Nasolabial Folds Fine — Why Do You Look Old?

"Doctor, my nasolabial folds look fine, so why do I look old?" — A question I received yesterday

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Q. Why does my mouth area still look droopy even after getting nasolabial fold filler?

A. Quite often, the real culprit isn't the nasolabial folds but the hollowness below the lips. Shadows form and make the surrounding wrinkles appear deeper than they actually are.


Q. Why does this area become hollow as we age?

A. It's due to repeated contractions of the mentalis muscle combined with loss of the lower fat pads.

Many of you focus only on your nasolabial folds when looking in the mirror,

but the real culprit that makes your mouth area look aged is often

right below your lips,

that hollow area transitioning to your chin.

Let me talk about this today.

Here's how this makes a difference

Under-lip hollowness filler involves

injecting a small amount of hyaluronic acid filler

into the depressed area between the lower lip and chin tip

(above the mental crease)

to eliminate shadows.

Unlike nasolabial fold filler,

under-lip filler doesn't directly fill wrinkles,

but rather flattens the 'surface' around the mouth

to change light reflection.

While the approach may seem similar, the purpose is quite different.

Where misunderstandings often occur

"When the area below the lips is hollow, it creates shadows that make nasolabial folds and marionette lines appear much deeper.

Even filling this area with a small amount can significantly rejuvenate the entire mouth area impression.

"

— Dr. Wi Young-jin (Beautystone Clinic, Hongdae)

Key Point


When the area below the lips is hollow, shadows form


making nasolabial folds and marionette lines appear much deeper.


Even filling this area with a small amount


can significantly rejuvenate the entire mouth area impression.

I remember a patient in her late 40s who came last month.

She had received nasolabial fold filler three times at another clinic.

Yet she came to see me because "I still look tired in photos"

despite the treatments.

When I examined her face from the side,

her nasolabial folds were already sufficiently filled,

but the area below her lower lip was hollowed about 3-4mm.

The shadows there made

her marionette lines appear deeper than they actually were,

and her mouth corners seemed to droop downward.

To be honest,

this area requires only about 0.1-0.15cc per side,

rarely exceeding 0.3cc for both sides combined.

Compared to the 1cc or more typically used for nasolabial folds,

it's about one-third the amount.

But the change this small amount creates

often appears more significant than injecting 1cc into nasolabial folds.

When the surface is restored,

the surrounding shadows naturally become lighter.

That patient also asked after receiving 0.25cc,

"Wait, you didn't touch my nasolabial folds, so why do they look better?"

However, this isn't always perfect.

The under-lip area is where the mentalis muscle

continuously contracts when moving the mouth,

so injecting too much can make it look lumpy when speaking

or cause the chin tip to protrude awkwardly forward.

But when the volume is properly calibrated,

this is definitely one of the most cost-effective areas to treat.

Dr. Wi Young-jin's Key Summary


If you keep filling nasolabial folds but something still looks awkward,


under-lip hollowness might be the cause.


Restoring the surface with a small amount (0.2-0.3cc)


can make the entire mouth area look much younger.

Here's how I categorize cases in my practice

While each case varies,

I usually approach them by dividing into three types.

Here's one important thing:

Even for combination types,

I don't start with nasolabial folds

but examine the under-lip area first.

Once the surface is restored,

the amount needed for nasolabial folds often decreases.

As a result, the total filler volume

actually ends up being less.

If you've read this far, you're probably wondering about this

Q1. Won't under-lip filler make speaking feel awkward?

A. With proper volume, it's barely noticeable.

The problem occurs when too much is injected.

Once you exceed 0.2cc per side,

you might feel a lumpy sensation when smiling.

For patients with strong mentalis movement,

it's much safer to use a small amount of Botox first

and proceed with filler 2 weeks later.

Q2. How long does it last after one treatment?

A. It varies by product,

but since this area has a lot of movement,

you can expect about 8-12 months.

It tends to last slightly shorter than nasolabial fold filler.

The cost is about half that of nasolabial fold filler

since it requires a smaller volume.

Q3. Are there any bruises or side effects?

A. Since blood vessels run through the central facial area,

bruising is rare but possible.

You might look slightly swollen for a day or two after injection,

and it settles into place after 3-5 days.

Avoid alcohol and saunas on the day of treatment.

If you still feel lumps after 2 weeks,

adjustments can be made with dissolving injections (hyaluronidase),

so don't worry too much.

If you have any confusing questions, I'll examine and guide you directly in the consultation room. This was Dr. Wi Young-jin.