Nasolabial folds, commonly called smile lines or laugh lines, extend from the sides of the nose toward the corners of the mouth. Although they are a normal feature of facial anatomy, these folds may become deeper or more noticeable because of aging, genetics, facial movement, changes in skin quality, and loss of structural support.

Nasolabial fold treatment is one of the established applications of injectable dermal fillers. For aesthetic clinics, successful correction requires more than simply placing product beneath a visible crease. Practitioners must evaluate the entire midface, identify the anatomical factors contributing to the fold, and select an appropriate product and treatment technique.

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Licensed medical professionals can use dermal fillers as part of an individualized plan for improving moderate or severe nasolabial folds. The selected approach may involve direct correction of the fold, restoration of support elsewhere in the face, or a combination of techniques.

Nasolabial folds should not be evaluated as isolated lines. In many patients, their appearance is connected to broader changes in the midface. Loss of cheek support, redistribution of facial fat, skin laxity, and skeletal remodeling can all influence the transition between the cheek and mouth.

However, not every pronounced fold is caused by the same anatomical changes. Some patients have visible nasolabial folds at a relatively young age because of inherited facial structure, cheek shape, or natural patterns of facial movement.

What Causes Nasolabial Folds?

The development of nasolabial folds is multifactorial. Practitioners should consider several possible contributing factors during patient assessment.

Midface Volume Changes

Changes in facial fat compartments and soft-tissue support can alter the position and projection of the cheek. As midface support decreases, the transition between the cheek and upper lip may become more pronounced.

Patients with midface volume loss may also present with flatter cheek contours, under-eye hollowing, shadows beneath the eyes, or a heavier appearance in the lower cheek.

Skin Aging and Laxity

Age-related changes in collagen, elastin, hydration, and skin thickness can reduce the skin’s ability to maintain a smooth surface. Environmental exposure, lifestyle factors, and genetics may also influence skin quality.

As the skin becomes less resilient, established facial folds may remain more visible when the face is at rest.

Facial Movement

The nasolabial area moves repeatedly during smiling, speaking, eating, and other expressions. Dynamic movement contributes to the natural formation of the fold and may make it more noticeable over time.

Muscle activity is only one part of the assessment. Practitioners should avoid attributing a patient’s nasolabial folds to one expression or muscle group without considering the surrounding anatomy.

Facial Structure and Genetics

The position of the cheekbones, shape of the maxilla, distribution of facial fat, lip projection, and inherited facial proportions can influence the appearance of nasolabial folds. Some patients therefore have prominent folds even when they have minimal age-related volume loss.

Changes in Body Weight

Significant weight loss or fluctuations in body weight may change facial volume and skin support. These changes can affect the cheeks, lower face, and visibility of existing folds.

Professional Assessment of Nasolabial Folds

Before recommending a dermal filler treatment, the practitioner should assess the patient’s face at rest and during expression. Evaluation should include the cheeks, lower eyelids, nasolabial folds, lips, mouth corners, jawline, and overall facial proportions.

Relevant factors may include:

• Fold depth and symmetry
• Midface projection and volume
• Skin thickness, elasticity, and texture
• Facial movement and expression
• Previous dermal filler treatments
• History of facial surgery or trauma
• Patient age and medical history
• Current medications and supplements
• Desired degree of correction
• Expectations regarding results and longevity

Photographs taken under consistent lighting may help document the pretreatment appearance and support treatment planning and follow-up.

How Dermal Fillers Can Treat Nasolabial Folds

Hyaluronic acid dermal fillers can add temporary volume to selected facial tissues. When treating nasolabial folds, practitioners may use filler to soften the crease directly, improve nearby structural support, or combine both approaches.

The treatment strategy should be based on the primary cause of the fold rather than a standardized injection pattern. A patient with substantial cheek volume loss may require a different plan from a patient with strong midface projection and an isolated deep fold.

Midface Rejuvenation and Nasolabial Fold Support

In some patients, restoring volume or projection in the cheek can improve support within the midface and reduce the prominence of the nasolabial fold. This approach may also improve facial contour and the transition between the lower eyelid and cheek.

A qualified practitioner can determine whether the patient’s anatomy supports treatment of the midface, the nasolabial fold, or both. Product choice, injection depth, and treatment volume must be appropriate for the selected area.

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Is Direct Nasolabial Fold Filler Appropriate?

Direct placement beneath or adjacent to the nasolabial fold can be appropriate for selected patients. It should not automatically be dismissed in favor of midface treatment, nor should it be used as the only strategy for every patient.

Direct treatment may help when the patient has a defined crease that remains visible after the surrounding facial structure has been assessed. However, excessive correction can create heaviness, alter natural facial contours, or produce an overfilled appearance.

For this reason, many practitioners use a staged or combination approach. Structural support may be addressed first when indicated, followed by conservative correction of any remaining fold.

Choosing a Nasolabial Fold Treatment

The most appropriate treatment depends on the patient’s anatomy, fold severity, skin quality, previous treatments, and aesthetic objectives. Options considered by a qualified practitioner may include:

• Direct hyaluronic acid filler treatment
• Cheek or midface volumization
• A combination of midface and fold treatment
• Skin-quality or resurfacing procedures
• Energy-based treatments for selected patients
• Surgical consultation when nonsurgical correction is unlikely to meet the patient’s goals

The practitioner should explain what each treatment can realistically accomplish, the expected duration of correction, potential side effects, and whether maintenance treatments may be needed.

Restylane Defyne for Nasolabial Folds

Restylane Defyne is a hyaluronic acid dermal filler formulated with XpresHAn Technology™. In the United States, it is indicated for mid-to-deep injection into facial tissue for the correction of moderate-to-severe deep facial wrinkles and folds, including nasolabial folds, in adults over the age of 21.

XpresHAn Technology™ is designed to provide flexible support in areas affected by facial movement and expression. Restylane Defyne is one option within the broader Restylane portfolio, and product selection should reflect the depth of the fold, treatment location, tissue characteristics, and practitioner assessment.

Clinics should review the current product labelling before use to confirm:

• Authorized treatment indications
• Recommended injection planes
• Contraindications and precautions
• Storage requirements
• Included components
• Potential adverse events
• Market-specific packaging and formulation

Expected Results and Treatment Duration

Improvement may be visible immediately after a nasolabial fold filler procedure, although swelling, redness, bruising, and tenderness can affect the early appearance.

The result should be reassessed after the initial treatment response has subsided. Treatment longevity varies according to the selected product, amount administered, injection location, patient anatomy, metabolism, facial movement, and other individual factors.

Practitioners should describe the expected duration as an estimate rather than a guaranteed period. Additional or maintenance treatment may be considered after clinical reassessment.

Potential Side Effects and Complications

Common injection-site reactions may include:

• Swelling
• Bruising
• Redness
• Tenderness or discomfort
• Firmness
• Itching
• Temporary lumps or irregularities
• Discoloration

Dermal filler injections can also cause uncommon but serious complications. These include infection, inflammatory reactions, nodules, vascular occlusion, tissue damage, visual impairment, blindness, or stroke.

Licensed injectors should have appropriate training in facial vascular anatomy, complication recognition, emergency management, and patient follow-up. Clinics should maintain written emergency protocols, necessary supplies, and appropriate referral pathways.

Patient Consultation and Informed Consent

The consultation should include a review of the patient’s medical history, allergies, medications, previous injectable treatments, active skin conditions, and relevant dental or medical procedures.

Patients should receive clear information about:

• The proposed product and treatment areas
• The reason for the recommended approach
• Reasonable treatment alternatives
• Expected short-term reactions
• Potential complications
• Aftercare requirements
• Warning signs requiring urgent assessment
• The temporary nature of the result

Consent and treatment records should be maintained according to clinic policy and applicable professional requirements.

Professional Inventory and Procurement Considerations

Aesthetic clinics should choose dermal fillers according to their treatment services, practitioner training, patient demand, and realistic inventory turnover. Stocking decisions should not be based on product popularity alone.

Professional buyers should evaluate:

• Product authenticity and traceability
• Supplier reliability
• Lot or batch information
• Expiration dates
• Packaging integrity
• Storage and handling requirements
• Market authorization and labelling
• Practitioner familiarity with the formulation
• Expected clinical demand

Injectable products with damaged packaging, unclear origins, incomplete traceability, or questionable storage conditions should not be administered.

The Bottom Line

Effective nasolabial fold treatment begins with an assessment of the entire face. Midface volume changes, skin quality, facial movement, inherited anatomy, and the depth of the fold can all influence the treatment plan.

For some patients, direct correction of the nasolabial fold may be appropriate. Others may benefit from midface support or a combination approach. The goal is to create balanced correction without unnecessarily adding volume or altering natural facial movement.

Restylane Defyne is a hyaluronic acid filler developed for moderate-to-severe deep facial wrinkles and folds, including nasolabial folds. Licensed medical professionals can buy Restylane Defyne online from Health Supplies Plus for their professional aesthetic inventory.

Doris

About the Author: Doris Dickson is a specialist writer for Health Supplies Plus, focusing on the aesthetic medicine industry. She diligently researches cosmetic treatments and products to provide clear, concise information relevant to licensed medical professionals. Her work supports Health Supplies Plus’s commitment to being a reliable informational resource and trusted supplier for the aesthetic community.

Disclaimer: The content provided in this article is intended for informational purposes only and is directed towards licensed medical professionals. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment, nor does it constitute an endorsement of any specific product or technique. Practitioners must rely on their own professional judgment, clinical experience, and knowledge of patient needs, and should always consult the full product prescribing information and relevant clinical guidelines before use. Health Supplies Plus does not provide medical advice.