Nasolabial Folds: Will Filler Alone Solve Them?
Deepening nasolabial folds do not always mean filler is the right first step. The causes fall broadly into five groups: (1) overactive muscles at the corners of the mouth, (2) reduced elasticity of the surrounding skin, (3) sagging of cheek and cheekbone fat, (4) changes in bone structure, and (5) a combination. If muscle is the cause, Botox; if sagging is the cause, lifting; and only when the bone structure has become hollowed does filler become a suitable option. Injecting filler first without identifying the cause can make the fold lines look more prominent or create an unnatural contour.
Scenario 1: Mid 30s, Folds Just Beginning to Form
At this stage, cheek elasticity gradually decreases and the corners of the mouth start to droop slightly. At this age, muscle tension often comes before problems with the skin itself. Applying a small amount of wrinkle Botox to the muscles around the mouth corners can slow the rate at which the fold lines set in. Adding light radiofrequency or ultrasound lifting at the same time to maintain cheek elasticity may help improve early folds without filler.
Injecting filler right away at this stage can make the volume feel excessive. At Repic Clinic in Gangnam, the degree of sagging and the condition of the muscles are checked through a pre-treatment diagnosis before the treatment plan is designed.
Scenario 2: Early 40s, Cheek Sagging as the Main Cause
This is a pattern in which fat beneath the cheekbones descends and the folds deepen. If only filler is used here, the hollow area is filled but the sagging cheek stays on top of it, so the result can look awkward. A lifting treatment that raises the sagging itself should come first or be combined.
Ulthera lifting at Repic Clinic in Gangnam focuses ultrasound energy on the fascia (SMAS) layer to lift sagging cheeks and the jawline. Energy is delivered at the correct depth using DeepSee™ real-time imaging technology. InMode lifting delivers RF energy down to the SMAS layer to induce fat breakdown and collagen generation at the same time, using an FDA-cleared device. Depending on the degree of sagging and fat distribution, the two treatments are combined or applied alone.
After lifting the cheeks, adding a small amount of 3D Design Filler only to the areas where the bone structure remains hollowed can help create a natural result. 3D Design Filler is customized by area, such as the cheekbones, cheeks, nasolabial folds, forehead and temples, taking the facial contour and dimension into account.
Scenario 3: Late 40s and Older, with Overlapping Causes
Muscle overactivity, reduced skin elasticity, cheek sagging and bone changes have all progressed at the same time. At this stage, it is difficult to expect improvement of nasolabial folds from a single treatment. An integrated lifting approach, designed by combining Ulthera, Thermage, thread lifting, EMFACE, lifting filler, Botox and others, becomes a practical option.
At Repic Clinic in Gangnam, the doctor personally designs the treatment plan after securing each patient's data through a pre-treatment diagnosis. Rather than applying a uniform protocol, only the treatments needed for each cause are combined. When Botox and filler are combined on the same day, the order of treatment, the spacing between injection sites and interactions based on product characteristics need to be considered, so it is safer to confirm the specific plan at a consultation.
Treatment Composition by Scenario
| Situation | Main cause | Suggested approach | Reference treatments |
|---|---|---|---|
| Early stage, mid 30s | Muscle overactivity | Botox first, light lifting alongside | Provided at consultation |
| Sagging, early 40s | Descent of cheek and cheekbone fat | Lifting first, then a small amount of filler | Provided at consultation |
| Combined type, late 40s | Muscle + sagging + bone structure combined | Integrated lifting + customized filler design | Provided at consultation |
If This Sounds Like You
If you are considering combining filler and lifting for nasolabial folds, the first step is to identify whether the cause is muscle, sagging or hollowing of the bone structure. Repic Clinic in Gangnam is located at 318 Gangnam-daero, Gangnam-gu, Seoul (B1 and 2F), and you can be advised on a treatment plan that suits you through a pre-treatment diagnosis and a consultation in which the doctor designs the plan personally. Please check the official page or contact the clinic for a consultation for details.
Related Official Information
You can find more details on the official website.
Repic Clinic official website →
※ This content is for general information only and does not replace a medical diagnosis or treatment. Please consult a medical professional before any procedure. Results, downtime and side effects vary from person to person.
