What Are Nasolabial Folds?
Nasolabial folds are the lines that extend from either side of your nose down to the outer corners of your mouth. They’re a completely normal part of facial anatomy. Every person has them, though they may be more or less visible depending on facial structure, skin thickness, and age.
These folds form where different muscles and tissue planes meet. When you smile, laugh, or talk, the muscles in your cheeks and around your mouth pull the skin in various directions. The nasolabial fold is a natural hinge point that allows this movement to happen smoothly.
In younger faces, these lines typically only appear during expression. They’re dynamic, showing up with movement and disappearing when the face relaxes. As we age, the folds can become deeper and remain visible even at rest, shifting from dynamic to static lines.
Some people develop deeper folds earlier than others due to genetics, sun exposure, lifestyle factors, and individual facial structure.
Why Nasolabial Folds Deepen Over Time
A single factor doesn’t cause the deepening of nasolabial folds. It’s the result of multiple age-related changes happening simultaneously in your face. Understanding these helps explain why treatment approaches vary so much from person to person.
Midface Volume Loss
The most significant contributor is volume loss in the cheeks and midface. Your face has natural fat compartments that provide structure and support. As you age, these fat pads gradually shrink and descend due to gravity and tissue changes.
When the cheek fat pads lose volume and drop lower, they no longer provide lift to the area above the nasolabial fold. The tissue that was once supported now falls forward and downward, bunching up at the fold line. This is why many people notice their nasolabial folds become more prominent at the same time their cheeks look flatter or less defined.
Skin Quality and Elasticity Changes
Your skin’s ability to bounce back diminishes with age. Collagen and elastin fibres break down over time, particularly with sun exposure. When skin loses elasticity, it can’t spring back into place as easily after movement or expression.
Thinner, less elastic skin shows creases more readily. It also has less capacity to smooth out when facial structures shift beneath it. This means that even small amounts of volume loss can lead to visible fold deepening when skin quality has declined.
How Bone Structure Plays a Role
Facial bones also change with age. The maxilla (upper jaw) and orbital bones can resorb slightly, reducing the bony foundation that once supported soft tissue. When the scaffolding shrinks, everything built on top of it has less support.
People with naturally prominent cheekbones may notice nasolabial folds later in life because they start with more structural support. Those with flatter midfaces might see changes earlier. These factors don’t work in isolation but combine to create a compounding effect, which is why treatment approaches need to be individualised.
The Support vs Treat Philosophy
When it comes to nasolabial folds, there are two main approaches: treating the fold directly or supporting the structures above it. Both have their place, but understanding the difference helps explain why we often recommend starting with cheek support.
Why Direct Fold Treatment Can Create Issues
Adding volume directly into a nasolabial fold might seem logical. The line is there, so fill it in. But this approach can create an unnatural appearance. The area can look puffy or overfilled, flattening your face’s natural contours rather than restoring youthful structure.
More importantly, it doesn’t address the underlying cause. The fold deepened because support above it was lost. Treating the fold addresses the symptom, not the problem.
The Structural Support Concept
Think of your face like a building. When the foundation shifts, cracks appear in the walls. You could repeatedly fill those cracks, but they’ll keep coming back until you fix the foundation.
Cheek support works the same way. By restoring volume to the midface, you’re rebuilding the scaffolding that holds everything in place. When the cheeks are lifted and supported, the tissue above the nasolabial fold has somewhere to rest. The fold naturally softens as a result.
This creates a more balanced, natural outcome. Your face regains its youthful proportions without looking overfilled or frozen in one area.
When Each Approach Works Best
For many people, particularly those in their 30s to 50s, midface volume loss is the primary driver of fold deepening. If your cheeks look flatter while your smile lines become more prominent, restoring cheek volume alone can significantly soften the folds without any direct treatment.
Some people benefit from a combination approach. This is more common in older clients or those with very deep, established folds. We might start by restoring midface support, then assess whether any residual fold depth needs to be addressed. Often, much less product is needed in the fold when the cheeks are properly supported first.
Direct fold treatment from the start may be appropriate if you have naturally prominent bone structure with good cheek volume but a deep fold due to repeated expression or skin quality issues. Your facial anatomy, the degree of volume loss, skin quality, and aesthetic goals all influence the treatment plan.
How We Assess Your Individual Pattern
Every face ages differently. The way your nasolabial folds have developed is specific to your anatomy, genetics, lifestyle, and the changes your facial structures have undergone over time. This is why we start every consultation with a thorough assessment rather than a predetermined treatment plan.
The Clinical Consultation Process
Your consultation begins with a conversation about your primary concerns, when you first noticed changes, and what you hope to achieve. This helps us understand your perspective and expectations.
We then examine your face from multiple angles, both at rest and in motion. How do the folds appear when you smile versus when your face is relaxed? This tells us whether we’re dealing with dynamic lines, static lines, or both.
Facial Anatomy Assessment
We assess several key factors during examination. First, where is the volume in your face? Are your cheeks full or flattened? Is there good support in the midface or has tissue descended?
We perform what’s often called a “support test.” By gently lifting the cheek tissue, we can see how much the nasolabial fold softens. This demonstrates whether restoring support above will improve the fold below. It’s a simple but revealing technique.
Skin quality matters too. We look at texture, elasticity, and thickness. Thicker skin with good tone responds differently from thin, sun-damaged skin. This influences both treatment choice and expected outcomes.
Understanding Your Unique Ageing Pattern
Some people lose volume primarily in the cheeks. Others experience more generalised facial volume loss. Some have excellent bone structure but struggle with skin quality. Your pattern is as individual as your fingerprint.
We also consider your facial proportions and starting point. Naturally high cheekbones provide more inherent support. Flatter midfaces show volume loss sooner. Age plays a role but isn’t the whole story. We’ve seen people in their early 40s with significant midface descent and others in their 60s with well-maintained structure.
Creating Your Personalised Treatment Plan
After assessment, we discuss what we’ve observed and explain the underlying causes of your fold deepening. We talk through treatment options that suit your specific pattern, whether that’s cheek support alone, skin quality treatments, or a phased combination approach.
We’re honest about realistic outcomes and timeframes. If you have very deep folds and significant volume loss, one treatment session won’t reverse decades of change. Most importantly, we never pressure you into treatment. The consultation is about education and understanding. You’re in control of the decision and timeline.
Treatment Options Available
Once we’ve assessed your individual pattern, we can discuss which treatments are most likely to address your concerns. The options vary depending on whether volume restoration, skin quality improvement, or a combination approach best suits you.
Cheek Restoration and Volumising Treatments
These treatments focus on rebuilding lost volume in the midface. By restoring fullness to the cheeks, we create a lifting effect that can naturally soften nasolabial folds. The treatment itself involves carefully placing the product in specific areas of the cheek to recreate youthful contours and provide support.
Results are visible immediately, though some settling occurs over the following days. Most people find this approach creates a natural, refreshed appearance without looking overdone.
Skin Sculpting Treatments
For those who need structural support and definition, skin sculpting treatments work beneath the skin’s surface to provide a scaffolding effect. These treatments stimulate your own collagen production over time, creating a gradual improvement in skin quality and support.
Because they work with your body’s natural processes, results develop slowly over several months. Many people combine this approach with volume restoration for comprehensive improvement.
Skin Boosting Treatments
When skin quality contributes to fold visibility, skin-boosting treatments can help. These work to hydrate, improve texture, and enhance skin elasticity from within. They won’t replace lost volume, but they can improve the skin’s appearance and function.
Skin boosting is often used as part of a broader treatment plan rather than a standalone solution for nasolabial folds.
What to Expect
Treatment appointments typically take 30 to 45 minutes. We use numbing cream to minimise discomfort, and most people find the process very tolerable. Some temporary swelling, redness, or bruising is normal and usually settles within a few days.
You’ll see initial results straight away with volumising treatments, though final results develop over two weeks as any swelling resolves. Skin quality treatments take longer to show visible improvement, usually three to six months.
We schedule a review appointment two to four weeks after treatment to assess results and determine if any adjustments are needed. This is also when we discuss maintenance plans and what to expect long-term.
During your consultation, we will comprehensively discuss the risks and benefits associated with treating nasal labial folds with our medical officer and the clinical nursing team