Choosing a Filler for Nasolabial Folds
Hyaluronic acid, calcium hydroxylapatite and poly-L-lactic acid fillers behave differently in the nasolabial fold. What each one does, how long it lasts and which suits which finding.
There is no single best filler for the nasolabial fold. There are materials that behave differently — in how long they last, whether they can be reversed and how much structural support they give — and the right one depends on the depth of the fold and what caused it.
What nasolabial folds are
Nasolabial folds are the creases that run from the sides of the nose to the corners of the mouth. They deepen with age.
Several factors contribute. With age, the skin loses collagen and elastin, leading to laxity and more pronounced folds. Repeated muscle movement from smiling or frowning etches deeper lines. Individual anatomy and lifestyle factors — smoking, sun exposure, dehydration — accelerate the breakdown of collagen.
An important distinction: a nasolabial fold caused primarily by mid-face volume loss is best addressed by restoring volume in the cheek, not by filling the fold itself. Filling a deep fold directly when the underlying cause is descent of the mid-face produces a heavy, unnatural result.
How fillers work here
Dermal fillers replace lost volume in the target area, filling hollows and softening the crease. Most are hyaluronic acid based — a substance occurring naturally in skin, which contributes volume and retains water.
Which filler is appropriate depends on the facial anatomy and the depth of the fold, and that assessment is made at consultation rather than by product preference.
The materials
Hyaluronic acid fillers
The most commonly used group, and the appropriate starting point because they are reversible.
Juvéderm range Products in this range vary. Some have a smooth consistency and last up to about a year. Others are formulated to add volume to the cheek and mid-face, which improves the appearance of the nasolabial fold indirectly by addressing the cause rather than the crease. Others are formulated for finer lines, or to balance flexibility and durability in areas of movement.
Restylane range A widely used hyaluronic acid range, formulated for different facial areas. The products intended for deeper placement provide support and volume in the deeper tissue layers, addressing moderate to severe folds. Results typically last around nine to twelve months.
The advantage of hyaluronic acid across the range is reversibility — the material can be dissolved with hyaluronidase if the result is not what was intended.
Calcium hydroxylapatite
Radiesse Composed of calcium hydroxylapatite microspheres suspended in a gel carrier. It provides immediate volume and also stimulates the body’s own collagen production, so the effect has two components. Results typically last up to a year or more.
It is denser than hyaluronic acid and suits deeper placement. It is not reversible in the same way, which is a relevant consideration.
Poly-L-lactic acid
Sculptra Primarily a collagen stimulator rather than a volumiser. It works gradually over multiple treatment sessions to increase facial volume. Results develop over months rather than immediately.
Other options
Revanesse Versa — smooth consistency, with limited swelling reported.
Belotero Balance — formulated to integrate into the skin, suited to finer lines as well as moderate to severe folds.
Teosyal RHA range — resilient hyaluronic acid fillers formulated to accommodate facial movement, which matters in an area as mobile as the nasolabial fold.
Choosing between them
The relevant factors are the depth of the fold, skin type, how long you want the result to last, and whether reversibility matters to you.
For a first treatment, hyaluronic acid is the sensible choice. It is reversible, it can be adjusted, and it resolves over time if the result is not what you wanted.
For deeper folds where more structural support is needed, calcium hydroxylapatite may be more appropriate — with the trade-off that it cannot be dissolved.
Where the underlying problem is generalised volume loss, a collagen stimulator addressing the whole mid-face may be more appropriate than filling the fold.
The procedure
- Consultation. Your concerns are discussed and the facial anatomy assessed.
- Preparation. On the day, the area is cleaned and a topical anaesthetic may be applied.
- Injection. The filler is injected at specific points along the fold.
- Immediate care. The treated areas may be gently massaged to distribute the filler evenly.
- Review. The result is assessed before you leave.
After the procedure, avoid vigorous activity, stay upright, use ice to reduce swelling and stay hydrated. Initial redness or swelling settles within a few hours to several days.
The result is visible immediately. It matures at around two weeks once residual swelling has settled. Duration varies by material, typically between six months and two years.
Who it suits
- Age. Filler is commonly used from the late thirties onwards, when nasolabial folds typically deepen.
- Skin elasticity. Patients with reasonable skin elasticity achieve the most natural results, as the skin accommodates the added volume.
- Previous treatment. Prior treatments such as botulinum toxin or laser should be disclosed, as they affect planning.
Where skin laxity is significant, filler will not correct descent and a surgical approach may be more appropriate.
How we quote
Fees depend on the product and volume used, and are set out in writing after assessment.
The procedure this relates to
Injectable hyaluronic acid gels used to restore volume, soften folds and adjust the contours of the face. The effect is temporary and the material is gradually absorbed, so treatment is repeated if the result is to be kept.
Before you act on this
Everything here is general. What applies to you depends on your anatomy, your history and what you are trying to achieve, and none of that can be assessed from a page. If a question here is yours, bring it to a consultation.