Nasolabial folds: filler or lifting? Start with the cause

Nasolabial folds may look like a single line, but volume loss, cheek sagging, established skin creases and facial structure can all contribute. Choosing between filler and lifting therefore takes more than comparing treatment names. This guide focuses on what should be assessed first, rather than listing ways to erase a fold.

Should I start with filler if my nasolabial folds are deep?

Filler may be considered when a lack of volume is a major contributor to the hollow area. However, if sagging tissue above the fold is the main cause, repeatedly filling the groove may not achieve the appearance you want. The support beside the nose, cheek volume and movement around the mouth should be assessed together. Fold depth alone does not determine how much filler is needed.

Is lifting the answer when cheek sagging is the cause?

Lifting may be an option, but nonsurgical treatments have limits. A fold becoming less visible when you pull your cheek upward by hand does not mean an energy-based treatment will reproduce that change. More pronounced sagging or excess tissue may warrant a discussion of surgical options. The plan will differ from one intended to achieve a modest improvement.

Do folds that appear when I smile need to disappear?

A crease running from the side of the nose toward the mouth during a smile can be part of normal facial expression. Distinguish shadows visible at rest from lines that form with movement. Trying to remove every line from every angle and expression can lead to excess volume or an unnatural appearance. Agree on a natural-looking goal first.

If filler and lifting are combined, which should come first?

When filler and ultrasound- or radiofrequency-based lifting are planned for the same area, we generally recommend lifting first, followed by filler where needed. This order is particularly worth considering for same-day treatment. Energy delivered over existing hyaluronic acid filler may affect it, depending on the device, treatment depth and interval. Some studies have observed reduced filler persistence after ultrasound or radiofrequency treatment, but this does not mean every treatment shortens filler longevity. If you already have filler, tell the clinician the product, location and treatment date so that the lifting area, depth and interval can be planned accordingly.

What should I prepare for a nasolabial fold consultation?

Identify what bothers you in front and side views, both at rest and when smiling. Share the product and date of any previous filler if you know them. Filler carries risks including bruising, swelling and vascular complications, so ask about the clinic’s emergency response arrangements. A realistic goal is the degree of natural improvement agreed during consultation, rather than complete removal.

What is the key question to ask?

At a nasolabial fold consultation in Gangnam, begin with: ‘What makes my folds look deep?’ rather than ‘How many cc do I need?’