There is no rule that every nasolabial fold should be filled directly, or that every fold should be treated by adding volume to the cheeks. These lines sit between the nose and mouth, but the reason they look prominent varies. The recommendation should explain what is being changed and where.
A visible fold is also a normal facial feature. Softening a concern and trying to erase every trace of it are very different goals.
A cheek change is not automatically a lift
Cheek filler adds volume where it is placed. The idea that it reliably pulls distant skin upward and removes a nasolabial fold is too simple.
A 2018 three-dimensional photographic study did not demonstrate the proposed lateral pulling effect in its expression-matched subgroup. Improvement was seen when filler addressed the nearby transition area directly. That study does not settle every injection decision, but it challenges a blanket promise of lifting the fold from the cheek. Three-dimensional study of cheek volumisation, 2018.
Why different approaches can still be reasonable
A small randomised study comparing low-volume cheek treatment, direct fold treatment and both found improvement with each approach, without a statistically significant difference between techniques. The findings are specific to the study, rather than proof that the approaches are interchangeable for every face. Randomised comparison of cheek and nasolabial-fold injections, 2014.
The assessment should consider your existing cheek fullness, the depth and location of the fold, previous filler and how the area looks when you smile. If you already like your cheeks, a recommendation to enlarge them needs a particularly clear explanation.
Ask what could become too full
With dermal filler, ask where the proposed volume will show from the front and side. Ask what would remain visible even if the treatment goes well. Adding more until a fold disappears may create a change elsewhere that you did not want.
Filler also carries risks, including swelling, lumps and, rarely, accidental injection into a blood vessel with serious consequences. Placement decisions require more than a cosmetic assessment of the line. US FDA: dermal filler benefits and risks.
Choose a useful endpoint
Bring a photograph that shows the concern in ordinary lighting. Explain whether it bothers you at rest, in motion or mainly in photographs. Ask the practitioner to describe the smallest meaningful change and when the result would be reviewed before considering more.
At SkinAlchemy in London, Ontario, a smile-line discussion can begin with the fold itself. You do not need to arrive committed to cheek filler, and accepting some visible fold can be part of a successful plan.
Related reading
Sources
There is no rule that every nasolabial fold should be filled directly, or that every fold should be treated by adding volume to the cheeks. These lines sit between the nose and mouth, but the reason they look prominent varies. The recommendation should explain what is being changed and where.
A visible fold is also a normal facial feature. Softening a concern and trying to erase every trace of it are very different goals.
A cheek change is not automatically a lift
Cheek filler adds volume where it is placed. The idea that it reliably pulls distant skin upward and removes a nasolabial fold is too simple.
A 2018 three-dimensional photographic study did not demonstrate the proposed lateral pulling effect in its expression-matched subgroup. Improvement was seen when filler addressed the nearby transition area directly. That study does not settle every injection decision, but it challenges a blanket promise of lifting the fold from the cheek. Three-dimensional study of cheek volumisation, 2018.
Why different approaches can still be reasonable
A small randomised study comparing low-volume cheek treatment, direct fold treatment and both found improvement with each approach, without a statistically significant difference between techniques. The findings are specific to the study, rather than proof that the approaches are interchangeable for every face. Randomised comparison of cheek and nasolabial-fold injections, 2014.
The assessment should consider your existing cheek fullness, the depth and location of the fold, previous filler and how the area looks when you smile. If you already like your cheeks, a recommendation to enlarge them needs a particularly clear explanation.
Ask what could become too full
With dermal filler, ask where the proposed volume will show from the front and side. Ask what would remain visible even if the treatment goes well. Adding more until a fold disappears may create a change elsewhere that you did not want.
Filler also carries risks, including swelling, lumps and, rarely, accidental injection into a blood vessel with serious consequences. Placement decisions require more than a cosmetic assessment of the line. US FDA: dermal filler benefits and risks.
Choose a useful endpoint
Bring a photograph that shows the concern in ordinary lighting. Explain whether it bothers you at rest, in motion or mainly in photographs. Ask the practitioner to describe the smallest meaningful change and when the result would be reviewed before considering more.
At SkinAlchemy in London, Ontario, a smile-line discussion can begin with the fold itself. You do not need to arrive committed to cheek filler, and accepting some visible fold can be part of a successful plan.
