[Doctor's Column] Nasolabial Folds Are Not 'Wrinkles': Why You Should Not Inject Fillers into the Nasolabial Folds First

"My nasolabial folds have deepened, so I came to get fillers." This is one of the most frequently heard comments in the consultation room. However, quite a few people have experienced that even after getting fillers in their nasolabial folds, "my face looks heavier" or "it went back to how it was after a few months." The reason is simple. This is because nasolabial folds are mostly not 'wrinkles'.

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▶ Q. If nasolabial folds are not wrinkles, what are they?

・ Here is a simple experiment. After checking your nasolabial folds in front of a mirror, Lie flat on your back looking at the ceiling Look. In most cases, one's fate fades or disappears.

・ As a result of a survey conducted by Japanese researchers on 108 women aged 20 to 60 ( Skin Research and Technology, 2012 ), when switching from a sitting position to a lying position, the nasolabial folds significantly decreased or disappeared, Only 13.8% of 'real wrinkles' remain even after changing posture. I did.

・ In other words, 86% of nasolabial folds are not lines etched into the skin The 'boundary' formed as the upper ball comes down and folds The problem is not at the corners of the mouth, but above them.

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▶ Q. Then why does the upper ball come down?

・Deep cheek fat is reduced. Facial fat is not a single mass but is divided into several compartments (sections). Plastic and Reconstructive Surgery, 2007 Among them, when the 'deep inner cheek fat' beneath the cheekbones decreases with age, the skin and superficial fat resting on top lose their support and sag downwards. The same research team calls this phenomenon 'pseudo-sagging,' and The nasolabial folds faded after replenishing deep fat. He reported ( 2008 ).

・The provincial district moves down. A study comparing the faces of young and old people using CT ( Plastic and Reconstructive Surgery, 2012 It was confirmed that as one ages, the mid-facial fat compartment moves downward, and within the compartment, the volume shifts downward.

・Dermal elasticity decreases. In the previously mentioned study, the severity of nasolabial folds was higher as skin elasticity levels decreased and the subcutaneous fat layer became thicker. This means that the loosened skin is unable to support the heavy cheeks.

❙ Image: Produced by Maypure Doctor Column

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▶ Q. So, why shouldn't you get fillers into your nasolabial folds first?

・ Filling the nasolabial folds with filler is the folded line Filling from below This is the method. Since it essentially only covers the folds while leaving the cause of the cheeks sagging intact, they return to their original state once the volume is absorbed, and if too much is added, the area around the mouth may look heavy.

・ Nasolabial fold filler is not a wrong procedure. However, order This is important. If the cause is "sagging of the upper cheeks and loss of volume," the general approach is to address that area first and then finish the remaining grooves with a small amount.

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▶ Q. How do you approach our Yeonsinnae branch?

At Maypure Clinic Yeonsinnae Branch, we view nasolabial folds not merely as the "corners of the mouth" but as the "entire mid-face," and proceed according to the cause as follows.

1) Approach to raising a descending ball: Coolsonic · Density · Inmode FX
・ CoolSonic (HIFU) creates thermal coagulation points in the deep layers of the skin and fascia to contract tissues and induce collagen regeneration. A study conducted on 22 Koreans ( Dermatologic Surgery, 2011 After just one treatment, two evaluators confirmed that improvement in nasolabial folds and jawline was observed in all patients, and 77% reported feeling a noticeable improvement in nasolabial folds.
・ Density (high frequency) and InMode FX are devices that address both sagging fat and elasticity in the lower cheeks, and are selected based on the pattern of sagging.

2) Approach to replenish reduced deep fat: Olidia (PLLA) · Cheek filler
Olidia is a volumizer that induces collagen production to gradually restore the support structure of the sunken area below the cheekbones. It is performed multiple times at intervals of at least 4 weeks, and changes become visible with each subsequent session.
・ When immediate support is needed, support the upper part first with anterior cheek filler (Neuramis).

3) Remaining furrows: Apply nasolabial fold filler last, in a small amount.
・ After trimming the upper area, fill only the necessary amount into the remaining folds. This reduces the amount of filler used and lowers the burden of the face looking heavy.

・ It is our Yeonsinnae branch's policy to administer heat-sensitive injectables (such as Olidia) after energy equipment procedures. Director Sim Dong-gyu will determine the order and combination based on the chart records during the consultation.

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▶ Q. Do you have any habits in your daily life that deepen your fate?

・The habit of sleeping on one's side. If one cheek is pressed against the pillow, that side of your face is prone to becoming more pronounced. If the depth of your facial folds differs between the left and right sides, check your sleeping posture first.

・Rapid weight change. If you lose weight rapidly, the fat in the deep cheeks will decrease first, causing your nasolabial folds to suddenly become more prominent. It is better for your face to control your weight gradually.

・UV protection. This is the most basic and affordable way to maintain dermal elasticity.

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▶ Summary

Most nasolabial folds are not etched wrinkles, but rather the boundary lines formed by the upper cheeks descending and folding.
So, the order is "raise the ball and fill → add a small amount to the remaining grooves."
・ The effects and duration of the results may vary depending on individual skin condition.

Chief Director Sim Dong-gyu of Maypure Clinic Yeonsinnae Branch
· Graduated from Korea University College of Medicine
· Master of Medicine, Korea University School of Medicine
· Full member of the International Society of Aesthetic Plastic Surgery
· Regular member of the Korean Society for the Study of Obesity
· Regular member of the Korean Society of Aesthetic Plastic Surgery and Laser Medicine
· Allegan Juvederm Expert Member

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📍 Maypure Clinic Yeonsinnae Branch
3rd Floor, Metro Tower, Directly Connected to Yeonsinnae Station (856 Tongil-ro, Eunpyeong-gu, Seoul)
☎ 02-389-9980
Clinic Hours: Weekdays 10:30–20:30 / Saturdays 10:00–17:00 / Closed on Sundays and Public Holidays

Skin concerns vary from person to person. After a consultation, we will guide you to the most suitable treatment based on your records.

※ This post is intended to provide general information about the procedure, and the effects and recovery period may vary depending on individual skin conditions.
※ Please be sure to consult thoroughly with medical staff before the procedure. Swelling, bruising, and redness may temporarily occur after the procedure.

References
1. Ezure T, Amano S. Involvement of upper cheek sagging in nasolabial fold formation. Skin Res Technol. 2012;18(3):259-64.
2. Rohrich RJ, Pessa JE. The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plast Reconstr Surg. 2007;119(7):2219-27.
3. Rohrich RJ, Pessa JE, Ristow B. The youthful cheek and the deep medial fat compartment. Plast Reconstr Surg. 2008;121(6):2107-12.
4. Gierloff M, et al. Aging changes of the midfacial fat compartments: a computed tomographic study. Plast Reconstr Surg. 2012;129(1):263-73.
5. Suh DH, et al. Intense focused ultrasound tightening in Asian skin: clinical and pathologic results. Dermatol Surg. 2011;37(11):1595-602.

#Yeonsinnae Dermatology #Yeonsinnae Nasolabial Folds #Yeonsinnae Lifting #Yeonsinnae Coolsonic #Eunpyeong-gu Dermatology #Yeonsinnae Olidia #Yeonsinnae Nasolabial Fold Filler

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