Hyaluronic acid (HA) fillers are the most commonly used type of filler for nasolabial folds. Several HA products are FDA-approved specifically for this area, and they work by adding volume beneath the skin to smooth out the creases that run from the sides of your nose to the corners of your mouth. Beyond HA, two other filler categories are also used: calcium hydroxylapatite and poly-L-lactic acid, each with different strengths and timelines.
Hyaluronic Acid Fillers
Hyaluronic acid is a sugar molecule your body already produces naturally, which makes HA fillers highly compatible with skin tissue. When injected into or beneath the nasolabial fold, the gel adds immediate volume that pushes the crease outward and smooths the surface. HA fillers also attract and hold water, which helps maintain that plumping effect over time.
Multiple HA products are approved for nasolabial folds, each formulated with slightly different gel consistencies to match the severity of the fold:
- Restylane and Restylane-L: Designed for mid-to-deep injection to correct moderate-to-severe wrinkles and folds.
- Restylane Refyne: Also targets moderate-to-severe folds but uses a flexible gel technology that allows for more natural movement when you smile or talk.
- Restylane Defyne: Formulated for deeper, more severe nasolabial folds with a firmer gel structure.
- Restylane Lyft: Placed deeper in the tissue and also approved for cheek augmentation, which can indirectly lift and soften nasolabial folds by restoring volume higher in the midface.
- Juvéderm products: The Juvéderm line (including Vollure and Ultra Plus) is also widely used for nasolabial folds, with formulations ranging from softer gels for moderate lines to thicker gels for deeper creases.
In a clinical trial comparing two HA fillers for moderate nasolabial folds, more than 70% of subjects were still showing visible improvement at 18 months, though they received a retreatment session at the 9-month mark. In general, most HA fillers in this area last roughly 9 to 12 months before a touch-up is needed, though thicker formulations can stretch longer.
One key advantage of HA fillers is reversibility. If you’re unhappy with the result or experience a complication, an enzyme called hyaluronidase can dissolve the filler. No other filler type offers this safety net.
Calcium Hydroxylapatite (Radiesse)
Radiesse is the main non-HA filler used for nasolabial folds. It contains tiny calcium-based microspheres suspended in a gel carrier. When injected, the gel provides immediate volume, similar to HA. But Radiesse also acts as a scaffold that triggers your body to produce new collagen, elastin, and blood vessels around the microspheres. This means you get a short-term filling effect plus longer-term structural improvement as your own tissue regenerates.
Because Radiesse is firmer than most HA gels, it works particularly well for deeper nasolabial folds where more structural support is needed. Results typically last 12 to 18 months. The tradeoff is that Radiesse cannot be dissolved if something goes wrong, so injector experience matters even more with this product.
Poly-L-Lactic Acid (Sculptra)
Sculptra works differently from both HA and Radiesse. It doesn’t add volume on the day of injection. Instead, it stimulates your body to gradually build new collagen over weeks to months. The injectable material itself is absorbed by your body, leaving behind the collagen it triggered.
For nasolabial folds, Sculptra typically requires three injection sessions spaced about one month apart. In a 3-year follow-up study, researchers found that Sculptra corrected nasolabial folds with longer-lasting results than HA or collagen fillers. The gradual onset means changes look subtle and natural, but you’ll need patience: full results may not be visible for two to three months after your final session.
Sculptra is best suited for people with significant volume loss across the midface rather than someone looking to fill a single crease. It rebuilds the foundation, while HA fillers are better for precise, targeted correction.
How Injection Technique Varies
The nasolabial fold isn’t treated with a single approach. Injectors choose their technique based on how deep the fold is and what’s causing it. For mild to moderate folds, filler is typically placed into the middle or deep layers of the skin using a technique called linear retrograde injection, where the needle is inserted along the fold and filler is deposited as the needle is slowly withdrawn. A fanning technique can also be used near the nose to spread product more evenly.
For deeper folds caused by significant volume loss in the cheek area, filler may be placed much deeper, at the level of the bone or in the fat pads beneath the muscle. In these cases, a blunt-tipped cannula is often used instead of a sharp needle, which reduces the risk of hitting a blood vessel. Some practitioners will treat both the fold itself and the upper cheek to address the root cause of the crease rather than just filling the line.
Why the Nasolabial Area Requires Caution
The nasolabial fold sits in one of the most vascular zones of the face. The facial artery runs closely along the fold, and a major branch called the angular artery lies within about 5 mm of it. A systematic review of filler complications found that the nose and nasolabial fold areas have the highest complication rates of any facial region, largely because of the dense network of blood vessels in this area.
The most serious risk is vascular occlusion, where filler accidentally compresses or enters a blood vessel, cutting off blood supply to nearby tissue. This is rare but can cause skin damage or, in extreme cases, vision problems if filler migrates toward the eye’s blood supply. This is one reason why choosing an experienced, anatomically knowledgeable injector is critical for nasolabial fold treatment.
Who Should Avoid Nasolabial Fillers
You shouldn’t get filler in this area if you have an active infection near the injection site, including dental infections, cold sores, or any oral or mucosal infection. A known allergy to the filler material itself, or to the lidocaine (a numbing agent) mixed into many filler syringes, also rules out treatment. These contraindications apply across all filler types, not just one brand or formulation.