As we age, one of the most commonly concerned facial wrinkles is the nasolabial fold, which sits at the center of the face.

 

Because of this, consultations regarding nasolabial folds are more frequent than for other areas.

 

However, the area around the nasolabial folds is not considered entirely safe, as important blood vessels run near the nose.

 

Additionally, since it's a part of the face that moves frequently, fillers in this area are more prone to shifting.

 

So, how much filler is appropriate for your own face?

Let’s take a look at some before-and-after cases of nasolabial fold filler treatments to find out.

 

Types of Nasolabial Folds

Why Do Nasolabial Folds Appear? Exploring the Anatomical Perspectives and the Role of Thread-Based Interventions, Gi-Woong Hong (2024)

 

The causes of nasolabial folds can be broadly categorized into three types, each resulting in a different appearance

 

1. Difference in fat layer thickness between the area around the mouth and the front of the cheeks
   　Recommended treatment: Thread lifting

2. Overdeveloped muscles around the mouth
   　Recommended treatment: Botox

3. Depression beside the nose (often associated with protruding mouth structure)
   　Recommended treatment: Filler

 

What’s crucial here is that fillers should not be used for types 1 and 2, so it is essential to distinguish between them.

 

(This article will focus specifically on type 3.)

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55 Part B: Filler Finesse: Cheeks | Plastic Surgery Key

 

The principle behind eliminating nasolabial folds with filler is to fill the “Deep pyriform space” (Ristow's space) beside the nose.

 

There are two methods: either filling this area with filler, or inserting an implant into the space through a cosmetic surgery procedure known as “noble surgery.”

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The Youthful Cheek and the Deep Medial Fat Compartment
Rohrich, Rod J. M.D（2008）

 

It becomes even clearer when viewed from above—
if that area is sunken, the wrinkle appears deeper.

Accurately lifting that specific area is where the practitioner’s skill comes into play and is the most critical point.

 

How many CCs of nasolabial fold filler are appropriate?

 

While it may vary depending on the properties of the filler used,
to conclude, a maximum of 2cc is recommended.

 

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使用量：

Medium-consistency filler: 1.2cc used

 

This patient presented with a combination of multiple types.

 

Therefore, both filler and Botox were used during the procedure,
and only 1.2cc was injected to avoid overcorrection.

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Amount used: Medium-consistency filler, 1cc

 

These two cases are classic examples of wrinkles caused by depressions beside the nose,
which generally require a relatively larger amount of filler.

 

Although more cc would be needed for complete correction,
I avoid using large volumes in the nasolabial fold area due to the increased risk of side effects.

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Amount used: Medium-consistency filler, 0.6cc

 

In this case, the wrinkles were not very deep,
but since the patient was concerned, a small amount was injected.

 

Using only the appropriate amount not only results in a natural finish,
but also helps prevent filler migration and potential side effects.

 

What happens if too much filler is injected?

 

Upward Migration of Filler

 

The vector direction of the muscles around the nasolabial folds mostly pulls toward the cheekbones and upward.

 

Therefore, if too much filler is injected or if it is placed too superficially, the filler will inevitably migrate upward,
potentially making the nasolabial folds appear even more prominent.

Additionally, an important facial artery runs alongside the nose.

 

If filler compresses this area, it can lead to skin necrosis in the glabella, nose, or cheek.

Therefore, if you experience sudden pain or discoloration after the procedure,
it’s essential to dissolve the filler as quickly as possible to prevent the progression of necrosis.

 

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Summary in 3 Lines

1. Treatment methods for nasolabial folds differ depending on the type.

2. To prevent side effects, it is recommended to use less than 2cc of filler.

3. Excessive amounts may cause filler migration and vascular complications.

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I hope this article is helpful to many of you.

 

If you have any questions, feel free to leave a like or comment—

I’ll be happy to respond kindly and thoroughly.

 

Thank you!

 

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📍 Primi Clinic
3F, 52 Seongsuil-ro, Seongdong-gu, Seoul (Primi Clinic)