Deep Nasolabial Folds: Why Do They Form and How to Reduce Them? — From Causes to Treatment Options

Deep nasolabial folds are not simply a 'single line of wrinkle' folded into the skin. Clinically, it refers to the Nasolabial Fold, the boundary structure of the face that runs from both sides of the nose to the corners of the mouth. The deepening of this valley is mostly the overlapping result of the loss and descent of cheek fat, combined with a decrease in skin elasticity. Therefore, simply filling the surface often does not resolve it naturally.

First, to start with the conclusion, the realistic goal for deep nasolabial folds is not to eliminate them completely, but to naturally alleviate them. This is because the nasolabial fold itself, which appears when smiling, is a normal anatomical structure. And what is most important is diagnosing the cause. The approach changes completely depending on whether it is caused by sunken areas or sagging.

🔍 What exactly are nasolabial folds?

The formal name for nasolabial folds is **Nasolabial Fold**. It is the natural boundary line of the face that runs from the side of the nose to the corners of the mouth, and when this area is deeply hollowed out, it makes one's impression look aged and tired.

There is a common misconception: thinking of nasolabial folds only as 'skin wrinkles.' However, deep nasolabial folds are closer to a structural folding of the face created by a combination of volume loss + sagging + loss of elasticity.

A study by a Japanese pharmaceutical company even released results showing that as nasolabial folds lengthen by 1cm, one looks about 6 years older than their actual age. That is how significant of a role this area plays in one's impression.

📌 Key Summary: The medical term for nasolabial folds is the nasolabial fold, and deep nasolabial folds are not just a skin problem, but a structural result intertwined with volume, sagging, and elasticity.

🧬 Why do deep nasolabial folds form?

The most fundamental cause is the loss and descent of cheek fat in the mid-face area. The fat that used to fill the upper cheek during youth decreases with age and moves downward, creating a 'valley' next to the nose.

Added to this is the decrease in collagen. Collagen decreases by about 1% every year after one's mid-20s, and for women, it rapidly decreases by about 30% for 5 years after menopause. Skin that has lost its support is not refilled, and wrinkles remain right where it folds.

The **Retaining Ligaments** of the mid-face, which connect the skin and bone, also play a part. When surrounding tissues sag, the valley becomes more distinct based on the point where these ligaments are attached.

UV Rays: As Dreadful as Aging

What surprisingly many people miss is **Photoaging**. To the extent that UV rays are estimated to cause about 80% of skin aging, sunlight is the main culprit that accelerates collagen breakdown. This is why UV protection is the most basic and evidence-based method for managing nasolabial folds.

Other lifestyle factors such as rapid dieting that causes cheek fat loss, smoking, and the habit of sleeping on one's side also make nasolabial folds deeper.

📌 Key Summary: Volume loss and descent are the core causes, and collagen decrease, sagging of retaining ligaments, and photoaging accelerate this.

🧩 Are there different types of nasolabial folds?

Yes, they are largely divided into four types. Since approaching the issue according to the cause increases satisfaction, it is important to know which type you are.

In clinical practice, the severity is quantitatively evaluated using the **WSRS (Nasolabial Fold Severity Scale)** on a 5-grade scale from 0 to 4 points. The recommended method varies depending on whether it is mild or moderate and above.

📌 Key Summary: Nasolabial folds are divided into sunken, sagging, muscular, and combined types, and type diagnosis is the starting point of satisfaction.

💉 What are the non-surgical improvement methods?

Onlif Clinic addresses nasolabial folds by focusing on non-surgical procedures from a dermatological perspective, rather than incision surgeries that use a scalpel. Below are commonly utilized methods.

Hyaluronic Acid (HA) Filler

This is a representative method that fills immediate volume for the sunken type. The maintenance period is usually 6 to 18 months, and the amount used for the nasolabial area ranges from about 0.5 to 2 mL per side, with a large difference depending on the depth. If it gets overcorrected or a problem arises, it is also good to know that it can be dissolved with **hyaluronidase (dissolving enzyme)**.

However, a point of caution. If you inject excessive filler only into the nasolabial line for the sagging type, the area around the mouth becomes bulged and actually looks unnatural. In this case, an approach that first reinforces the mid-face volume of the upper cheek and cheekbone, rather than the nasolabial line, is natural.

Thread Lifting

This is a non-surgical lifting suitable for the sagging type. PDO dissolvable threads are absorbed in the body over about 3 to 6 months, and the lifting effect is maintained for approximately 1 to 2 years. Since it works by pulling up sagging tissue to alleviate the valley, using it together with volume procedures increases the level of completion.

Botulinum Toxin & Thermal Energy Procedures

For the muscular type caused by overactive facial expression muscles, Botox is used as an aid, but its sole effect is limited. Thermal energy procedures such as ultrasound HIFU or radiofrequency RF are utilized supportively by inducing collagen regeneration and tissue contraction.

An Approach That Fills Collagen Together — Onbollassom

Onlif's signature, Onbollassom, is a calcium collagen booster dedicated to nasolabial folds. While hyaluronic acid fillers focus on 'physically filling,' Onbollassom's bio-friendly calcium mineral (CaHA) particles immediately fill the sunken area to replenish volume, and at the same time, slowly decompose to stimulate fibroblasts and induce self-collagen production.

Thanks to the patented Lattice-pore structure, the central core supports volume for a long time, while the outer layer is absorbed layer by layer to lead collagen regeneration. It features the expectation of both immediate filling and improvement of the 'texture' that fills from within over time.

The procedure itself takes approximately 10 to 15 minutes from consultation and design to completion, and returning to daily life right after the procedure is generally possible. If it is a combined type that also has sagging, a direction that addresses both volume and lifting by combining Onbollassom and thread lifting is natural.

📌 Key Summary: Volume is basic for the sunken type and lifting is basic for the sagging type, and Onbollassom is an approach dedicated to nasolabial folds that allows you to expect both filling and collagen regeneration.

⚠️ Safety Points to Know Before the Procedure

A blood vessel called the **Facial Artery** passes through the nasolabial area. If this blood vessel is blocked during filler injection, it can lead to serious problems such as skin necrosis or, rarely, loss of vision. Therefore, the judgment of an experienced medical staff skilled in anatomy is absolutely necessary.

If the following symptoms appear after the procedure, you must seek medical attention immediately.

• Skin becoming pale or mottled

• Discoloration to purple or black

• Blisters or ulcers

• Blurry vision or decreased vision

These signals can be signs of vascular embolism, so quick response is important. As a normal reaction, mild bruising or swelling may appear for a few days, and it is recommended to avoid unnecessary stimulation to the area for about a week after the procedure.

📌 Key Summary: Blood vessel safety is key in nasolabial procedures, and emergency signals such as discoloration or vision abnormalities must be treated without delay.

🏠 Management You Can Do at Home

Already deeply hollowed structural nasolabial folds cannot be eliminated with cosmetics or creams alone. However, it is definitely helpful for prevention and skin quality improvement.

• UV Protection: The most definite way to prevent photoaging

• Retinoids: Ingredients with a basis in promoting collagen production and improving skin turnover

• Lifestyle Correction: Refraining from rapid dieting and smoking, reducing the habit of sleeping on one's side

• Mouth Muscle Exercises: Light home care such as pronouncing 'A-E-I-O-U' and puffing up cheeks

Ultimately, home care is management to slow down progression, and a procedural approach is realistic for valleys that have already deepened.

📌 Key Summary: Home care is effective for prevention and skin quality management, but cannot eliminate deep valleys themselves.

❓ Frequently Asked Questions (FAQ)

At what age do deep nasolabial folds start to form? Do they also form in one's 20s?

Yes, they can form. Collagen begins to decrease from the mid-20s, and there are studies showing that the length of nasolabial folds visibly increases between one's 20s and 30s. Depending on natural facial structure or rapid weight changes, they can deepen even in one's 20s.

Is it correct to put filler directly into the nasolabial line, or is it correct to put it in the cheeks?

It depends on the type. For the sunken type, replenishing volume in the nasolabial area is effective, but for the sagging type, over-injecting only in the nasolabial line actually makes it look unnatural. In this case, an approach that first reinforces the mid-face volume of the upper cheek and cheekbone is natural.

Which is correct between nasolabial fold filler and thread lifting?

If it is a volume problem caused by being sunken, the basic direction is a method to fill volume; if it is a problem caused by sagging, it is thread lifting. If it is a combined type where both factors are mixed, ONbollassom and thread lifting are sometimes performed together. Accurate judgment starts with type diagnosis.

Can it be improved with cosmetics or massage?

While it helps in prevention and skin quality improvement, it is difficult to eliminate already deeply hollowed structural nasolabial folds with cosmetics alone. Since UV protection and retinoids are evidence-based management methods, it is good to combine them.

Can hyaluronic acid fillers be dissolved later?

Yes, it is possible. Hyaluronic acid fillers can be dissolved with a dissolving enzyme called hyaluronidase, which serves as a coping mechanism in overcorrection or vascular-related emergencies.

My nasolabial folds suddenly deepened after a rapid diet.

When weight decreases quickly, cheek fat is also lost, which can deepen nasolabial folds. In this case, an approach to replenish the lost volume can be effective, so it is recommended to decide on a direction after checking the condition.

When is it possible to return to daily life after a nasolabial fold procedure?

In the case of ONbollassom, the procedure is short and most daily activities are possible immediately afterward. Mild bruising or swelling may occur, and it is recommended to avoid strong stimulation to the treatment area for about a week.

Deep Nasolabial Folds, Things to Check Before Choosing a Clinic

Even with the same procedure, the results and recovery process vary depending on where, by whom, and how it is performed. Asking the following items directly during consultation will help you make a judgment.

• Is it a place that frequently performs that procedure? — The main procedures handled vary by clinic. Check if it is a place that regularly performs procedures for deep nasolabial folds.

• Can you check the products and equipment used? — Ask if you can check the product name and whether it is genuine (whether it is an import-approved product, and if there is an unboxing verification process) during the consultation.

• Do they explain the breakdown of costs? — Rather than just hearing the total amount, you must hear an explanation of what product is used, how much of it, and in what area to make a judgment.

• Do they design by looking at the entire face? — Even for the same procedure, the location and amount injected vary depending on facial shape, skin condition, and left-right asymmetry.

• Do they explain adverse reactions and the recovery process first? — Rather than a consultation that only talks about expected changes, a place that also informs you of possible adverse reactions and how to cope with them is better for making a judgment.

• Is there a way to verify after the procedure? — Check if the timing for checking progress, how to contact them if there is an issue, and the criteria for re-visiting are established.

This is how Onlif Clinic handles deep nasolabial folds

• We divide responsibilities — With the thought that a single doctor does not handle all procedures, Onlif divides medical treatment by assigning doctors responsible for each field.

• We check products and equipment together during consultation — We guide you through the products used and the unboxing verification process during the consultation process.

• Costs are guided along with the breakdown after diagnosis — Since the area, volume, and scope differ for each person, we explain what costs how much together.

• We design by looking at the overall facial balance — We look at the face through three axes: texture, balance, and signals of youth, and set a plan in a direction that tidies up parts that overshadow your natural impression rather than changing your shape.

• We tell you about adverse reactions and the recovery process first — Along with the changes that can be expected, we guide you through individual differences, possible adverse reactions, and countermeasures before the procedure.

• We look at the progress together after the procedure — If verification is needed during the recovery period, we guide you on re-visiting and contact routes.

If you are concerned about deep nasolabial folds, it is better to first check what is possible and what is difficult in your current state. Accurate diagnosis and treatment plans can only be determined through face-to-face medical treatment. Check through a consultation at Gangnam Onlif Clinic.