhinoplasty, or chin augmentation), this treatment creates harmony across the midface.
Disadvantages and Considerations
While the procedure is safe and effective, it’s important to understand potential limitations:
Swelling and bruising can occur for up to 2 weeks
Requires experienced surgical hands to avoid asymmetry
Implants can be felt in very thin-skinned individuals (though this is rare)
Not recommended for patients with active gum or sinus infections
We carefully assess all patients during consultation to ensure suitability and discuss alternative treatments if necessary.
Why International Patients Choose HERS Clinic for Paranasal Augmentation ?
Bangkok is renowned for medical tourism, and HERS Clinic has become a trusted destination for paranasal augmentation in Thailand.
Why we’re considered the best clinic for paranasal augmentation:
Experienced facial specialists with an artistic eye
Sterile, hospital-grade surgical facilities
Custom implant shaping based on facial assessment
Multilingual consultation and patient coordination
Medical travel assistance for overseas patients
Natural results with patient comfort as a top priority
What to Expect Before, During & After
Pre-Surgery
Facial photography and evaluation
Personal consultation with our surgeon
Surgery Day
Procedure takes 40 minutes to 1 hour
Local anesthesia
Outpatient basis (no overnight stay)
Recovery
Cold compresses for 48 hours
Avoid vigorous movement or chewing hard food for 5–7 days
Stitches dissolve naturally
Swelling subsides after 1 week
Final result visible after 1 month
Frequently Asked Questions (FAQs)
Q: Is it painful?
A: Most patients report mild soreness or tightness, manageable with oral pain medication.
Q: Can the implant be removed later?
A: Yes, though most patients keep their implants for decades without issue.
Q: Will it make me look “fake” or overdone?
A: No. Our technique focuses on subtle enhancement—not distortion. The goal is balance, not exaggeration.
Q: Can I combine this with other surgeries?
A: Absolutely. It’s commonly performed alongside rhinoplasty, chin augmentation, or buccal fat removal for full-face harmony.
Special Technique at HERS Clinic – The Triple Lock Approach
At HERS Clinic, we believe that great results come not just from the material used, but from how precisely and securely it is placed. Our signature approach to paranasal augmentation has been developed and refined by Dr. Naruechit Laothaimongkhon (Dr. Joe), known for his advanced facial contouring techniques and meticulous attention to anatomical harmony.
Triple Lock Technique
To ensure the implant remains in its ideal position and blends naturally with the facial structure, Dr. Joe uses the Triple Lock Technique—a multi-layered approach that significantly reduces the risk of implant movement, sharp edges, or long-term complications.
🔒 Lock 1: Strategic Bone Positioning
The implant is carefully placed between the facial bone ridges, allowing the natural contours of your facial skeleton to secure it in place. This acts as the first physical barrier to movement.
🔒 Lock 2: Sub-Periosteal Pocket Placement
The implant is positioned beneath the periosteum (the connective tissue layer covering the bone). This provides deep integration with the facial structure and prevents the edges of the implant from being visible or palpable.
🔒 Lock 3: Tissue Fixation Suturing
To further stabilize the implant, Dr. Joe sutures it directly to the surrounding soft tissues. This added fixation prevents lateral or vertical shifting, ensuring that the implant remains securely in place over time—even with facial movement, aging, or pressure.
Seamless Contour with Edge-Hiding Technique
Another key component of Dr. Joe’s approach is his Edge-Hiding Technique. By placing the implant precisely onto the bone surface with a sub-periosteal pocket, it becomes well integrated into the facial structure. As the surgical site heals, the implant gradually blends into the natural contours of the midface, eliminating visible or palpable edges.
This technique allows for:
Smooth transitions from the nasal area to the cheeks
A more natural look even in high-definition photography
No “ridge” effect or unnatural contours that can occur with poorly placed implants
Prevention of Implant Shifting
Implant migration is one of the most common concerns with traditional augmentation techniques. To eliminate this risk, Dr. Joe uses a proprietary tissue fixation method, suturing the implant directly to the stable connective tissue within the augmentation site.
This ensures that:
The implant stays exactly where it was placed
The midface structure remains symmetrical over time
Long-term durability and aesthetic integrity are preserved
Why This Technique Matters
Many patients worry about implant-related complications like shifting, visible edges, or an artificial look. The advanced techniques used at HERS Clinic address all of these concerns head-on.
With Triple Lock Stability + Edge Hiding + Fixation, patients can expect:
A natural appearance with no hard edges
Minimal risk of implant migration
Long-lasting results that age gracefully with your face
Whether you’re looking to enhance midface volume, soften laugh lines, or rebalance your facial proportions, HERS Clinic’s technique offers precision, safety, and natural aesthetics that set us apart from standard augmentation procedures.
Author
นพ.นฤชิต เลาหไทยมงคล (หมอโจ้)
Facial Design Specialist
Before & After
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