# Treating the nasolabial fold *correctly.*

> The fold between nose and mouth corner is the most common request – and the most often wrongly treated.

- Source: https://www.vivaderm.de/guide-nasolabial-fold-treatment-en.html
- Language: en
- Publisher: VIVA DERM, Privatpraxis für ästhetische Medizin, Rosastraße 6a, 45130 Essen, Germany, +49 1520 8367711
- Responsible physician: Katayoun Mostaghimi (Fachärztin für Allgemeinmedizin)
- Updated: 2026-10-05

'Can you remove this line?' Yes – but the most effective treatment usually takes place two centimetres higher up.

## The fold is the symptom.

**What the nasolabial fold is:** a skin fold between nostril and mouth corner that every person has – children too when they laugh. It deepens over the years because the cheek fat above shrinks and descends and the skin loses elasticity. The fold itself is the border where the cheek meets the fixed upper lip.

**Why filling the fold is often not enough:** filling only the fold makes it shallower – but the face stays 'sunken', and with larger amounts a bulge forms that shows when smiling. The more natural way: replace volume where it was lost – in the cheek and at the cheekbone. That lifts the fold from above, often with less material and an invisible result.

**When the fold is treated directly:** with deep, sharp folds and thin skin, in slim faces without cheek loss, or as a supplement to cheek treatment – then with small amounts of soft hyaluronic acid and a cannula to 'cushion' the fold, not fill it up.

**What botulinum toxin cannot do here:** the nasolabial fold is not an expression line but a static one. Muscle relaxation does not help – on the contrary, botulinum toxin in this region can disturb the smile. It does not belong here.

**Other building blocks:** skin boosters improve skin quality over the fold; with very slack skin a surgical lift is the more honest option. The fold when laughing will always remain – and that is good.

**Realistic:** a softening of 30 to 50 percent at rest is a good result. A nasolabial fold that is 'gone' looks unnatural – and is no goal in reputable practices.

## The essentials.

- **Cause:** volume loss in the cheek
- **Best approach:** support cheek/cheekbone
- **Fill directly:** only as supplement, small amounts
- **Botulinum toxin:** not suitable

## Important note.

This text is general information. It replaces neither a medical examination nor the consultation required before any treatment under German law (§ 630e BGB). Whether and which treatment is suitable for you can only be said after examination and consultation. No treatment results are promised.

## Frequently asked questions.

**How much hyaluronic acid is needed?**

For the cheeks usually 1–2 ml, for the fold itself 0.5–1 ml. Individually after examination.

**Why do some people show a bulge?**

Too much material too superficially in the fold. That can be corrected with hyaluronidase.

## Related.

- [Nasolabial folds](https://www.vivaderm.de/nasolabial-folds-en.html) – Treatment
- [Cheeks & mid-face](https://www.vivaderm.de/cheeks-mid-face-en.html) – Treatment
- [Nasolabial fold](https://www.vivaderm.de/lexicon-nasolabialfalte-en.html) – Lexicon

## Sources

- [NHS: Dermal fillers – patient information](https://www.nhs.uk/conditions/cosmetic-procedures/non-surgical-cosmetic-procedures/dermal-fillers/)
- [MPDG – German medical devices act (fillers are medical devices)](https://www.gesetze-im-internet.de/mpdg/)
- [BfArM – Federal Institute for Drugs and Medical Devices](https://www.bfarm.de/)
- [DGPRÄC – German Society of Plastic, Reconstructive and Aesthetic Surgeons](https://www.dgpraec.de/)
- [NHS: non-surgical cosmetic procedures](https://www.nhs.uk/conditions/cosmetic-procedures/non-surgical-cosmetic-procedures/)
- [Medical Association North Rhine – patient information](https://www.aekno.de/patienten)
- [§ 630e BGB – duty to inform before treatment (German Civil Code)](https://www.gesetze-im-internet.de/bgb/__630e.html)

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This page is general information and does not replace medical consultation and informed consent (§ 630e BGB). No guarantee of results. Prices are guide prices per GOÄ. Quoting with attribution (VIVA DERM, Essen) is expressly permitted.