Nasolabial Fold: What Patients Need to Know

A nasolabial fold is the natural line that runs from each side of the nose to the corners of the mouth. These folds are normal facial features, but they may become more noticeable over time because of aging, sun exposure, skin changes, and loss of facial volume.

Overview: what a nasolabial fold is

A nasolabial fold is the curved crease that extends from the side of the nose to the corner of the mouth. It is a normal part of facial anatomy and is present in children and adults, although it usually becomes more visible with age. Many people notice it when they smile, but deeper folds can remain visible even when the face is at rest.

Patients often use the terms “smile lines” or “laugh lines” for this area. While these names are common, the fold is not caused by smiling alone. It reflects a combination of skin quality, the support of fat and connective tissue beneath the skin, bone structure, and repeated facial movement over time.

For some people, nasolabial folds are simply a natural feature that does not need treatment. Others may seek advice because the folds make the face look tired, heavy, or older than they feel. A careful assessment helps distinguish normal age-related change from a concern that may benefit from medical or aesthetic evaluation.

Why nasolabial folds become more noticeable

The appearance of the midface changes gradually over time. Skin produces less collagen and elastin with age, so it becomes thinner and less resilient. At the same time, facial fat pads can shift downward and lose volume, reducing support in the cheeks and making the fold between the nose and mouth appear deeper.

Sun exposure can accelerate these changes by damaging collagen and contributing to uneven texture and laxity. Smoking, air pollution, poor sleep, and other lifestyle factors may also affect skin quality. Weight changes can play a role as well: weight loss may reduce facial fullness, while weight gain may change how tissues sit around the cheeks and mouth.

Genetics are also important. Some people naturally have stronger facial contours or deeper creases even at a younger age. In practice, a visible nasolabial fold is usually the result of several factors acting together rather than one single cause.

Common features and what patients usually notice

Nasolabial folds may appear as fine lines at first and later become more defined creases. They are often more noticeable in certain lighting or photographs and may deepen when smiling or talking. Some people also notice associated changes such as flatter cheeks, mild jowling, or lines near the mouth.

One side of the face may look slightly different from the other, and mild asymmetry is common. A person may feel that makeup settles into the fold or that the lower face looks heavier than before. These changes are usually gradual, which is one reason many people only become aware of them after comparing newer photos with older ones.

Although nasolabial folds themselves do not cause pain or illness, they can affect self-image. In medical consultation, it is helpful to describe what is most bothersome: the depth of the line, loss of cheek support, skin texture, or overall facial tiredness. This helps guide a more individualized plan.

Assessment and diagnosis

Diagnosis is usually based on a clinical examination. A doctor evaluates the face at rest and in motion, looking at skin thickness, elasticity, sun damage, volume loss, muscle activity, and underlying facial structure. The goal is not simply to identify the fold, but to understand why it has become prominent in that specific person.

Photos may be used to compare both sides of the face and to track changes over time. In many cases, the most effective approach is to assess the whole midface rather than treat the line alone. For example, loss of cheek support can make the fold seem deeper, so restoring balance in nearby areas may sometimes be more natural than focusing only on the crease.

If the concern is part of broader skin aging, a dermatologist or plastic surgeon may also assess wrinkles, pigmentation, and skin laxity. When there are signs of more significant age-related changes, discussion may include non-surgical options as well as facial rejuvenation procedures such as facelift surgery for appropriately selected patients. Some people may also benefit from evaluation in plastic surgery services when there are combined concerns about skin, contour, and soft tissue support.

Treatment options and how doctors choose among them

Treatment depends on the person’s anatomy, age, skin quality, expectations, and preference for non-surgical or surgical care. Many patients do not need any procedure at all. When treatment is desired, the plan usually aims to improve overall facial harmony rather than erase every line, since some natural creasing helps the face look expressive.

Non-surgical options may include medical skin care, sun protection, collagen-supporting treatments, and selected in-office procedures. Injectable fillers are commonly used to soften facial folds or restore midface support, but the choice of product, depth, and placement requires professional assessment. Energy-based treatments and skin resurfacing may be considered when surface texture and mild laxity are also concerns, often alongside dermatology care for overall skin health.

When skin laxity and tissue descent are more advanced, surgical lifting may provide a longer-lasting structural improvement than treating the fold alone. In some cases, the concern overlaps with broader facial aging patterns such as sagging skin or loss of contour, which may be discussed in the context of skin aging. A qualified specialist explains the benefits, limits, recovery considerations, and possible risks of each option so the patient can make an informed decision.

• Skin care and sun protection for prevention and maintenance
• Injectable treatments to restore volume or soften folds
• Resurfacing or energy-based procedures for texture and mild laxity
• Surgery for selected patients with more pronounced tissue descent

Prevention and self-care

Nasolabial folds cannot be completely prevented, because they are part of normal facial anatomy and aging. However, healthy skin habits can help slow the changes that make them more prominent. Daily broad-spectrum sunscreen, avoiding tanning, and not smoking are among the most important steps for protecting collagen and preserving skin quality.

A simple, consistent skin care routine may also help. Gentle cleansing, moisturization, and the use of doctor-recommended active ingredients can support skin barrier function and improve texture over time. Good sleep, regular physical activity, balanced nutrition, and hydration also contribute to general skin health, even though they cannot remove established folds on their own.

It is wise to be cautious with unproven home devices or aggressive techniques promoted online. Over-treating the skin can cause irritation without meaningfully changing a structural fold. If a person is considering treatment, a medical evaluation is the safest way to identify which concerns are due to surface skin changes and which are related to deeper facial support.

When to seek medical care

A gradual deepening of the nasolabial fold over the years is usually a normal cosmetic concern rather than a medical problem. However, medical advice should be sought if a facial crease appears suddenly, especially if it is accompanied by facial drooping, weakness, numbness, difficulty speaking, severe headache, or changes in vision. These symptoms need urgent evaluation because they may point to a neurologic or vascular problem rather than routine aging.

It is also sensible to arrange a review if one side of the face changes noticeably, if there is persistent pain, swelling, a new lump, or skin changes such as ulceration or unexplained redness. These findings are not typical of simple nasolabial folds and should be assessed by a qualified doctor. People who have had previous facial procedures and are concerned about asymmetry or unexpected changes should also seek professional follow-up.

For individuals exploring treatment, consultation is helpful when the folds affect confidence or when there are related concerns such as loss of volume, laxity, or skin damage. Near the end of the care journey, some patients may choose assessment at centers such as Acibadem International, where multidisciplinary specialists in JCI-accredited hospitals evaluate and treat facial aging concerns for international patients.

Frequently asked questions

Are nasolabial folds normal?

Yes. Nasolabial folds are normal facial creases that most people have to some degree. They often become more noticeable with age because skin loses elasticity and the cheeks lose support.

What causes nasolabial folds to deepen?

They usually deepen because of a combination of aging, repeated facial movement, sun exposure, collagen loss, and changes in facial fat and bone support. Genetics and weight changes can also influence how prominent they look.

Can skin care alone remove a nasolabial fold?

Skin care can improve hydration, texture, and sun-related damage, which may soften the overall look of the area. However, it usually cannot fully remove a deeper fold caused by structural volume loss or tissue descent.

What is the best treatment for nasolabial folds?

There is no single best treatment for everyone. The most suitable option depends on skin quality, facial structure, the depth of the fold, and whether the person prefers non-surgical or surgical care.

Are nasolabial folds the same as marionette lines?

No. Nasolabial folds run from the sides of the nose to the corners of the mouth, while marionette lines extend downward from the mouth corners toward the chin. They can appear together, but they involve different facial areas.

When is a facial crease not just a cosmetic issue?

A facial crease should be medically assessed if it appears suddenly or comes with weakness, numbness, facial drooping, pain, swelling, or other neurologic symptoms. These features are not typical of ordinary aging and may need urgent evaluation.

References

• American Academy of Dermatology
• American Society of Plastic Surgeons
• National Institute on Aging
• Mayo Clinic
• British Association of Dermatologists

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.