Can Botox fix smile lines? Who benefits from it and who doesn't

"Aren't nasolabial folds resolved with just a single shot of Botox?" This is one of the most common questions we hear in consultations. To give you the conclusion first, most nasolabial folds cannot be resolved with Botox alone. This is because the main cause of nasolabial folds is not muscle contraction, but rather the drooping of cheek fat and the reduction of collagen, which means 'volume loss and skin sagging.'

Botox is a treatment that temporarily relaxes muscles, so it helps with muscular (dynamic) wrinkles that only appear when making facial expressions. However, Botox cannot fill in deep nasolabial folds that remain even in a resting state, or areas that have lost support due to the depletion of collagen. That is why knowing what type of nasolabial folds you have first is the proper sequence.

🔍 Botox for Nasolabial Folds: Why Do Results Vary?

The medical term for nasolabial folds is Nasolabial Fold (鼻脣溝). It is the line that runs from the side of the nose to the corner of the mouth. There is more than one reason why this area deepens.

As we age, the fat pads in our cheeks sag downward, and as collagen in the dermis decreases, the skin loses its support. Facial skeletal changes such as the maxilla, UV rays, smoking, rapid weight changes, and repetitive facial expression habits compound this. Because the causes are so diverse, a single treatment cannot be the answer for everyone.

Botulinum toxin type A is an ingredient that temporarily weakens muscle contraction by inhibiting acetylcholine release at nerve endings. While it is effective for wrinkles caused by muscles, the principle itself does not address hollows caused by volume loss.

📌 Key Summary: Since the cause of nasolabial folds is mostly volume loss and sagging, Botox, which relaxes muscles, is only a secondary measure and not the primary solution.

🧭 What Type Are My Nasolabial Folds? (Self-Assessment)

There is a way to roughly estimate this at home. While not perfect, it helps in setting a direction.

• If the nasolabial folds become fainter when you lift your cheeks upward with your hands → Sagging Type (Lifting and volume replenishment take priority)

• If they deepen only when laughing or speaking → Muscular Type (Consider Botox)

• If they are deeply hollowed even when resting → Volume/Static Type (An approach to fill volume is needed)

An important concept here is the distinction between dynamic wrinkles and static wrinkles. Dynamic wrinkles are those that appear and then smooth out when making facial expressions, while static wrinkles remain even with a straight face. Botox is suitable for dynamic wrinkles, while filling treatments are suitable for static wrinkles.

However, the self-test is only a reference. In reality, most cases are a mix of volume, sagging, and muscular types, so we must look at and touch the face to know the exact proportion of causes.

📌 Key Summary: If it improves when lifting your cheeks, it is the sagging type; if it is severe only when making expressions, it is the muscular type—however, because most are complex types, diagnosis is necessary.

💉 The Role and Limits of Botox in Nasolabial Folds

Multiple facial muscles are intertwined around the nasolabial area. These include the levator labii superioris alaeque nasi (LLSAN), levator labii superioris, risorius, zygomaticus major and minor, orbicularis oris, and the depressor anguli oris (DAO) which pulls the corners of the mouth downward.

If it is a muscular-type nasolabial fold, we can soften the impression by precisely controlling the muscles responsible. The effect starts 2 to 7 days after the procedure, reaches its maximum effect in 1 to 2 weeks, and the duration is 3 to 4 months on average (3 to 6 months depending on the individual).

The issue is that these muscles are all involved in smiling, speaking, and eating. If injected excessively, facial asymmetry, awkward mouth movements, and speech discomfort can occur. If you have a profession where expressions and pronunciation are crucial, such as broadcasting, lecturing, or sales, you must be particularly cautious.

Another thing. Even if side effects occur with Botox, there is no drug to immediately reverse them, so you must wait for the effect to naturally wear off (3 to 4 months). This response method is different from fillers, which can be dissolved with hyaluronidase. In rare cases of repeated or excessive treatments, neutralizing antibodies may develop, reducing the effectiveness.

📌 Key Summary: Botox is effective for 3 to 4 months on muscular nasolabial folds, but there is a risk of facial awkwardness if injected excessively, and immediate reversal is impossible.

⚖️ Botox vs. Filler vs. Lifting: What is the Difference?

The most common misconception is "Aren't Botox and fillers similar?" The two are completely separate treatments with different ingredients and principles. Botox 'relaxes' muscles, while filler 'fills' volume.

Filler is close to the primary standard for nasolabial folds, but because of the facial artery that passes through the nasolabial area, there is a risk of vascular embolization and skin necrosis, so it is recommended to verify if the clinic is equipped with hyaluronidase to dissolve it in an emergency. If sagging is the primary cause, thread lifting or non-invasive elasticity treatments like Radiofrequency (RF) and Ultrasound (HIFU) are more suitable, and if mid-face volume is lost, volume supplementation or fat grafting is closer to the root cause.

There are also methods such as smoothing fine wrinkles and skin texture with **Skin Botox (Dermotoxin)** injected in small amounts into the shallow layer of the skin, or combining fillers and Botox to improve results. The key is a combination tailored to the cause.

📌 Key Summary: Botox = Muscular type, Filler = Volume type, Lifting = Sagging type. In most cases, satisfaction is highest when combining them according to the cause.

🌿 Filling and Restoring Collagen: The Choice of Onbolassom

As seen earlier, the real cause of nasolabial folds is usually areas that have lost support due to collagen reduction. They deepen as facial expressions are repeated, and once collagen decreases, it is not replenished naturally. Therefore, Gangnam Onlif Clinic guides patients with volume-type and static-type nasolabial fold concerns toward **Onbolassom (ON-bolassom)**.

Onbolassom is a collagen booster dedicated to nasolabial folds made of biocompatible Calcium Hydroxylapatite (CaHA) minerals. Unlike HA fillers that simply fill, it immediately replenishes volume in sunken areas while gradually decomposing in the body to activate fibroblasts and induce self-collagen production. In other words, it is a direction of 'filling immediately and regenerating for a long time.'

Thanks to its patented lattice-pore structure, the central core stably maintains volume while the outer layer is slowly absorbed, inducing collagen regeneration. The procedure takes about 10 to 15 minutes in total. After applying anesthetic cream, the sunken areas are delicately corrected, and most patients can return to daily life immediately after the procedure.

This is an appropriate approach for those whose nasolabial folds are distinct even when not smiling, those concerned about an aged appearance, or those who want to improve both nasolabial folds and skin elasticity together. Depending on the sagging type and depth, combining it with thread lifting or fillers can further enhance the results.

Onlif does not aim to alter the shape of the eyes, nose, or mouth, but rather pursues non-surgical skin treatments that lift skin aging and loss of elasticity that obscure one's natural beauty. Believing that a single doctor cannot excel at everything, we operate under a medical specialty system where doctors undertake the procedures they perform best in each field.

📌 Key Summary: Onbolassom is a calcium collagen booster that simultaneously targets volume replenishment and self-collagen regeneration, making it a non-surgical approach suitable for volume and static-type nasolabial folds.

📋 Before and After the Treatment, Be Sure to Check This

Whatever the treatment, diagnosing the cause comes first. It is safe to inform us of your history of previous fillers, thread lifts, fat grafts, or history of facial paralysis in advance.

• Contraindications: Those who are pregnant, breastfeeding, or have neuromuscular diseases should avoid Botox.

• Post-treatment Care: Do not lie down within 4 hours, and refrain from strong massage on the treated area, drinking alcohol, smoking, and using saunas for about 1 week.

• Comparison Photos: Keeping photos of your front, 45-degree angle, and smiling expression under the same lighting, distance, and angle is great for objectively checking changes.

The average cost of Botox for nasolabial folds in Korea is roughly 25,000 KRW to 70,000 KRW per area, varying depending on the size of the clinic and the products used. Since domestic and imported products have different unit systems, simple comparison should be done cautiously.

📌 Key Summary: Diagnosis comes first, and checking contraindicated subjects, managing post-treatment, and taking before-and-after photos will increase both satisfaction and safety.

❓ Frequently Asked Questions (FAQ)

Will nasolabial folds really disappear if I get Botox?

In most cases, they do not disappear completely. Since the main causes of nasolabial folds are volume loss and sagging, Botox, which relaxes muscles, is closer to an auxiliary measure. It can be helpful if it is a muscular type that worsens only when making facial expressions.

Between Botox and filler (or volume booster), which is more effective for nasolabial folds?

It depends on the cause. Botox is suitable for dynamic wrinkles that appear only when laughing, while filling treatments are more appropriate for deep volume/static wrinkles that remain even in a resting state. An approach like Onbolassom, which fills volume and collagen together, is also suitable for the static type.

Will my smile look unnatural if I get Botox for nasolabial folds?

Excessive injection can cause facial asymmetry, awkward mouth movements, and speech difficulties. This is because the muscles around the nasolabial folds are involved in smiling, speaking, and eating. It is important to adjust the dose and position precisely.

When does the effect start showing and how long does it last?

The effect of Botox begins 2 to 7 days after the treatment, reaches its peak in 1 to 2 weeks, and lasts for 3 to 4 months on average. Onbolassom shows volume improvement immediately after the procedure, and then collagen fills up, lasting for 6 months to over a year.

My nasolabial folds are deep even when resting. Will Botox be effective?

If they are deeply hollowed out even with a expressionless face, there is a high possibility that they are of the static or volume type, so Botox alone has its limits. In this case, an approach that fills the hollowed area and induces collagen regeneration is more suitable.

Is Onbolassom possible even if I have received filler treatments in the past?

Yes, it is possible. However, since the treatment plan can vary depending on your previous treatment history and current skin condition, it is best to check the exact details during an in-person consultation.

Are there people for whom nasolabial fold treatment is not suitable?

Botox should be avoided if you are pregnant, breastfeeding, or have a neuromuscular disease. Other than that, if the treatment does not match the cause, the effect may not be as expected, so diagnosing the cause before the treatment is absolutely necessary.