Understanding Nasolabial Fold Treatment Options

Nasolabial folds, the lines that run from the sides of the nose to the corners of the mouth, are among the most common aesthetic concerns that bring patients through our doors. While these folds are a completely normal facial feature present even in youth, their deepening over time can create an appearance of tiredness or ageing that doesn’t reflect how you actually feel. Understanding the full range of treatment options available is the first step toward making an informed decision about addressing them.

Why do nasolabial folds deepen over time?

Nasolabial folds are not wrinkles in the traditional sense, they are dynamic creases formed by the junction between the cheek and the upper lip. Everyone has them to some degree, even children when they smile. However, several factors contribute to their becoming more prominent with age:

• Volume loss in the midface: As we age, the fat pads in the cheeks descend and diminish, reducing the support above the nasolabial fold. This is often the primary driver of deepening folds.
• Bone resorption: The maxilla (upper jaw bone) gradually loses volume over decades, reducing the skeletal framework that supports the overlying soft tissue.
• Collagen and elastin degradation: The skin’s structural proteins break down over time, particularly with UV exposure, reducing the skin’s ability to bounce back from repeated folding.
• Repetitive muscle movement: Years of smiling, talking, and facial expressions naturally deepen these creases.
• Gravity: The cumulative effect of gravity on ageing soft tissue contributes to tissue descent along these natural fold lines.

Understanding the underlying cause of your nasolabial folds is crucial because it determines which treatment approach will be most effective. A fold caused primarily by midface volume loss, for example, may respond better to cheek augmentation than to direct filler placement in the fold itself.

Injectable treatments for nasolabial folds

Dermal fillers remain the most popular and immediately effective treatment for nasolabial folds. However, the approach has evolved significantly in recent years.

Direct fold treatment

The traditional approach involves injecting hyaluronic acid filler directly into or beneath the nasolabial fold. Products such as Juvederm Vollure, Restylane Defyne, and Belotero Balance are commonly used. These fillers are specifically designed to integrate naturally into the tissue while providing enough support to soften the crease.

This approach works well for mild to moderate folds and provides immediate improvement. However, overfilling the nasolabial fold directly can create an unnatural, puffy appearance, a common pitfall when treatment is not performed conservatively.

Midface volume restoration

Modern aesthetic medicine increasingly recognises that the most effective way to address nasolabial folds is often to treat the cause rather than the symptom. By restoring volume to the cheeks and midface, where volume loss is actually occurring, the fold softens naturally as the tissue above it is lifted and supported.

Products like Juvederm Voluma and Restylane Lyft are placed over the cheekbone and in the midface region, creating a lifting effect that reduces the depth of the nasolabial fold without any filler being placed in the fold itself. Many experienced practitioners now use a combination approach: cheek augmentation for structural support, with smaller amounts of softer filler in the fold if needed for fine-tuning.

Biostimulatory Treatments

For patients seeking longer-term improvement, biostimulatory injectables such as Sculptra (poly-L-lactic acid) stimulate the body’s own collagen production over several months. While results are not immediate, the gradual improvement can look exceptionally natural and may last two years or more. This approach is particularly well-suited to patients with generalised facial volume loss.

Non-injectable treatment options

Several non-injectable treatments can complement or serve as alternatives to dermal fillers for nasolabial fold treatment:

• Radiofrequency microneedling: Devices like Morpheus8 combine microneedling with radiofrequency energy to stimulate collagen remodelling in the deeper skin layers. This can improve skin quality and provide modest tightening around the nasolabial area over a series of treatments.
• Ultrasound skin tightening: Treatments such as Ultherapy use focused ultrasound energy to stimulate collagen production at the foundational layers of the skin. Results develop gradually over two to three months and can provide subtle lifting of the midface.
• Chemical peels and laser resurfacing: While these treatments cannot address volume loss, they can improve the skin texture and quality around the nasolabial folds, making them appear less pronounced. Medium-depth peels and fractional laser treatments are most commonly used.
• Thread lifts: PDO (polydioxanone) threads can be placed in the midface to create a mechanical lift while also stimulating collagen production. Results are subtle but can be a good option for patients not ready for fillers or surgery.

The most effective treatment plans often combine multiple modalities. For example, a patient might benefit from cheek filler for immediate volume restoration, combined with a course of radiofrequency microneedling to improve skin quality over time.

What to expect from treatment and long-term management

Regardless of the treatment chosen, it’s important to have realistic expectations. The goal of nasolabial fold treatment is typically to soften rather than eliminate the folds entirely. Complete eradication would look unnatural, some degree of nasolabial fold is a normal, expected feature of the face, particularly when smiling.

With dermal fillers, results are immediate, with the final outcome visible after approximately two weeks once any swelling has settled. Most hyaluronic acid fillers in this area last between 9 and 18 months, depending on the product and individual factors. Regular maintenance treatments can help maintain results and may even improve outcomes over time as some residual collagen stimulation occurs.

A comprehensive skincare routine also plays an important role in long-term management. Daily broad-spectrum SPF 30 or higher, regular use of retinoids, and adequate hydration all support skin health and can slow the progression of nasolabial fold deepening. A clinical team can recommend a tailored skincare regimen to complement your professional treatments.

Frequently asked questions

At what age should I start treating nasolabial folds?

There is no specific age at which treatment should begin, it depends entirely on your individual anatomy, the degree of fold deepening, and your personal concerns. Some patients in their late twenties notice early deepening due to genetics or lifestyle factors, while others don’t develop significant folds until their fifties. Treatment is appropriate whenever the folds bother you enough to seek professional help.

Can nasolabial folds be permanently treated?

No non-surgical treatment provides permanent results for nasolabial folds, as the ageing process continues regardless of treatment. However, regular maintenance with fillers, combined with collagen-stimulating treatments and good skincare, can effectively manage their appearance long-term. Surgical options such as facelifts can provide more lasting improvement but still do not halt the ageing process entirely.

Is treating nasolabial folds painful?

Most patients find nasolabial fold treatment very manageable. The area can be slightly more sensitive than other facial zones, but topical anaesthetic cream applied beforehand and the lidocaine contained within modern fillers make the procedure comfortable for the vast majority of patients. Most describe a sensation of pressure rather than sharp pain.

What are the risks of nasolabial fold fillers?

Common side effects include temporary swelling, bruising, tenderness, and redness, typically resolving within a week. Rare but more serious risks include infection, asymmetry, and vascular compromise. The nasolabial region contains important blood vessels, making practitioner expertise and anatomical knowledge essential. Always choose a qualified, experienced medical professional for this treatment.

This article is for informational purposes only and does not constitute medical advice. Results vary between individuals. If nasolabial folds are a concern, we encourage you to book a consultation with the clinical team for a personalised assessment and treatment recommendation.