Conditions · Face · Lines & Wrinkles

Nasolabial Folds Treatment Singapore: Smile Lines, Lifting Before Filling

Medically reviewed by Dr Sin Yong · Last reviewed · 18 min read · Assessed personally by Dr Sin Yong · Jump to questions

The nasolabial fold is the line running from each nostril to the corner of the mouth — present in every smiling face, and deepening at rest with age. Here is the counterintuitive truth of modern practice: the fold is usually the shadow of a problem happening above it, in the cheek — which is why the least sophisticated treatment is the one everyone asks for: filling the line itself.

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Nasolabial folds treatment starts with the cheek above the fold, not the line itself. Where cheek deflation drives the fold, support is restored at the mid-face; where descent drives it, lifting such as VF Lift – Vertical Facelift is considered; conservative, deep filler at the fold comes last. Skin-quality treatment improves how the crease reflects light.

In brief
  • The nasolabial fold is a structural crease where the mobile cheek meets the fixed upper lip; every face has it.
  • It deepens with age as cheek fat compartments deflate and descend and tissue piles against the fold from above.
  • Assessment starts with the cheek above the fold; the line itself is treated conservatively and last.
Key takeaways
  • The nasolabial fold is a structural crease where mobile cheek meets the fixed upper lip; every face has it.
  • It deepens with age as cheek fat compartments deflate and descend and tissue piles against the fold from above.
  • Assessment starts with the cheek above the fold; the line itself is treated conservatively and last.
  • Filling only the line, face yoga and smile line creams do not address the cause.
  • Dr Sin Yong, an aesthetic physician, assesses the mid-face personally; treatment is elective.
An East Asian woman in her mid 40s smiling softly — illustrative image
Illustrative image — not a patient.

LookalikesOften read as a line problem when it is a cheek problem: a fold that has deepened alongside a flatter mid-face and hollowing above it usually reflects cheek deflation or descent rather than a crease in the skin itself. hollow cheeks and volume loss.

Key Facts

What it is
The junction where mobile cheek tissue folds against the fixed upper lip — a structural crease, not a wrinkle
Why it deepens
Cheek fat compartments deflate and descend with age, piling tissue against the fold from above
The at-rest threshold
Visible in animation is normal at any age; carved-in at rest is the ageing change
The classic error
Volume injected into the fold itself — adding bulk where tissue is already piling up
The evidence
Meta-analysis of randomised trials supports HA filler for fold correction — technique and placement drive results
The overfill risk
A heavy, flattened mid-face — the pattern covered in the pillow face guide
Who assesses this
An aesthetic physician — reading the cheek above before the fold itself
Typical first step
Mid-face assessment; the fold is treated cause-first, not line-first
In brief

Nasolabial folds treatment in Singapore starts with the cheek above the fold, because smile lines, also called laugh lines, deepen mainly as the cheek descends and loses support. Lifting such as the VF Lift – Vertical Facelift, well-placed filler, or both are considered after assessment; smile line fillers in the crease itself are kept for a finishing step.

What is nasolabial fold treatment?

Nasolabial fold treatment aims to soften the smile lines from the nose to the mouth corners by treating what deepens them, usually a cheek that has descended or deflated. Dr Sin Yong lifts first, with the VF Lift – Vertical Facelift or Time Freeze Laser LCLR®, and uses filler sparingly, where support or an etched crease still needs it.

What do nasolabial folds look like?

The nasolabial fold (circled) — the crease from nose to mouth corner that deepens with age
The nasolabial fold (circled) — the crease from nose to mouth corner that deepens with age. Image: Mikael Häggström, from original by Sue Campbell/U.S. Air Force, via Wikimedia Commons (Public domain).
Nasolabial folds seen from the front and in profile
Nasolabial folds seen from the front and in profile. Image: Patin E et al., International journal of women's dermatology (2026), via PubMed Central (CC BY).

Why does the nasolabial fold deepen with age?

Every face has this fold — it is where the mobile cheek meets the fixed upper lip, and it creases every time you smile. What changes with age is the traffic arriving from above: the cheek's fat compartments — discrete, named structures in the anatomical literature [2] — deflate and slide downward, and the descending tissue piles up against the fold like snow against a fence. The fold does not so much deepen as become the collection point for everything the mid-face is losing. That is why it appears alongside cheek volume loss and early jowling — three symptoms of one descent.

The root cause of nasolabial folds: fat, ligament, bone, skin or muscle

The root cause of a deep nasolabial fold is rarely the crease itself. A 2025 paper on assessing nasolabial folds in Chinese patients sorted them by cause into skin, fat pad, bone retrusion, muscular and mixed types, and argued that treatment should follow the cause. In practice most folds are mixed, and the mix decides the plan.

Five causes, often together

  • Fat that descends. A computed tomography study of cadaver heads found that the midfacial fat compartments shift downward with age, with volume moving to the lower part of each compartment and loss in the deep medial cheek fat. That descent loads the fold from above.
  • Ligaments that loosen. The retaining ligaments of the cheek hold the fat pads in place. As they slacken, the malar fat slides toward the fold.
  • Bone that recedes. A 2012 review of skeletal ageing named the maxilla, including the area around the opening of the nose, among the bones that lose volume predictably with age. Less support beneath the upper fold deepens it, and some people are born with a flatter mid-face.
  • Skin that etches. Thinning dermis along the crease folds the same way with every smile until a line stays at rest.
  • Muscle that creases. Strong upper-lip elevator muscles crease the fold deeply on smiling. A fold that shows only in animation is normal.

How the cause changes the treatment

Descent and laxity are lifted first with the VF Lift – Vertical Facelift, monopolar radiofrequency on Volnewmer. Heaviness from fat or settled product above the fold is treated with Time Freeze Laser LCLR®, and the two can be combined. Where bone support is genuinely lacking, a firmer product on the bone, usually CaHA or PCL, may be considered. An etched crease may take a small amount of soft hyaluronic acid filler as a finishing step. Filler is used as needed, but sparingly; the choices are set out on nasolabial fold filler. A fold that is mostly muscle in animation is usually left alone.

Why filling the line itself is often the wrong move

The intuitive treatment — inject the crease — treats the shadow and ignores the object. Meta-analytic evidence supports hyaluronic-acid fillers for nasolabial fold correction [1], but modern technique reads that evidence anatomically: restoring the deflated cheek above often softens the fold more naturally than loading the fold itself, because it removes the tissue traffic rather than padding the collection point. Direct fold treatment still has a role — conservative, deep, and structural — but as the finishing move, not the opening one. Overfilled folds and cheeks are precisely how faces end up in pillow face territory, and unpicking that costs more than doing it right once.

Nasolabial folds treatment without filler: where VF Lift and Time Freeze fit

Nasolabial folds treatment without filler is possible when the fold is driven by descent or by heaviness above it, rather than by lost volume. Dr Sin Yong’s two protocols work on those two causes.

  • Descent with skin laxity. The VF Lift – Vertical Facelift heats the dermis and subcutis along vertical vectors with Volnewmer monopolar radiofrequency, working on the laxity that loads the fold. Its Sculpt mode flattens fullness beside the fold.
  • Fat, or old filler, piled above the fold. Time Freeze Laser LCLR® tightens mid-face tissue at several depths of the dermis, working on the fold from above rather than filling it from below, and its Sculpting mode is directed at sagged fat in the nasolabial area and at settled product. No redness, no downtime.

Both work on your own tissue. Nothing is injected, so there is no filler to overfill, migrate or form lumps beside the nose. Change builds gradually and varies. Where hyaluronic acid filler is already causing puffiness, it is dissolved first; where the excess is a biostimulator, it is mapped with ultrasound before any heat.

What they cannot do, and when smile line fillers or another tool fits

Neither protocol replaces cheek volume that has deflated or fills a crease etched into the skin. A deflated mid-face needs support restored at the cheek, and an etched line may still need conservative, deep filler at the fold as a finishing step. A defined descent may suit a thread lift, focused ultrasound reaches the SMAS where the face has normal fullness, and marked laxity with skin excess is referred for a surgical opinion. Compare the routes on VF Lift vs fillers and face lifting without fillers.

What actually works for nasolabial folds?

Assessment starts above the fold: how much is cheek deflation (restore support at the cheek and mid-face), how much is descent (the lifting conversation — VF Lift, HIFU-class energy), and how much is the fold's own etching (conservative structural filler at the fold, supported by the trial literature [1]). Skin-quality work — bio-remodelling, polynucleotides — improves how the crease reflects light. Most faces need the sequence, not a syringe in the line.

What doesn't work for nasolabial folds?

Face yoga against a structural fold — the crease is anatomy, not weakness. 'Smile line' creams — no topical reaches the fold's depth. Aggressive filling of the fold alone — the classic route to a heavy, simian mid-face that reads worse than the line did. And treating the fold while ignoring the deflating cheek above it — the traffic keeps arriving, and so do the appointments.

“The nasolabial fold is usually the shadow of the cheek above it — fill the shadow and you've padded the collection point while the descent continues.”

— Dr Sin Yong
A woman in her thirties in soft profile light (illustrative image, not a patient)
Illustrative image — not a patient.

Dr Sin Yong’s Viewpoint

The nasolabial fold is where I most often decline the treatment a patient arrives asking for. Filling the line is intuitive, quick to sell, and frequently wrong — the fold is usually collecting what the cheek above is losing. I treat the cause first, the crease last, and conservatively. It takes longer to explain than to inject, which is exactly why the explanation matters.

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Which type do you have?

Types of nasolabial fold and look-alikes: how each is recognised and what it needs
Type / look-alikeHow to recognise itWhat it needsWhat does not work
Cheek-deflation foldEmptied mid-cheek above a deepening fold, often after weight lossSupport restored at the cheek and mid-faceFilling only the line itself
Descent-driven foldCheek tissue sits lower and piles against the foldLifting, such as VF Lift – Vertical Facelift, where indicatedAdding filler, which adds weight in the wrong place
Fold etched at restCrease visible at rest, not only when smilingConservative, deep structural filler at the fold, as a finishing stepOverfilling, which flattens the cheek-to-lip transition
Fold with surface quality changeFine lines and a crease that reflects light unevenlySkin-quality treatment such as bio-remodelling or polynucleotidesSmile line creams, which do not reach the fold's depth
Marionette lines (look-alike)Lines running down from the mouth corners, separate from the foldSeparate assessment of lower-face supportTreating them as the same fold

What does not work, and why

When to see a doctor

Related
Guide: thread lift Singapore — what PDO, PCL and PLLA threads can and cannot do, and when the VF Lift fits instead.

Your next step
  1. 1. MessageWhatsApp +65 8023 7170 with what is bothering you. A reply comes from the clinic, not a bot.
  2. 2. AssessmentDr Sin Yong examines you himself on Orchard Road, with ultrasound where earlier filler is involved.
  3. 3. A plan in writingWhat he would do, what he would not, the fee factors, and the option of no treatment.

Every treatment is performed by Dr Sin Yong personally. Singapore Medical Council registered · invited to share his clinical expertise internationally as a Key Opinion Leader for CLASSYS, DEKA, HIRONIC, FOTONA, ALMA, LUTRONIC and ILOODA · HSA-registered devices · ultrasound-guided correction

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A woman in her thirties in soft profile light (illustrative image, not a patient)
Illustrative image — not a patient.

Myths we hear in clinic

“Filling the line is the standard fix for a nasolabial fold.”

The fold is usually the shadow of the cheek above, so filling it alone pads the collection point while descent continues.

“Face yoga can strengthen a fold away.”

The crease is structural anatomy rather than muscle weakness, so exercise does not reach it.

Questions Patients Actually Ask

How do you get rid of nasolabial folds?+
A nasolabial fold cannot be removed, because it is normal anatomy, but what has deepened it can be treated. Dr Sin Yong starts by lifting: the VF Lift – Vertical Facelift for descent and laxity, and Time Freeze Laser LCLR® where fat or settled product sits above the fold. Filler is used sparingly, for bone support or an etched crease that remains. Daily sunscreen, not smoking and a stable weight slow the changes that deepen it.
What is the most effective treatment for nasolabial folds?+
The treatment that matches the cause of your fold. Where the cheek has descended or the skin has loosened, lifting comes first, which is why Dr Sin Yong leads with the VF Lift – Vertical Facelift or Time Freeze Laser LCLR®. Where bone or deep fat support has been lost, a small amount of filler may be added for support. An etched crease may take conservative, deep hyaluronic acid filler last. Filling the line alone adds weight where tissue is already piling up.
What is the root cause of nasolabial folds?+
The root cause is change in the cheek above the fold rather than in the fold itself. With age the midfacial fat compartments descend and deflate, the ligaments that hold them loosen, and the bone beside the nose recedes, so tissue piles against the fixed upper lip. Thinning skin and strong smile muscles deepen the crease further, and weight loss, sun exposure and smoking speed these changes.
Can nasolabial folds be reversed naturally?+
Not in the sense of removing them. The fold is anatomy, and face yoga, massage and creams do not reach the fat, ligaments and bone that deepen it. Natural measures can slow the change: daily broad-spectrum sunscreen, not smoking, avoiding large swings in weight, and a retinoid for skin quality if your doctor agrees. Where the fold has already deepened, an examination decides whether lifting or support is needed.
Can lifting the nasolabial folds cause overfilling like filler?+
Not from product, because nothing is injected. The VF Lift – Vertical Facelift and Time Freeze Laser LCLR® use heat to work on the laxity and heaviness that load the fold, so there is no filler to overfill, migrate or form lumps beside the nose. Heat has its own risks, such as redness, tenderness and, rarely, a blister or pigment change. A fold driven by lost cheek volume still needs support.
Are fillers the right way to treat smile lines?+
Sometimes, but rarely as the first step. Smile lines usually deepen because the cheek above has deflated or descended, so the cause is treated first: support at the mid-face where volume is lost, and lifting where tissue has descended. Filler placed in the line itself is kept conservative and deep, as a finishing step for a crease that remains. Hyaluronic acid is preferred there because it can be dissolved with hyaluronidase.
Are smile lines and laugh lines the same thing?+
Yes. Smile lines and laugh lines are everyday names for the nasolabial folds, the lines running from each side of the nose to the corners of the mouth. Marionette lines, which run down from the mouth corners toward the chin, are a separate crease with different causes, so the two are assessed separately.
What causes smile lines to get deeper?+
The fold itself is normal anatomy. It deepens at rest mainly because the cheek above deflates and descends, so tissue piles against the fold. Weight loss, sun damage and thinning skin add to it. Because the cause usually sits above the line, treatment starts with the cheek rather than with filling the line itself.
Do smile lines go away on their own?+
No. The fold is part of every face and forms each time you smile. What can change is how deep it sits at rest. Sun protection and avoiding large swings in weight help slow the changes that deepen it; where it has already deepened, the plan depends on whether deflation, descent or etched skin is driving it.
Are nasolabial folds normal?+

Completely — every face makes them in animation at every age. The ageing change is when they carve in at rest. Treatment is elective aesthetics, never necessity.

Why did mine deepen after losing weight?+

Facial fat loss deflates the cheek compartments, and the deflating tissue settles against the fold. Significant weight loss commonly deepens nasolabial folds even as the body improves.

Is filler in the nasolabial fold safe?+

In experienced hands, with conservative technique, the trial evidence supports it — though this area contains the facial artery's path, which is exactly why anatomy-led injection matters here.

Why do some filled nasolabial folds look strange?+

Overfilled folds flatten the natural transition between cheek and lip, producing the heavy 'monkey mouth' look. Restraint and treating the cause above the fold is the difference.

Can HIFU or lifting treatments soften nasolabial folds?+

When descent is the driver, repositioning cheek tissue reduces what piles against the fold — often more naturally than any filler in the line.

Will the fold come back after treatment?+

The ageing process continues, so maintenance applies to every approach. Sequenced cause-first treatment tends to hold its result more gracefully than fold-stuffing.

At what age do nasolabial folds start to show at rest?+
There is no fixed age. The fold is present in animation at every age, and when it begins to stay visible at rest depends on bone structure, cheek fullness, weight changes and sun exposure more than on the calendar.
Can nasolabial folds be improved without filler?+
Sometimes. Where descent and laxity are the driver, energy-based lifting such as VF Lift – Vertical Facelift or focused ultrasound works on the tissue that piles against the fold, and skin-quality treatment improves how the crease reflects light. Where cheek volume loss is the driver, those approaches cannot replace the missing volume.
Is hyaluronic acid filler in the nasolabial area reversible?+
Hyaluronic acid filler can be dissolved with hyaluronidase if required, which is one reason it is preferred in this area. Collagen-stimulating fillers do not dissolve in the same way, which makes conservative planning more important when they are considered.
How is a nasolabial fold assessed at consultation?+
The fold is examined at rest and in animation, from the front and in profile, together with the cheek above it, the jawline below and the quality of the skin. Previous filler or threads are noted, because earlier product changes the plan. Only then is the balance of deflation, descent and etching decided.
Can a thread lift help smile lines?+
Where the fold is fed by a cheek that has descended, cog threads placed from a temporal anchor across the cheek reposition the malar fat pad. Threads add no volume, so where the fold is driven by volume loss they do not resolve it on their own, and filler is assessed separately.
What causes nasolabial folds?+
The fold is where mobile cheek meets the fixed upper lip, so it creases with every smile. With age, cheek fat compartments deflate and slide downward, and the descending tissue piles against the fold. Bone structure, cheek fullness, weight changes and sun exposure influence when it stays visible at rest.
Can nasolabial folds be fully removed?+
No, because the fold is normal anatomy present in every face. Treatment addresses what deepens it, such as cheek deflation or descent, and softens how pronounced it looks at rest. Ageing continues, so maintenance applies to every approach, and an assessment decides whether treatment is advised.
Which treatment suits nasolabial folds?+
It depends on what drives the fold. Cheek deflation suits restoring support at the mid-face, descent suits lifting, and an etched fold may suit conservative deep filler as a finishing step. Skin-quality treatment improves how the crease reflects light. Most faces need a sequence rather than a single injection.
How much does nasolabial fold treatment cost in Singapore?+
The fee depends on whether the cheek, the descent or the fold itself is treated, the product or device used, the areas involved, and whether treatments are combined in sequence. A written quote is given at consultation after mid-face assessment, and the assessment decides whether treatment is advised at all.

References

  1. Tissue Fillers for the Nasolabial Fold Area: A Systematic Review and Meta-Analysis of Randomized Clinical Trials — Aesthetic Plastic Surgery (PubMed).
  2. The Fat Compartments of the Face: Anatomy and Clinical Implications for Cosmetic Surgery — Plastic and Reconstructive Surgery (PubMed).
  3. The Assessment, Strategy, and Treatment Protocol: Nasolabial Fold Assessment, Strategy, and Treatment With Hyaluronic Acid Fillers in Chinese Patients (Li Q, Cui H, Tseng FW, et al.). Plastic and Reconstructive Surgery Global Open, 2025. pmc.ncbi.nlm.nih.gov
  4. Aging changes of the midfacial fat compartments: a computed tomographic study (Gierloff M, Stöhring C, Buder T, et al.). Plastic and Reconstructive Surgery, 2012. pubmed.ncbi.nlm.nih.gov
  5. Changes in the facial skeleton with aging: implications and clinical applications in facial rejuvenation (Mendelson B, Wong CH). Aesthetic Plastic Surgery, 2012. pubmed.ncbi.nlm.nih.gov

Why do some people have deep nasolabial folds when they are young?

Deep nasolabial folds at a young age usually reflect anatomy rather than ageing. The fold forms where the mobile cheek meets the fixed upper lip, so anything that makes the cheek fuller or the support beneath it flatter deepens the crease — even in someone in their twenties with no laxity at all.

An East Asian woman in her mid 40s smiling softly — illustrative image
Illustrative image — not a patient.

The common contributors are structural. A flatter mid-face skeleton, with less forward projection of the upper jaw beside the nose, gives the cheek less to rest on. A full medial cheek fat pad adds weight on the cheek side of the fold. Strong upper-lip elevator muscles crease the fold deeply with every smile, and habitual expression repeats that crease many times a day.

Weight changes play a part too: rapid loss deflates the cheek, while weight gain adds bulk that folds more heavily. Sun exposure and smoking matter more later, through skin quality. The practical consequence is that a young, deep fold is rarely a reason for filler in the line. It calls for reading the cheek and skeleton first — and sometimes for no treatment, because a fold that only shows in animation is normal.

Nasolabial folds, marionette lines and smile lines — what is the difference?

Smile lines and laugh lines are everyday names for the nasolabial folds; marionette lines are a separate crease. The nasolabial fold runs from each nostril to the corner of the mouth. Marionette lines run downward from the corners of the mouth toward the jawline and chin, and they belong to the lower face rather than the mid-face.

The distinction matters because the causes differ. The nasolabial fold is fed by deflation and descent of the cheek above it. Marionette lines are shaped by changes around the jawline and chin — loss of support, descent of tissue toward the jowl, and the pull of the muscle that draws the mouth corners down. A face can show one without the other, and treating the wrong one leaves the visible problem in place.

Vertical lines on the upper lip are a third, unrelated group: fine etched lines from lip movement and skin quality, treated very differently again. In consultation, the first task is to name which lines are present and which one is actually bothering you, because a plan for the fold does little for the mouth corners, and the reverse.

Deep smile lines treatment in Singapore: when the crease is set in the skin

Deep smile lines treatment depends on one question: is the crease still a fold that opens when the cheek is supported, or has it become a line set into the skin itself? Most deep smile lines are both. The cheek above has deflated or descended, and years of folding in the same place have also etched the skin along the crease.

woman in her forties, front view, natural cheek contour, gold earring
Illustrative image — not a patient.

How a set-in crease is recognised

At assessment the fold is examined at rest, on smiling and with the cheek gently supported by hand. If the crease almost disappears when the cheek is lifted, the main problem sits above it, in the mid-face. If a sharp line remains even with the cheek supported, part of the problem is in the skin: the dermis along the crease has thinned and lost elasticity, so it folds the same way every time. Sun damage, smoking, weight changes and thin skin make this more likely. Profile and three-quarter views show how much of each is present.

What is considered for a deep crease

  • Support above first. Where the cheek has deflated, restoring support at the mid-face reduces the tissue piling against the fold, and the crease is reassessed before anything is placed in it. See hollow cheeks and volume loss.
  • Lifting where descent leads. Radiofrequency such as VF Lift – Vertical Facelift, or focused ultrasound, works on the laxity that loads the fold. Neither fills a line.
  • Conservative, deep filler at the fold. Once the cause above has been addressed, a small amount of hyaluronic acid placed deep along the crease softens what remains. It is a finishing step, and hyaluronic acid can be dissolved with hyaluronidase if needed. The choices are set out on nasolabial fold filler.
  • Skin-quality treatment. Bio-remodelling and polynucleotides improve thin skin along the crease, so it reflects light more evenly. See skin boosters.

What a deep crease does not need

Filling a deep line heavily to flatten it is the usual route to a heavy, flattened cheek-to-lip transition. A crease set into the skin rarely disappears completely, so treatment aims to soften how deep it sits at rest rather than erase a normal fold. Filler placed too close to the surface to chase an etched line can show as a ridge or a bluish tint. Earlier filler in the area changes the plan, so it is checked first, with ultrasound where needed; problems after filler are covered on smile line filler gone wrong.

Dr Sin Yong examines the fold, the cheek above and the skin over the crease himself, and the plan is written as a sequence: what is treated first, what is reassessed, and what may not need treating at all.

When is a nasolabial fold beyond non-surgical treatment?

A nasolabial fold is beyond non-surgical treatment when the descent and loose skin behind it are greater than restoring volume or tightening can address. The signs are usually visible together: heavy tissue hanging over the fold, established jowls, a loose neck and skin that gathers rather than springs back when gently lifted.

In that situation, adding more filler is the route to a heavy, overfilled mid-face, and energy-based lifting may soften but not reposition the tissue. A surgical facelift or mid-face lift repositions descended tissue and removes excess skin, which is something no injectable or device does. Patients in that category are told so plainly and referred to a plastic surgery specialist for assessment.

Surgery is not the end of the conversation. A lift repositions tissue but does not restore the volume the cheek has lost, nor improve skin quality, so conservative volume and skin treatment may still have a role afterwards. The point of assessment is to match the treatment to the stage of the face, rather than stretching one approach beyond what it can do.

An East Asian woman in her mid 40s smiling softly — illustrative image
Illustrative image — not a patient.
Nasolabial fold treatment options compared by cause
OptionWhat it doesWhat it cannot doTypical recoveryWho it tends to suit
Cheek and mid-face support with hyaluronic acid fillerRestores deflated cheek fat compartments above the fold, reducing the tissue that piles against itReposition heavy descent or erase a fold that has etched into the skinPossible swelling and bruising that settle; hyaluronic acid can be dissolved with hyaluronidase if requiredA fold driven mainly by cheek volume loss
Conservative, deep filler at the foldSoftens the fold's own etching as a finishing stepAddress the deflation and descent above that feed the fold; overfilling flattens the cheek-lip transitionPossible swelling and bruising that settle; reversible with hyaluronidase if hyaluronic acid is usedAn etched crease that remains once the cause above has been addressed
VF Lift – Vertical Facelift (Volnewmer monopolar radiofrequency)Heats the deeper skin to work on laxity and the descent that loads the foldReplace lost volume or fill an etched lineVaries between patients; discussed at consultationDescent with skin laxity, where volume is reasonably preserved
HIFU (focused ultrasound)Delivers focused ultrasound energy to deeper tissue layers to address descentReplace lost volume or treat skin qualityVaries between patients; discussed at consultationDescent-led folds in a face that does not need volume
Skin-quality treatment (bio-remodelling, polynucleotides)Improves skin quality so the crease reflects light more evenlyChange the structure beneath the fold or fill itSmall raised injection points that settleThin or crepey skin over a moderate fold
Facelift surgery — referred to a plastic surgery specialistSurgically repositions descended mid-face and lower-face tissue and removes excess skinRestore lost volume on its own or change skin qualitySurgical recovery, guided by the operating teamAdvanced descent and skin excess beyond the reach of non-surgical treatment

Medically reviewed by Dr Sin Yong, MBBS (NUS), MRCS (Edinburgh) · Last updated 21 October 2026 · Editorial policy

How do you get rid of smile lines?

Smile lines cannot be erased entirely, because the nasolabial fold is normal anatomy that forms every time you smile; what treatment can change is how deeply it sits at rest. Getting rid of a deepened fold starts with finding out what is feeding it, not with treating the line itself.

Three causes are separated at assessment. Where the cheek above has deflated, support is restored at the mid-face and the fold is reassessed before anything is placed in it. Where tissue has descended, lifting is the conversation: radiofrequency such as VF Lift – Vertical Facelift, focused ultrasound, or a thread lift for a defined descent. Where the crease has etched into the skin, conservative, deep filler at the fold is the finishing step, and skin-quality treatment improves how the crease reflects light.

Creams, face yoga and gadgets do not reach the structures involved. Sun protection and avoiding large swings in weight address two of the things that deepen the fold over time, and where descent and loose skin are advanced, referral to a plastic surgery specialist is the honest answer.

Smile lines: filler vs thread lift vs energy device
ApproachWhat it addresses in smile linesLimitsWhere it fits
Hyaluronic acid filler, cheek firstRestores deflated cheek support above the fold; conservative, deep filler at the fold softens remaining etchingDoes not reposition heavy descent; overfilling flattens the cheek-to-lip transitionVolume-led folds, with the fold itself treated last, if at all
Thread lift (Bliss Lift, PDO and PCL cog threads)Repositions a descended malar fat pad along vectors from a temporal anchor across the cheekAdds no volume and removes no skin; a fold driven by volume loss is not resolved by threads aloneDescent-led folds with skin that still has elasticity
Radiofrequency (VF Lift – Vertical Facelift, Volnewmer monopolar RF)Heats the dermis and subcutis along vertical vectors to work on the laxity that loads the foldCannot replace lost volume or fill an etched lineLaxity where volume is reasonably preserved
Focused ultrasound (HIFU)Places thermal coagulation points in deeper layers to work on descentCannot replace volume; used with caution in thin faces because of the risk of fat lossDescent-led folds in a face that does not need volume

Lifting the nasolabial fold before any filler is considered

The nasolabial fold deepens because the cheek above it has dropped, not because the line itself is missing volume. Filling the line adds weight to the exact place that is already heavy. Dr Sin Yong lifts the fold with the Time Freeze Laser LCLR® first, planning the cheek, the fold and the jowl as one zone, so that the crease softens because the tissue above it has been repositioned.

Where the fold has previously been overfilled, the same session can take away the excess filler with the Sculpting mode before lifting. Filler is considered only afterwards, if at all, and only for a true volume deficit on the bone.

Nasolabial folds: sessions, downtime and how long it lasts

Nasolabial fold treatment at a glance
How many sessionsLifting with Time Freeze Laser LCLR® or VF Lift: 1–2 sessions. Filler, where a fold needs support after lifting: one session.
DowntimeMild swelling for 1–3 days after lifting; bruising for up to a week after filler.
How long it lastsLifting is reviewed at 3–6 months and repeated yearly; filler lasts 9–15 months in this area.

Figures are typical ranges from Dr Sin Yong's practice and the published literature; your plan, including the number of sessions, is set after the assessment and may differ. Fees are given in writing after the assessment: see how we quote.

Time Freeze Laser LCLR®, in one line. Dr Sin Yong uses it to lift every zone of the face and neck, to take away excess filler in the same session, and to reduce loose fat in sagging areas while the skin tightens. The three uses, explained · Sculpting mode for excess filler.

A device is only a device. Ultherapy Prime, Thermage or a filler syringe is a tool, like a suture; technique, experience and customisation to the face decide the result. Why technique, not the device, decides the result.

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