Nasolabial fold – Cheek lines

Nasolabial Fillers, At A Glance

  • Best ResultsImmediate
  • Treatment RecoveryNil
  • Procedure Time10 minutes
  • Skin SpecialistDermatologist, Nurse Injector
  • Duration of Results12 months to 3+ years
  • AnaestheticNumbing in filler
  • Back to WorkImmediately
  • Cost$$

Nasolabial fold – Cheek lines

The nasolabial folds are one of the most frequently treated areas in cosmetic dermatology. Careful and accurate placement of dermal fillers can support & diminish the nasolabial fold without adding more volume-weight to the mount area. This gives a better outcome compared to filling in laugh lines. My best advice is to look beyond the fold or line at the big picture. Filling lines is easy, however in many cases this may not be visually pleasing.

FactsFacts on nasolabial fold fillers

  • Nasolabial or laugh lines are one of the most popular treatments
  • These lines are also one of the most badly filled areas
  • The nasolabial fold is a naturally occurring line
  • Too much dermal filler will result in a heavy look
  • The aim of treatment is to ‘blunt’ & not obliterate this natural line
  • For mature patients it is not wise to add volume & weight below the cheek bone

Why is treating the upper cheek more important than treating the fold?

Volume should be used to lift & not only fill in lines. As we age there is downward descent of the cheeks & the mouth area. By filling down low we exaggerate the heaviness of ageing. In most cases the aesthetic appeal of just filling in lines may not be the best option as this gives what I call the Homer Simpson look (heavy around the mouth). Strategic filling above the deep nasolabial folds creates much needed support that can lessen the depth of the lines, & at the same time lift the cheeks. 

How much filler is needed to treat the nasolabial folds?

Typically,1-3 mls of filler, depending on the depth of the fold & the level of correction. Remember, in most cases filling at the apex or above the fold provides lifting or blunting of the deep lines. This should be the first step prior to NL fold directed fillers.

What type of fillers do I use to treat the nasolabial fold?

I employ both hyaluronic acid as well as collagen stimulating fillers in this region. The choice largely depends on clinical examination, taking into consideration your age, volume depletion, depth of fold, associated laxity, as well as your expectations. There are pro & cons of using HA fillers compared to collagen stimulating fillers.

Filler TypeLongevity Costs vs VolumeUse
Hyaluronic AcidUp to 2+ years++++Finesse & contours
Collagen stimulating

Ca OH Apatite 

3-5 years++Volume & bulk increase of collagen

What is the best filler for the nasolabial fold?

An ideal filler gives a balance of support, volume & longevity. My go to fillers include Hyaluronic Acid fillers from Allergan or Merz, whilst in older patients I prefer calcium hydroxyl apatite fillers.

Davin’s take on nasolabial fold dermal filler injections

Nasolabial (NL) folds were the very first location we used to fill 20 years ago! Now, less than 2% of my dermal filler cases are specifically directed at reducing this line. It is important to note that NL lines are natural. Most often, blunting or decreasing this fold does not add to the overall aesthetics.

Taken in isolation, treating the fold itself can give you a great before & after photo, however it also adds volume & weight to the muzzle area- AKA the Marge Simpson look (in reality Homer has more volume in this area).

The majority of my filling in this area is aimed at the piriform fossa, the area where the NL fold meets the alar base of the nose. Strategic filler in this area reduces the shadow of the NL fold, supports the medial cheek, and in some cases provides an upper lip lift. In patients with really deep folds, I do employ both hyaluronic acid as well as non-HA collagen stimulating fillers to decrease the lines.

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