Why nasolabial folds deepen
Three things happen at once, and only one of them is about the fold itself.
Collagen and elastin decline. Collagen production slows, skin elasticity falls, and the skin becomes slower to spring back after it folds, so a crease that used to disappear starts to linger.
The cheek fat pads descend. This is the big one. The pads that sit high in a younger face gradually drop, and the tissue that arrives at the top of the fold has to go somewhere. The fold deepens because of what is happening above it, which makes this a change in facial structure rather than in the skin.
Repeated movement. Facial expressions fold the same line thousands of times a week, which is how a crease becomes one of the permanent facial lines that stay visible at rest.
Sun exposure, smoking and genetics all accelerate the first of those. The second is structural and happens regardless of how well you have looked after your skin.
That middle point is the one worth holding on to, because it explains why the most effective treatment is often not in the line at all.
How the filler actually works
Hyaluronic acid is a sugar your body already produces, and it binds water. A filler gel placed under a crease does two things: it physically occupies the space where support has been lost, and it draws in water, which restores facial volume and adds hydration to skin tissue that has thinned.
The result is that the fold becomes shallower. The shadow it casts softens, and the transition from cheek to mouth reads as a curve rather than a line.
What it does not do is remove the fold. Nasolabial folds are a normal feature of facial anatomy and they exist on young faces too. A result that erases them entirely has used too much product, and it usually shows as heaviness around the mouth rather than youth.
Why we often treat the cheek instead
This is the part most patients have not heard, and it is the single most useful thing on this page.
If the fold has deepened because the cheek above it has descended, then filling the fold treats the symptom. It flattens the line while leaving the face bottom-heavy, and the result can look fuller rather than lifted.
Restoring mid-face support with cheek filler frequently improves a nasolabial fold more convincingly than injecting the fold does, because it addresses the reason the fold got deeper.
In practice many treatment plans use both: cheek support to lift, and a small amount in the fold itself to soften what remains. Which way round, and how much of each, is what the consultation decides.
What happens at the appointment
It takes about 30 minutes. Most of that is assessment and marking rather than the injections themselves.
Needle or cannula. Dermal filler injections here can be given with either. A cannula is blunt-tipped and moves through tissue rather than piercing it, which reduces bruising and is often preferred near vessels. Your practitioner will choose based on the depth and the plan.
It is more comfortable than people expect. The products we use contain lidocaine, so the area numbs as the gel goes in.
You see the change immediately, though that first look includes swelling. The settled result is visible after a few days, and fully integrated at two to four weeks.
There is no real downtime. Mild swelling or a small bruise is common and settles within a few days. Avoid strenuous exercise, alcohol and heat for 24 to 48 hours.
What the results look like
Most people describe the outcome as looking less tired rather than looking different, which is the right answer. Natural results leave your facial features recognisable, including the expression lines that belong there.
The fold is reduced in depth, not erased. The transition between cheek and mouth is smoother. In photographs the change is usually visible in the shadow rather than in the line itself.
Results from dermal filler treatment in London in this area typically last nine to twelve months. That is at the shorter end of the filler range, because the area around the mouth moves constantly and movement breaks product down faster.
What changes how long it lasts
- The product. Softer gels suit fine creases; firmer ones are needed where the fold is deep or where the cheek is being supported. Using the wrong one is why some results fade faster than expected.
- How much movement is in the area. The mouth is the most mobile part of the face after the lips, and filler here does not last as long as the same product placed along a jawline.
- Your metabolism. Some people break hyaluronic acid down noticeably faster, and it is not something you can predict in advance.
- Lifestyle. Smoking and significant sun exposure both accelerate the breakdown.
Skin health does not make filler last longer, but it does make the same result look better, which is why skin and structure are usually planned together rather than separately.
When filler is not the answer
Filler treats lost volume. It does not treat everything that makes a nasolabial fold look worse, and several other non-surgical treatments address the things it cannot.
If the skin quality is the issue, and the concern is thinning, crepiness or skin texture rather than depth, skin rejuvenation with skin boosters does more than filler will.
If there is significant laxity, skin tightening addresses the cause where filler would simply add weight to tissue that is already descending.
If the fold only appears when you smile, you are at an early stage and adding volume now is treating something that is not yet a problem at rest.
If the crease is very deep and long-standing, filler alone will improve it without changing it, and resurfacing alongside injectables is usually the honest answer.
We would rather tell you that at consultation than take a payment for a treatment that gets you part of the way.
Why precision matters here
The nasolabial region sits close to significant blood vessels, and the angular artery runs alongside the fold. That makes anatomical knowledge more consequential here than in many other areas.
Complications are uncommon, and what reduces the risk is experience as much as technique: correct depth, small volumes placed slowly, a practitioner who recognises early warning signs, and hyaluronidase on site ready to use without delay.
Two more common problems are not complications at all, just poor judgement. Overfilling makes the lower face heavier rather than lifted. Placement too superficial can show as a ridge or a bluish tinge in thin skin.
All dermal fillers at our Harley Street clinic are temporary hyaluronic acid fillers, which means a result you are unhappy with can be dissolved rather than waited out.
What it costs
Dermal filler treatment at PHI Clinic starts from £400. Nasolabial folds are usually a small-volume treatment, but a plan that includes cheek support will need more product, and your practitioner will set out the full cost at consultation before anything is agreed.
Your treatment over time
Because filler fades gradually rather than disappearing, most people come back for review at around nine to twelve months.
Some choose a smaller top-up at that point. Others wait until the original treatment has gone completely. Both are reasonable, and the one thing worth avoiding is topping up early, while the previous treatment is still substantially present, because that is how a face drifts rather than being treated.
Book a consultation
If nasolabial folds have started to bother you, the useful first step is having someone look at them properly, in movement and at rest, and work out whether the fold or the cheek is the real problem.
Book a consultation with our team at PHI Clinic on Harley Street. We will assess your face as a whole, discuss your aesthetic goals, and plan any cosmetic treatment around facial harmony rather than around one feature. That includes telling you honestly if the answer is that you do not need treatment yet.
If you are considering nasolabial fold filler in London, that is where it starts. Our dermal fillers page carries detailed information on products and prices, and on the other rejuvenation options if filler turns out not to be the right answer.
