How to Approach the “Smile Lines” aka Nasolabial Folds

Written by: Brielle Kirk, PA-C

Hate those lines extending downward from your nose towards your mouth? They are often referred to as “smile lines,” but they are really called nasolabial folds (NLF). I would say they are one of the most common complaints I hear from patients consulting at our medical spa. It is normal to have them and we do not want to completely eliminate these folds, for that would look completely unnatural. However, as we age, the NLF become heavier and the folds become deeper. For appropriate correction, we want to alleviate their heaviness and prevent further sagging from occurring. In this blog, I will address some misconceptions about correcting the NLF and ways to achieve correction.




1. Botox treats NLF – False! Botox cannot be used for correction of the NLF. Botox weakens muscles, and we do not want to weaken the muscles that allow you to smile and make mouth movements for speaking.

2. Treat just the NLF – Not necessarily. More often than not, the NLF are created from volume loss or heaviness in the cheeks. Usually, one must correct the cheeks before the NLF themselves. If someone is young and has great cheek volume/no sagging, this is the only instance in which the NLF could be injected directly.

1. Sleep on your back – When you put your head down to sleep, your face compresses against the pillow, which causes the skin on your face to fold. Not only that, but you’re in that position for hours at a time! This absolutely contributes to fine lines and wrinkles, and it is best to try sleeping on your back to help smooth out those lines over time!
2. Lasers – Laser treatments help with skin laxity, fine lines and wrinkles. How so? They induce trauma to the skin which then allows for stimulation of collagen and elastin. Every laser is different, so take a look at our blog posts for more information. Specifically, read those about Morpheus8 and Neogen, for these lasers are GREAT with improving skin laxity, texture, fine lines and wrinkles. They do an amazing job with lifting the skin, and will absolutely help with NLF. Sciton’s Halo and BBL also do a wonderful job with antiaging of the skin and also if you have some pigmentation and vascular issues!
3. Fillers – As discussed above, fillers can be used to correct heavy NLF. Fillers are made of hyaluronic acid gel and help to smooth out wrinkles as well as provide a lift. Juvederm Voluma is a great filler for volume replacement in the cheeks and to provide an upward lift. If one already has appropriate cheek volume, Juvederm Ultra or Ultra Plus, or Vollure can be used to directly fill the NLF depending on how heavy they are. Your injector will assess you and choose the right filler for you!

I hope this helps you better understand the NLF and approach to treatment. Please contact our office for consultation of your NLF if this is something that bothers you and one of our providers will absolutely guide you in the right direction!

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