Hello, I'm Dr. Wangjin Lee, Director of Boost Clinic Cheongdam.
The nasolabial fold is one of the first signs of aging most people notice. The deep shadow running from beside the nose to the corner of the mouth reads as tired, and tends to age the face more than its actual years.
But I never look at the fold line by itself. Push volume into the groove without understanding why it's there, and you risk "overcorrection" — a puffiness around the mouth that shows up the moment you smile — because a deepening nasolabial fold is rarely caused by just one thing.
It's not a simple surface wrinkle
The nasolabial fold isn't skin simply folding at the surface. It's the structural result of bone, fat, ligaments, and muscle working together.
Three separate causes, working at once
1. Descent of upper cheek and midface volume. As we age, the ligaments that support the skin stretch, and the malar fat pad in the upper cheek can no longer resist gravity and begin to descend. As that descending cheek tissue settles onto the fixed nasolabial ligament, a deep groove and shadow form beneath it.
2. Bone resorption at the base beside the nose (maxilla). The area of bone just beside the nostril, around the piriform aperture, naturally undergoes bone resorption with age. As that foundational bone settles inward, the soft tissue sitting on top of it sinks along with it, deepening the hollow.
3. Repetitive use of expression muscles. The muscles that repeatedly lift the corner of the mouth and upper lip, with every word and every smile, gradually break down the elastic fibers in the dermis, and the resulting crease slowly hardens into a fixed, permanent line.
These three causes operate at different structural layers, but on the surface, they all show up overlapping as a single fold — which is exactly why filling the line alone doesn't address the cause.
Three problems that come from filling the line alone
Push a large volume of filler into a deep fold without accounting for the underlying cause, and three issues tend to follow:
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Philtrum and mouth-area protrusion. The area around the start of the fold and the mouth thickens, making the space between nose and lip look longer, or the mouth look like it's pushing forward.
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Unnatural expression. The added volume physically gets in the way of muscle movement when speaking or smiling, making expressions look stiff.
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Added sagging from gravity. The weight of the overfilled volume adds downward pull, and over time, the surrounding tissue can end up sagging even more than before.
Restoring support, not filling a line
Smoothing a nasolabial fold without creating that stiffness means shifting the frame entirely: from "filling in a wrinkle" to "restoring and redistributing a collapsed support structure."
1. Build deep structural support at the sunken base first. A precise, firm support point is built in the deep layer, right above the sunken bone beside the nose — like resetting a foundation stone back in place — using filler or a collagen-boosting injectable, so the depth of the hollow is reduced without needing to force the surface upward.
2. Lift with the midface vector in mind. The forward cheek fat that has settled downward and is weighing on the fold needs upward tension to return closer to its original position. Thread lifting or other lifting treatments, applied along the correct midface vector, lift that accumulated weight off the fold, helping the line itself soften.
3. Blend by plane, not by line. Once deep support is secured, a soft, flexible filler is layered thinly across the surface — blending along a plane rather than chasing the line itself — so it moves naturally with the surrounding skin instead of creating a visible step.
Key takeaways
- When a nasolabial fold looks deep, we look at the collapsed support structure behind it, not just the line itself.
- Deep structural support, midface lifting, and shallow-layer blending are designed together.
- The whole face is the reference point — not just the one fold.
A nasolabial fold isn't something to simply erase like a pencil mark. It's a balance problem, tied to the direction of gravity and the three-dimensional structure of the whole face — and resolving it means correctly separating what needs to be lightened from what needs structural support.
At Boost Clinic Cheongdam, every nasolabial fold consultation looks at the collapsed support point underneath the fold before anything else.
If you're considering treatment for nasolabial folds and want an honest assessment of what's actually causing yours, we're glad to walk you through it — in English, free of charge, over WhatsApp.
Message us on WhatsApp: wa.me/821072736699
