This is the most important thing to understand about nasolabial filler — and the point most generic guides miss entirely.
Nasolabial folds deepen primarily because of volume loss in the mid-face, not because of the fold itself. As the fat pads in the cheeks reduce and descend with age, the skin loses its structural support and folds where the cheek meets the lower face. Treating only the fold — injecting directly into the crease — can soften its appearance, but it does not address the underlying cause.
For some patients, particularly those with significant mid-face volume loss, restoring volume to the cheeks first produces a more natural and more effective improvement to the smile lines than any amount of direct fold treatment. In these cases, the fold retreats naturally as the mid-face is lifted and supported.
At Dr Hass Clinic, Dr Hasaneen Al-Janabi assesses the full facial context at consultation — not just the fold in isolation. Where mid-face volume is a significant contributor, he will discuss a combined approach or recommend treating the cheeks as the primary intervention. Filling a fold that is driven by cheek descent rather than localised volume loss can result in a heavy, unnatural appearance — something we always aim to avoid.