Managing Nasolabial Folds and Laugh Lines: A Treatment Overview

Nasolabial folds — the creases running from the nose down to the corners of the mouth, colloquially called laugh lines — are among the most frequently raised concerns in facial consultations. They form through repeated facial movement combined with age-related changes in skin and soft tissue, and they tend to deepen progressively rather than plateau, which is part of why patients often seek treatment sooner than they might for other lines. Several distinct approaches address them, each suited to a different stage of severity.

Why Nasolabial Folds Form

Facial muscles contract many thousands of times a day, and the nasolabial area sits at the intersection of several of them. Over time, that repeated movement combines with declining collagen and elastin, descent of cheek fat pads, and reduced skin elasticity to establish a persistent crease rather than a purely dynamic one. Cumulative sun exposure accelerates the process, which is why sun protection is a reasonable baseline recommendation regardless of which treatment a patient ultimately chooses.

The severity and character of the fold varies considerably between patients. Some present with a fold driven almost entirely by cheek volume loss, where the surrounding tissue has thinned and the crease has become more prominent by comparison; others present with a fold driven more by tissue descent, where midface soft tissue has migrated downward and settled against a relatively stable point near the nose and mouth. Distinguishing between these presentations at consultation is what determines which of the following treatments is most likely to help.

Dermal Fillers

Hyaluronic acid fillers are the most established treatment for nasolabial folds and remain the option most patients ask about first. Because the fold is largely a volume and structural issue rather than a purely muscular one, adding volume beneath the crease tends to produce a visible softening, generally within days of treatment. Results typically last from several months up to around eighteen months depending on the product and the individual, after which most patients opt for maintenance treatment. Product selection matters: folds vary considerably in depth and the surrounding tissue in thickness, so the dermal fillers range includes a spread of viscosities suited to superficial through to deeper correction.

It is also worth noting that treating the fold in isolation does not always produce the most natural result. Where cheek volume loss is contributing to the fold, some practitioners choose to address midface volume first and reassess the nasolabial area afterwards, since restoring support higher in the face can soften the fold indirectly without additional product placed directly into the crease.

Microneedling

For folds that are only beginning to establish, or as an adjunct to filler in more established cases, microneedling is a useful lower-intensity option. Fine needles create controlled micro-injury that prompts the skin's own collagen production during healing. It is generally best suited to early, superficial folds rather than deep, well-established creases, and is often combined with topical serums or growth-factor formulations to support the skin's response. Devices and complementary products are available in the microneedling range.

Resurfacing and Thread Lift Options

Two further approaches are worth knowing even where they sit outside a typical injectables-led practice. Skin resurfacing techniques work by controlled removal of superficial skin layers to prompt regeneration, and can be effective on established folds, though they involve more downtime and are not suitable for every patient or every setting. Thread lift, by contrast, addresses folds indirectly by lifting and repositioning sagging soft tissue with fine threads placed beneath the skin, which can reduce the appearance of a fold caused primarily by tissue descent rather than volume loss alone. Thread products are available in the PDO threads range for practices offering this treatment.

Choosing an Approach

• Early, superficial folds often respond well to microneedling alone or combined with topical support.
• Established folds with clear volume loss are the classic indication for HA filler.
• Folds driven more by tissue descent than volume loss may respond better to a thread lift than to filler alone.
• Deeper, more textured skin change around the fold may warrant resurfacing as part of a broader plan.

Many patients benefit from a combination approach built around assessment of what, specifically, is driving their fold, rather than a single default treatment. In practice, cheek volumisation, direct fold filling, and skin-quality support are frequently phased across a treatment plan rather than delivered all at once, allowing the practitioner to reassess the fold at each stage before deciding whether further correction is needed.

The Takeaway

Nasolabial folds have more than one underlying cause, and the most effective treatment plan matches the technique to the mechanism — volume loss, tissue descent, or textural skin change — rather than defaulting to filler in every case.

To review HA fillers suited to nasolabial correction, browse the dermal fillers catalogue.