Smile Lines
The folds from nose to mouth — a volume problem, which is why the toxin aisle can't help.
Nasolabial folds are normal anatomy — everyone who smiles has them — that deepen as midface volume thins and tissue descends. Understanding that mechanism sorts the treatment menu instantly: these aren't muscle-contraction lines, so botulinum toxin has nothing to act on; they're creases with lost support behind them, which is why filler is the mainstay and why one popular alternative pitch doesn't survive contact with the evidence.
Why it happens
ASPS lists deepening folds between the nose and mouth corners among the standard changes of facial aging, alongside fat that has fallen or disappeared — descent and deflation, not muscle overactivity. That's the entire reason the treatment answer differs from frown lines: the AAD's list of FDA-approved cosmetic toxin uses covers the glabella and crow's feet, and nasolabial folds are absent from it because relaxing a muscle can't refill a fold.
Beware the cheek-filler detour: a 3D-imaging study of 77 patients found cheek volumization produced no measurable improvement in the nasolabial fold — only filler placed at the fold itself did. Lifting the cheek to “indirectly” fix the fold is how people end up with overfilled cheeks and the same fold.
Treatment options, honestly compared
HA filler in the fold
Non-surgicalThe classic, FDA-approved indication — immediate and reversible.
Moderate-to-severe nasolabial folds are the textbook indication most absorbable fillers were approved on. Results are immediate, durations run roughly nine to twelve months for most HA products, and hyaluronidase can undo an outcome you don't like. The evidence supports treating the fold directly rather than hoping cheek volume trickles down.
Compare providers for this treatment →Sculptra
Non-surgicalGradual collagen rebuild for the same folds, over sessions.
FDA-approved for shallow-to-deep nasolabial fold contour deficiencies: up to four sessions, with extension data following results to 25 months after the last. Slower and subtler than HA, and not dissolvable.
Skin resurfacing — for the etched line
Non-surgicalFor the surface crease, not the fold beneath it.
Where years of folding have etched a line into the skin itself, resurfacing — laser, peel, dermabrasion — addresses the crease component that filler under it won't erase. Many complete plans pair the two: support below, surface above.
Compare providers for this treatment →
Deep folds with genuinely sagging tissue are a lifting problem.
ASPS lists deepened nasolabial folds among the changes a facelift addresses: when the fold is the leading edge of descended cheek tissue, repositioning that tissue treats the cause rather than padding the symptom, and filler becomes the finishing tool instead of the whole plan.
Compare providers for this treatment →What it costs
ASPS average surgeon/physician fees — surgeon only, excluding anesthesia, facility, and related expenses.
| Hyaluronic acid filler (per treatment) | $715 |
| Non-HA filler incl. Sculptra (per treatment) | $901 |
| Skin resurfacing (laser, peel, dermabrasion) | $1,829 |
| Facelift | $11,395 |
Some fold is normal — chasing zero is how faces go wrong
The nasolabial fold exists on every face that moves; flattening it completely requires volumes that distort the cheek and upper lip. The documented overfilled look starts exactly here — cheek filler stacked in pursuit of a fold that was never going to photograph flat.