Getting Rid of Nasolabial Folds? A Complete Guide to What Causes Them and How to Improve Them
Nasolabial folds are rarely just a "wrinkle" problem — they are a downstream sign of midface volume loss. Filling the fold itself alone is often futile.
Key Takeaways
- Nasolabial folds have 3 types of cause: dynamic (from muscle movement), static (from tissue loss and settling), and structural (failed cheekbone support) — and the three call for completely different treatment strategies that shouldn't be lumped together.
- A common mistake when "filling nasolabial folds" is filling only the line itself — in reality, rebuilding midface volume (the cheek and area above the malar arch) is the core. Filling the crease directly only makes it deeper and less natural.
- Hyaluronic acid is the go-to material, but products should be chosen by layer: high-G-prime fillers such as Voluma/Lyft/Volift for deep support, Volift/Belotero Volume for mid-layer transition, and Volbella/Belotero Balance for surface refinement.
- A single treatment usually uses 2–4 ml, depending on the degree of volume loss. Results typically last 12–24 months.
- For severe static lines and skin laxity, filler alone won't solve the problem. Combining Sculptra (collagen stimulation), HArmonyCa (hyaluronic acid + CaHA dual support), or thread lifting may be needed.
Direct Answer
Nasolabial folds are fundamentally a downstream sign of midface volume loss — as the support from the cheek (malar) fat pads above declines, gravity pulls the skin downward and a hollow and crease appear along the nasolabial groove. The problem isn't the "line" itself, but the support structure above it.
Injecting hyaluronic acid directly into the fold itself is like trying to "prop up a collapsing roof" while ignoring the failed load-bearing wall — the line may look shallower short-term, but because the tissue above keeps descending, the groove can actually look more abrupt and the smile stiffer. At ID Cosmetic Clinic (Markham/Toronto), Dr. Dan Xu follows a "top-down" logic: first restore midface volume, then refine the fold itself. That is why experienced physicians often need 2–4 ml per side rather than 0.5 ml placed straight in the crease.
Table of Contents
What are nasolabial folds? What options exist for filling them? These are questions many people care about. This article will give you a comprehensive understanding of why nasolabial folds form and how to improve them, helping you address this concern and keep your face looking youthful.
What Are Nasolabial Folds?
Definition of Nasolabial Folds
Nasolabial folds (also called smile lines or laugh lines) are the two prominent skin creases that run from either side of the nostrils down to the corners of the mouth. They are among the earliest and most common signs of facial aging. Even when someone’s overall complexion is good, deep nasolabial folds can make the whole face look older, tired, and lacking in vitality.
Nasolabial folds are a combination of static and dynamic lines. In youth they mostly appear as dynamic lines when smiling, but as the skin ages, fat shifts, and collagen is lost, they gradually turn into static lines — deep creases that remain visible even when you are not smiling.
Location and Classification of Nasolabial Folds
3. Three Common Types of Nasolabial Folds
Hollow (Skeletal) Type:
Owing to structural differences between the cheekbone and upper jaw, a recessed nasal base creates early, visible deep lines.
Muscular Type:
Caused by rich facial expressions or frequent muscle pulling, often accompanied by a raised band-like ridge.
Aging Type:
Caused by collagen loss and skin laxity; this is the most common type.
Nasolabial folds sit at the very center of the face, forming an “expression crease” that spans the midface and lower face. Their causes involve multilayered changes in skin, fat, muscle, and bone. Visually they can be divided into shallow and deep nasolabial folds:
Shallow nasolabial folds: usually expression lines that can appear even in younger people and become more visible when smiling;
Deep nasolabial folds: visible even at rest, common in middle-aged and older people, reflecting skin laxity and insufficient support.
In addition, some people develop nasolabial folds early due to skeletal factors such as underdeveloped cheekbones or a recessed midface structure — situations that are often difficult to improve with skincare products alone.
Main Causes of Nasolabial Folds
Aging and Skin Deterioration
This is the primary culprit behind nasolabial folds. As we age, collagen and elastin fibers in the skin are lost in large amounts, the skin gradually loses elasticity and support, and the fat pads in the midface begin to descend, creating a “sunken” feeling that deepens the folds.
At the same time, facial muscles slacken with age and the skin’s attachment weakens, making the folds more pronounced. Aging is a multilayered process involving dermal thinning, bone loss, and fat redistribution across several dimensions.
Frequent Facial Muscle Movement
Prolonged overuse of facial expressions — especially frequent smiling and talking — causes the muscles around the nasolabial area to contract repeatedly, easily forming “dynamic lines” that harden into “static lines” over the years.
Some professions require abundant facial expression, such as teachers, presenters, and customer-service staff. Because their work involves frequent talking and expressive faces, their nasolabial folds may be more pronounced than those of peers the same age.
Impact of Unhealthy Lifestyle Habits
Long-term late nights, smoking, drinking, and an unbalanced diet accelerate skin aging, reducing elasticity and causing collagen loss, so nasolabial folds appear earlier. Excessive UV exposure also damages skin tissue, promotes photoaging, and speeds up line formation.
In addition, incorrect skincare habits — such as excessively pulling the facial skin or neglecting hydration — can quietly deepen nasolabial folds.
Genetics and Skeletal Structure
Some people are naturally born with flatter skeletal structures or an underdeveloped midface, lacking support, which makes the nasolabial groove naturally deeper. Others have prominent folds because of low, flat cheekbones or a protruding jaw, which worsens midface hollowing.
This structurally determined type of fold is difficult to improve with skincare and often requires medical-aesthetic treatment to assist.
How Nasolabial Folds Affect Facial Appearance
Looking Older and More Tired
Nasolabial folds are one of the important markers of an aging face. Once they deepen, they make the whole face look tired, serious, and lacking in energy. Even if you are full of vitality and in good spirits, prominent folds can make others assume you are “exhausted,” “in a bad mood,” or “old.”
This is especially true for women after age 30 — once the folds deepen, they create a visual impression of “laxity and sagging,” the facial contour is no longer firm, and this affects overall presence and confidence.
Disrupting Facial Contour and Balance
A youthful facial contour is usually smooth, firm, and three-dimensional, but the appearance of nasolabial folds breaks this visual balance, creating an obvious “stepped” look that becomes even more pronounced during expressions.
Nasolabial folds also form visual intersections with the nostrils and corners of the mouth, so the face no longer looks young and firm but instead takes on a lax, sunken contour.
How Nasolabial Folds Differ From Other Facial Wrinkles
Dynamic Lines vs. Static Lines
Dynamic lines appear only during expressions — for example laugh lines and forehead lines. Static lines are clearly visible even when the face is at rest, indicating that structural changes have already occurred in the skin.
Nasolabial folds start out as dynamic lines, mostly caused by frequent smiling, but over time and with collagen loss they gradually become static lines. This transition is an important reference for judging whether medical intervention is needed.
Nasolabial Folds vs. Marionette Lines
Nasolabial folds run from the nostrils to the corners of the mouth, while marionette lines run downward from the mouth corners to either side of the chin, resembling the “strings” of a puppet’s face.
The two differ in location and formation mechanism. Nasolabial folds are mainly related to midface descent, while marionette lines relate to laxity of the lower-face muscles. However, they often appear together, further intensifying the aged appearance.
Common Ways to Reduce Nasolabial Folds
Hyaluronic Acid Filler
Hyaluronic acid injection is currently one of the most common ways to improve nasolabial folds, suitable for people with early to moderate folds. It can quickly fill the hollow areas, restore a smooth facial curve, and look natural.
Advantages include:
No surgery required, with fast results;
Short recovery, essentially non-invasive;
Highly reversible and generally safe.
However, hyaluronic acid is a biodegradable material that typically lasts 6–12 months and needs periodic top-ups.
Autologous Fat Transfer
For people with deep folds or accompanying midface hollowing, autologous fat transfer is a longer-lasting option. It uses your own fat tissue, offering good compatibility and a natural, soft filling effect.
Not all transferred fat survives in a single session; usually 2–3 procedures are needed to refine the final result, but once the fat takes, the effect can last for many years.
Collagen Injection
Similar to hyaluronic acid, collagen is also an injectable filler. It not only fills hollows but can also stimulate the skin to produce new collagen. However, it lasts a shorter time — generally 3–6 months — and suits first-time users or those with mild folds.
Energy-Based Devices (such as Ultherapy and Thermage FLX)
These devices use high-energy heat to stimulate new collagen deep in the skin, lifting facial tissue and tightening the skin, thereby indirectly improving nasolabial folds.
Advantages are that they are non-invasive and can address several facial concerns at once; drawbacks are slower results, the need for multiple sessions, and a higher price.
Suitable for those who prefer not to have injections and favor a more natural approach.
Surgery for Nasolabial Folds
When folds are very prominent and accompanied by obvious skin sagging and tissue displacement, surgery may be needed for a fundamental improvement, for example:
Midface lift;
Facial fat-pad suspension;
Nasolabial fold repositioning, and so on.
Although recovery is longer and the procedure is more invasive, the results are marked and stable over the long term.
Aftercare and Maintenance Recommendations
Whichever treatment you choose for nasolabial folds, aftercare is extremely important. We recommend:
Avoiding strenuous exercise and expressive movements for a week;
Avoiding hot compresses, saunas, and UV exposure;
Eating sensibly and supplementing collagen;
Following your doctor’s advice on regular follow-ups;
Focusing on hydration and using repairing skincare products.
Lifestyle is crucial to maintaining results. Regular sleep, a healthy diet, and moderate exercise can effectively extend the duration of filler results and the anti-aging cycle.
How to Prevent Nasolabial Folds in Daily Life
Use anti-aging eye creams and serums containing peptides and retinol;
Keep facial muscles relaxed, avoiding excessive frowning and exaggerated laughing;
Do daily facial massage to promote blood circulation and lymphatic drainage;
Avoid sleeping face-down or on your side to reduce facial compression;
Quit smoking, limit alcohol, and supplement vitamin C to prevent oxidative skin aging.
Developing good lifestyle habits is the way to delay the formation and deepening of nasolabial folds at the source.
Conclusion
Nasolabial folds are one of the unavoidable processes of facial aging, but they are not irreversible. Whether through science-based skincare, medical aesthetics, or lifestyle improvements, we can slow their progression and reduce their impact on appearance.
The key lies in “early detection, early intervention, early care.” Only by truly understanding the causes and treatment pathways of nasolabial folds can you make the decision that best suits you and enjoy a more confident, youthful face.
Before-and-After Results of Nasolabial Fold Reduction
Video Case — Reducing Nasolabial Folds & Tightening the Lower Face — ID Cosmetic Clinic, Toronto
Book a Consultation Now
If you would like to book a nasolabial fold treatment or learn more about improving them, feel free to contact us:
📍 ID Cosmetic Clinic, Toronto: Unit 113-115-116-117, 30 Gibson Dr. Markham L3R 2S3
📞 Phone booking | Free initial assessment: (905)-477-2225
Further Reading
Cost of Hyaluronic Acid Filler for Nasolabial Folds
Where Is Hyaluronic Acid Injected for Nasolabial Folds?
About Dr. Xu
- Dr. Dan Xu, chief physician at ID Aesthetic Medicine, possesses a Canadian Medical Doctorate.
- In-depth knowledge of North American aesthetics and Asian facial intricacies.
- By integrating Eastern and Western aesthetics, she expertly crafts ideal facial features for Asians.
- She boasts over 80,000 treatment areas.
- Dr. Xu has innovated a technique using injections for eye and face lifts, targeting the Asian facial profile.
- Tailored solutions for your skin, emphasizing the medical core of aesthetic medicine.
- As an experienced physician, she personally conducts procedures.
- Bilingual consultations are available on-site, ensuring safe treatments.
- Free consultation appointments are offered.
Frequently Asked Questions
Frequently Asked Questions
Are nasolabial folds a skin problem or a structural problem?
Mainly a structural problem. More than 70% of nasolabial fold formation comes from midface volume loss and changes in the underlying support structure; the dermal wrinkle is just a surface, downstream sign. That's why skincare alone, which improves skin thickness, has limited effect on the folds — you need to restore midface support to reduce them at the source. This is also why "anti-aging skincare" always has limited impact on these folds.
Can young people have nasolabial folds too?
Yes. In young people the folds are usually dynamic lines (appearing when smiling or talking), driven by muscle movement and not necessarily a sign of aging. If your family genetically has less midface volume, or if soft tissue suddenly diminishes after rapid weight loss, prominent static folds are entirely possible in your 20s or 30s. In such cases, early intervention (light filler plus expression management) works better.
Is hyaluronic acid injection for nasolabial folds safe?
In qualified hands it is relatively safe, but the facial (angular) artery runs right near the nasolabial groove, and accidental intravascular injection can cause skin necrosis. That's why physician-level anatomy training matters so much here: aspiration testing, slow injection, avoiding high-risk zones, and keeping hyaluronidase on hand — a protocol that shouldn't be left to injectors without a medical background.
Can I improve my nasolabial folds with self-massage?
It can mildly help dynamic lines (by relaxing facial muscles and improving microcirculation) but is essentially ineffective for static and structural folds. Over-massaging may actually worsen skin laxity and overactive expression, backfiring. Sensible daily care means sun protection (against photoaging), hydration, avoiding excessive expressions, and regular in-person assessment — not relying on some "miracle massage."
Will surgery to remove nasolabial folds leave scars?
It leaves hidden scars, but they are usually placed inside the hairline in front of the ear or along the inner nasolabial groove, invisible in daily life. Surgery (including SMAS facelift and facial fat grafting) suits patients with severe skin laxity, significant volume loss, and willingness to accept a recovery period. For mild-to-moderate folds, minimally invasive options (hyaluronic acid, Sculptra, thread lifts) are usually recommended first, before considering surgery.
Are nasolabial folds and the nasolabial groove the same thing?
What's the difference between nasolabial folds and marionette lines?
How long does hyaluronic acid filler for nasolabial folds last?
Can RF skin tightening (such as InMode Forma) improve nasolabial folds?
How do I choose between a thread lift and hyaluronic acid filler?
Where in Toronto or Markham can I find professional nasolabial fold treatment?
Next Step
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Laxity, wrinkles and facial sagging have different root causes — one physician-led consultation identifies the true problem layer before deciding which plan fits you best.
