Nasolabial folds are the two lines that run from the sides of your nose down to the corners of your mouth. Everyone has them, from birth. They are not wrinkles. They are a fixed anatomical crease, and the reason they look deeper in your forties than they did in your twenties is not the crease itself changing. It is the cheek above it losing volume and sliding forward over the top. That distinction matters, because it explains why filling the fold directly is so often the wrong answer, and why the treatments that actually work tend to be aimed a couple of centimetres higher up your face.
On this page
- What are nasolabial folds?
- Why do nasolabial folds get deeper with age?
- Why does filling the fold often look wrong?
- What treatments actually work for nasolabial folds?
- Treatment comparison
- When is treatment not the right answer?
- Frequently asked questions
What are nasolabial folds?
The nasolabial fold is the boundary between your cheek and your upper lip. It exists because the muscles that lift your upper lip attach firmly to the skin along that exact line. Every time you smile, those attachments pull the skin inward and the fold appears. Babies have them. Children have them. They are a normal part of how a face is built.
What changes with age is the depth. Research published in the Aesthetic Surgery Journal found that the position of the crease stays essentially fixed throughout life. What moves is everything above it.
Why do nasolabial folds get deeper with age?
Three things happen at once, and they compound.
The cheek fat pads shrink and descend. A young midface has round, well supported fat sitting high on the cheekbone. Over time that fat thins and drops, changing from a full shape into a teardrop shape that hangs over the fold from above.
The bone underneath resorbs. The upper jaw bone slowly loses volume with age. Less bone means less scaffolding, so the soft tissue sitting on top of it moves backwards and downwards.
Collagen and elastin decline. Skin gets thinner and less springy, so it drapes rather than holds. Sun exposure and smoking both speed this up considerably.
Put those together and you get a fold that looks carved rather than creased. The fold did not get deeper. The cheek got emptier.
Why does filling the fold often look wrong?
This is the single most useful thing to understand before you book anything.
If the problem is a collapsed cheek and you inject filler straight into the groove, you are adding volume to the one part of the face that was never the issue. The fold flattens on the treatment couch, then over the following weeks the face looks heavier around the mouth, the smile looks slightly stiff, and the cheek is still empty. This is the look people describe when they search for overfilled or puffy results, and it is why “too much filler in nasolabial folds” is a phrase thousands of people type into Google every month.
There is a safety dimension too. The nasolabial region is one of the higher risk areas of the face for injecting. The angular artery runs close to the surface here, and in some people it sits within millimetres of the skin. If filler enters that vessel it can block blood supply to the skin and the side of the nose. Published case reports document tissue loss from exactly this. It is uncommon, but it is real, and it is the reason this area should only ever be treated by an experienced medical injector who knows the anatomy and holds dissolving agent on site.
None of that means filler in the fold is always wrong. In a face where the cheek support is genuinely intact and the crease itself is the only issue, a small, carefully placed amount can work well. It just should not be the default.
Rebuilds midface volume gradually by stimulating your own collagen, so the cheek supports itself again rather than being propped up.
Book a Consultation →What treatments actually work for nasolabial folds?
Rebuilding the cheek. Sculptra is an injectable poly-L-lactic acid made by Galderma, licensed for aesthetic use in Europe since 1999. Rather than adding volume directly, it triggers your skin to produce new collagen over the following months. The standard protocol is two to four sessions spaced roughly four to six weeks apart, and clinical study participants saw results sustained for up to two years. Because it restores support across the whole midface, the fold softens as a consequence rather than as a target.
Structural cheek filler. Where volume loss is more pronounced or someone wants a faster change, hyaluronic acid placed on the cheekbone lifts the tissue that has descended. Hyaluronic acid fillers typically last somewhere between six and eighteen months depending on product and placement. The advantage over Sculptra is speed. The disadvantage is that it is a scaffold rather than a rebuild.
Skin quality work. If the fold looks crepey as well as deep, treatments that improve the skin itself help. Polynucleotides and skin boosters both improve hydration and skin quality, and microneedling stimulates collagen in the surface layers. On their own these will not lift a heavy fold, but they change how light sits on the skin, which changes how obvious the crease looks.
What does not work. Anti-wrinkle injections do not treat nasolabial folds. The fold is created by muscles that lift your upper lip, and relaxing those muscles affects your smile and your ability to eat and speak normally. Any clinic offering this should be questioned.
Treatment comparison
| Treatment | What it targets | Typical sessions | How long results last |
|---|---|---|---|
| Sculptra | Midface collagen and volume loss | 2 to 4, spaced 4 to 6 weeks | Up to 2 years |
| Cheek filler | Descended cheek tissue, lack of projection | 1, sometimes 2 | 6 to 18 months |
| Filler in the fold | The crease itself, only when cheek support is intact | 1 | 6 to 18 months |
| Polynucleotides | Skin thinness and crepiness around the fold | 3, spaced 2 to 3 weeks | Around 6 to 9 months |
| Anti-wrinkle injections | Not suitable for this area | Not applicable | Not applicable |
Places support back on the cheekbone where it was lost, which lifts the tissue sitting over the fold.
Book a Consultation →When is treatment not the right answer?
If your folds are shallow and only visible when you smile, that is normal facial movement and nothing needs treating. If your skin is very thin and the fold is more of a fine crease than a groove, skin quality work will serve you better than volume. And if you have had filler placed in the fold before and disliked the result, the honest first step is usually assessing whether that filler is still there rather than adding more on top.
Whoever you see, check they are on a recognised register. The NHS guidance on dermal fillers is clear that you should confirm your practitioner’s training, skill and insurance, and avoid anyone who has only done a short course.
Improves skin thickness and hydration around the fold, useful when the crease looks crepey rather than deep.
Book a Consultation →Frequently asked questions
Can you get rid of nasolabial folds completely?
No, and you would not want to. The fold is a permanent anatomical feature that gives the lower face its shape. The realistic goal is softening a fold that has deepened, not erasing a line that has always been there.
Do facial exercises help nasolabial folds?
There is no good evidence that they do. The fold deepens because of fat, bone and collagen loss, none of which respond to muscle exercise. Repeatedly working the muscles that create the crease is unlikely to help.
How soon will I see results from Sculptra?
Not immediately. Sculptra works by stimulating your own collagen, so change builds over weeks and months rather than appearing on the day. Most people notice the difference after the second session. You can read more in our guide to Sculptra compared with dermal fillers.
Is the treatment painful?
Most people describe it as manageable. Topical numbing is used, and many filler products contain a local anaesthetic. Expect some tenderness, redness or bruising for a few days afterwards.
I am in my thirties. Is it too early?
Not necessarily. Volume loss begins earlier than most people expect, and treating gradually tends to produce a more natural result than waiting until the change is dramatic. Our article on why the face loses volume after 40 covers the timeline in more detail.
Find out what is actually causing your folds
A consultation at SIX1 starts with assessing where the volume has gone, not with reaching for a syringe. If treatment is not right for you, we will tell you.
Book Your Consultation →Bracknell, Berkshire. Serving Wokingham, Reading, Ascot, Windsor, Camberley and Guildford. Same-week appointments often available.
