"I Can See My Nasolabial Folds Even When I'm Not Smiling"
There was a time when you only noticed your nasolabial folds for a moment at the height of a broad smile — but then one day you catch them in the mirror with a completely neutral expression, and it gives you pause. At Cellinique's consultation room, "What can I do about my nasolabial folds?" is one of the questions we hear most often.
Today, Dr. Kim Gun-woo, Medical Director of Cellinique on Dosan-daero in Gangnam, walks through why nasolabial folds form, what care and treatment options exist, and how to choose the direction that suits you best. This is not a post promoting a single procedure — the focus is on the framework for thinking through nasolabial fold concerns.
3-Line Summary
1. Nasolabial folds deepen not from one cause but from multiple layers of aging acting together — declining dermal collagen, descent of mid-face fat compartments, and maxillary bone resorption. One study found fold length differed by roughly 2.8-fold between people in their 20s versus their 30s.
2. Management options fall into four main branches: filler (volume support) · collagen-stimulating treatment · skin booster · lifting — and the right combination depends on the underlying cause.
3. Results and duration vary considerably by individual and side effects are possible, so "completely eliminating" folds is not an accurate framing. The more precise approach is "addressing the cause to improve the fold." This is evaluated individually during a consultation.
1. Why Do Nasolabial Folds Form? — A Multi-Layer Issue, Not a Single Line
Nasolabial folds (nasolabial folds) are the creases that run from the sides of the nose toward the corners of the mouth. Many people assume they are simply a skin-surface sign of aging — but in reality, not just one layer of the skin, but multiple layers of change act together to deepen them.
- Declining dermal collagen and skin thickness — As we age, the collagen content and overall thickness of the dermis gradually decrease, creating conditions in which folds can more easily form and set in.
- Descent of mid-face fat compartments — The malar and buccal fat pads migrate downward as their supporting structures weaken under gravity, making the crease beside the nose more pronounced.
- Maxillary bone resorption — The mid-facial skeleton, particularly the upper jaw bone, is resorbed over time, reducing the structural support for the overlying soft tissue and making nasolabial folds appear deeper.
- Photoaging and lifestyle factors — Cumulative UV exposure, smoking, and inadequate sleep are also known to affect collagen architecture.
This is why, even among people with the same concern about nasolabial folds, some are primarily dealing with volume loss, others with significant tissue descent, and still others with skin texture and collagen as the leading issue. It is precisely why, in an initial consultation, we first clarify "which axis needs to be addressed first" before deciding "what to do."
💡 Fact-check ✓
Source: Aesthetic Surgery Journal Open Forum 2025 (PMC12322485)
- Nasolabial folds deepen through the combined action of declining dermal collagen and skin thickness, descent of mid-face fat compartments (malar and buccal fat), and mid-facial skeletal resorption including the maxilla, as reported in the literature.
- The same study reported that fold length differed by approximately 2.81-fold between individuals in their 20s versus their 30s, with the upper portion changing gradually from the 30s through the 50s and the lower portion showing more marked change from the 40s through the 70s.
- The extent and pace of these changes, however, vary by the individual's genetics and lifestyle patterns.
2. Not "Eliminate" — But "Approach the Cause to Improve"
Let us be straightforward. We cannot promise to "completely eliminate" nasolabial folds. The structural changes that come with natural aging cannot be reset to zero. However, by breaking down the contributing causes and combining methods matched to each, it is possible to address the perceived depth and overall appearance of the folds.
That is why Cellinique does not approach nasolabial folds with a single default answer like "filler, always." Recommending a texture-only treatment to someone whose primary issue is volume loss — or filling volume alone for someone whose main concern is tissue descent — can lead to differences in the stability and satisfaction of results.
3. Four Branches of Care and Treatment Options (Within Cellinique's Scope)
Nasolabial fold management can broadly be divided into the following four branches. Rather than choosing just one, combining approaches according to the underlying cause is the standard approach.
A) Filler — Direct Volume Support for Deflated Areas
Hyaluronic acid (HA) filler adds volume to deflated creases, helping to reduce how deeply the fold folds inward. It is one of the most extensively researched options for the nasolabial fold area, with a relatively robust clinical evidence base. That said, results and duration vary by product, injection volume, and individual condition, and reactions such as swelling, bruising, and nodule formation are possible.
💡 Fact-check ✓
Source: Aesthetic Plastic Surgery 2018 (PMID 29740661) · Aesthetic Surgery Journal Open Forum 2025 (PMC12322485)
- HA filler for nasolabial folds was evaluated in a systematic review and meta-analysis of 12 randomized controlled trials involving 908 patients, which reported correction efficacy and safety (Aesthetic Plastic Surgery, PMID 29740661).
- In the same analysis, HA with lidocaine was advantageous for reducing injection-site pain, while correction efficacy and safety were reported to be similar regardless of lidocaine inclusion. Reactions such as swelling, erythema, bruising, pruritus, and induration showed no significant difference between the two groups.
- Results and duration vary by product, injection volume, and individual differences; the option best suited to you will be confirmed during a pre-treatment consultation.
B) Collagen-Stimulating Direction — Building a Foundation Over Time
This approach stimulates the skin's collagen production pathway. Options handled at Cellinique such as Juvelook fall into this category. Juvelook is composed of PDLLA (poly-D,L-lactic acid) combined with non-crosslinked hyaluronic acid, and is understood to support the direction of endogenous collagen production. Rather than filling immediately, the experience is one of gradual improvement perceived over time — making it an option considered for those taking a long-term management perspective.
💡 Fact-check ✓
Source: Korea's MFDS (tissue-restoration biomaterial classification · domestic approval) · CE · Vaim Global Co., Ltd. (manufacturer)
- Juvelook is composed of PDLLA + non-crosslinked hyaluronic acid (HA) and holds Korea's MFDS approval as a tissue-restoration biomaterial and European CE certification (manufacturer: Vaim Global Co., Ltd.).
- No US FDA approval history has been confirmed; guidance is provided only within the scope of Korea's MFDS approval and CE certification.
- Collagen-stimulating treatments produce gradual effects with significant individual variation.
C) Skin Booster — Supporting Texture and Hydration Foundations
This approach supports the texture, hydration, and elasticity foundation of the skin around nasolabial folds. Rejuran, offered at Cellinique, is a tissue-restoration biomaterial based on PN (polynucleotide) derived from salmon DNA and approved by Korea's MFDS as a medical device. Rather than filling the nasolabial fold directly, it is more often combined as a complementary axis to manage the condition of the surrounding skin alongside other treatments.
💡 Fact-check ✓
Source: Korea's MFDS medical-device approval No. 14-825 (2014, PharmaResearch Co., Ltd.)
- Rejuran is a tissue-restoration biomaterial containing PN (polynucleotide, salmon-DNA-derived) 20 mg/mL, holding Korea's MFDS medical-device approval No. 14-825 (2014, PharmaResearch Co., Ltd.).
- Options differ by treatment area and formulation; the formulation best suited to you will be confirmed during a pre-treatment consultation.
- Individual variation exists in perceived texture, hydration, and elasticity benefits.
D) Lifting Direction — Supporting the Tissue-Descent Axis
When mid-face and cheek descent accounts for a significant portion of the nasolabial fold concern, a lifting approach to reposition descending tissue may also be considered. This is a fundamentally different direction from volume-filling approaches, which is why it is important to first distinguish "whether the issue is deflation or descent." Pre-treatment evaluation is required to determine which approach is appropriate for you.
4. At a Glance: Characteristics by Option
| Direction | Primary Cause Addressed | Perceived Experience | Example Situations to Consider |
|---|---|---|---|
| Filler (HA) | Volume deflation | Relatively immediate volume support | When the fold feels deeply sunken |
| Collagen stimulation (Juvelook, etc.) | Dermal collagen and foundation | Gradual improvement over time | When taking a long-term management approach |
| Skin booster (Rejuran, etc.) | Surrounding texture, hydration, elasticity | Texture and condition support | When the surrounding skin is dry or sensitive |
| Lifting direction | Mid-face tissue descent | Contour and descent support | When descended cheeks make the fold appear deeper |
※ The table above is for general guidance only. Which direction is the right fit for you is assessed individually during a pre-treatment consultation. Specific procedure names and combinations are discussed at the consultation stage.
5. How Do You Choose the Right Direction for You?
When you come in for a nasolabial fold consultation at Cellinique, we typically work through the following together. Proceeding to treatment before these items are clarified can lead to differences in the stability and satisfaction of outcomes.
- Identifying the primary cause — Is it mainly volume deflation, tissue descent, or skin texture and collagen?
- History of previous treatments — Past history of filler, lifting, or skin booster treatments and recovery patterns
- Lifestyle patterns — UV exposure, sleep, smoking, stress
- Health status and medical history — Allergies, blood disorders, autoimmune conditions, current medications
- Management goals and downtime — Whether the priority is short-term improvement or long-term maintenance, and how much downtime is manageable
Within this framework, Dr. Kim Gun-woo works with you to determine the direction and priorities that suit you best. If you would like to understand the broader arc of skin aging, the Anti-Aging Complete Guide is a helpful companion read; if you would like to look more deeply at skin elasticity itself, the Skin Elasticity Treatment Guide is a useful reference.
6. Safety Standards and Precautions
Nasolabial fold-related treatments vary in type, but there are safety standards common to all directions. These are always confirmed together during the pre-treatment consultation.
What You Must Tell Us Before Treatment
- Whether you are pregnant or breastfeeding (including if you are planning to become pregnant)
- Medications you are currently taking (particularly anticoagulants, antiplatelet agents, and immunosuppressants)
- History of allergies (particularly to anesthetic agents such as lidocaine)
- History of active infections or autoimmune conditions
- Any other recent treatments received (interval adjustments may be necessary)
Points to Note After Treatment
- Temporary swelling, redness, and bruising are common reactions and vary by individual
- Rare risks include infection, allergic reactions, and nodule formation; in the case of filler, vascular complications are also possible — please contact Cellinique immediately if you notice any unusual reactions
- If you experience severe swelling, pain, visual changes, or changes in skin color at night or on holidays, please call 119 or visit the nearest emergency room
7. How Cellinique Approaches Nasolabial Fold Consultations
Cellinique is an anti-aging dermatology clinic located in Gangnam-gu on Dosan-daero. For areas like nasolabial folds, where multiple causes overlap, the process of accurately identifying and matching each cause often matters more than the success of any single procedure.
For this reason, Cellinique operates with Dr. Kim Gun-woo personally handling everything from the initial consultation through treatment and follow-up check-ins. Because the same physician follows your progress consistently, planning the next session and the next combination of approaches flows naturally. Our location on Dosan-daero in Gangnam also makes return visits and post-treatment follow-ups straightforward — an advantage for an area like nasolabial folds, where ongoing management tends to matter.
Frequently Asked Questions (FAQ)
Q1. Can nasolabial folds be completely removed?
It is difficult to say that the structural changes that come with natural aging can be "completely removed." However, by breaking down the contributing causes — volume deflation, tissue descent, collagen decline, and so on — and combining methods matched to each, it is possible to address the perceived depth and overall appearance of the folds. Results vary considerably by individual, and identical outcomes cannot be guaranteed.
Q2. Is filler always the answer for nasolabial folds?
Not necessarily. Filler (hyaluronic acid) is an option with extensive research support for addressing volume deflation, but it may not be the right fit for those whose primary concern is significant tissue descent or skin texture and collagen. Depending on the cause, combining collagen-stimulating treatments, skin boosters, or a lifting direction is the standard approach. Your primary cause will be identified together during a pre-treatment consultation.
Q3. How long does filler last?
Duration varies considerably by product, injection volume, treatment area, and individual condition, making it difficult to state a definitive number of months. Clinical studies have evaluated outcomes up to 24 months, but results differ from person to person. Accurate guidance based on your specific conditions will be provided during a pre-treatment consultation.
Q4. Will results be visible immediately after treatment?
It depends on the approach. Volume-filling approaches such as filler may produce a relatively immediate change in appearance, whereas collagen-stimulating approaches (Juvelook, etc.) involve gradual improvement perceived over time. Whether your priority is "a faster visible change" or "building a long-term foundation" will determine which option is the better fit.
Q5. Are there any side effects or risks?
No treatment is free from side effects. Temporary swelling, redness, and bruising vary by individual, and rare risks include infection, allergic reactions, and nodules; in the case of filler, vascular complications are also a possibility. This is why medical history, current medications, and allergies are carefully reviewed during the pre-treatment consultation, and guidance on how to respond to any unusual reactions is provided in advance.
Q6. Can I come just for a consultation?
Of course. With nasolabial folds, identifying the cause is where management begins — simply working through your condition and options during a consultation can be genuinely valuable. Whether or not you proceed with treatment, you are welcome to reach out by phone at 02-6203-3434 or via KakaoTalk. (Information on consultation fees is provided at the time of inquiry.)
Closing
Managing nasolabial folds does not begin with "which treatment is best?" — it begins with "which cause is driving my nasolabial folds?" Only by first distinguishing whether the issue is volume deflation, tissue descent, or skin texture and collagen do the right directions become visible. Finding that framework is ultimately work that comes together in a pre-treatment consultation.
At Cellinique (Gangnam, Dosan-daero), Dr. Kim Gun-woo personally handles everything from the first consultation through treatment and follow-up check-ins. If you are unsure how to approach your nasolabial fold concerns, please feel free to come in for a consultation.
This content is provided for general health information purposes only; individual diagnosis and treatment should always be discussed with a qualified physician. Results, duration, and suitability vary based on individual skin condition, age, and lifestyle, and identical outcomes cannot be guaranteed. Treatments carry the possibility of side effects such as temporary erythema and swelling, and contraindications may apply — these are confirmed during the pre-treatment consultation.
✅ Fact-check Report
The medical information in this article has been verified against the following sources:
1. Aesthetic Surgery Journal Open Forum 2025 (PMC12322485) — In-depth mechanism of nasolabial fold formation (declining dermal collagen and skin thickness, mid-face fat compartment descent, maxillary bone resorption) and age-related changes (approximately 2.81-fold difference in fold length between individuals in their 20s vs. 30s) · pubmed.ncbi.nlm.nih.gov
2. Aesthetic Plastic Surgery 2018 (PMID 29740661) — Systematic review and meta-analysis of HA filler for nasolabial folds (12 RCTs, 908 patients), correction efficacy, safety, and pain reduction with lidocaine co-administration · pubmed.ncbi.nlm.nih.gov
3. Korea's MFDS · CE · Vaim Global Co., Ltd. — Juvelook PDLLA + non-crosslinked HA, domestic approval as tissue-restoration biomaterial and CE certification (no US FDA approval) · nedrug.mfds.go.kr
4. Korea's MFDS medical-device approval — Rejuran PN (salmon-DNA-derived) 20 mg/mL, approval No. 14-825 (2014, PharmaResearch Co., Ltd.) · nedrug.mfds.go.krKey verification items: ✓ Multi-layer nasolabial fold mechanism (dermis, fat, skeleton) ✓ HA filler efficacy and safety (meta-analysis) ✓ Juvelook composition and approval scope (no US FDA approval explicitly noted) ✓ Rejuran composition and approval ✓ Individual variation and side effects disclosed. Duration and efficacy are expressed conservatively; claims such as "completely eliminate" and "FDA approved" are not made.
