Nasolabial folds in Daegu: filler or lifting?
If you have asked around about nasolabial folds, you have probably heard opposite advice about the same area. One clinic says fill it; another says lift it. Neither is wrong. Very often they are simply not looking at the same fold. This is about how that fork is decided.
The short version
A nasolabial fold is not one thing. A true hollow beside the nose, a step created by cheek tissue settling onto it, and a crease that only appears when you smile are three different problems. Filling addresses the first, tightening bears on the second, and the third is closer to an expression mark than a fold. So the first question is not which treatment is better, but which kind of fold is yours.
What the nasolabial scale is actually measuring
There is a quiet oddity here. The widely used grading scale is called a wrinkle severity scale, yet the paper describes what it grades as the presence of depression and shadowing — not depth as such.
In 100 healthy subjects, grade and the grey value of a three-dimensional image correlated at 0.985. Much of what the grade tracks, in other words, travels through light. That is not the whole story: in 75 Asian women, grade correlated significantly with length, width and depth alike.
One practical consequence follows. You do not have to fill the groove completely; softening the step at its edge already lowers how visible it is. Put the other way round: looking better in a photograph and feeling shallower under a fingertip are not the same claim.
So here is the fork
What we look at first are three simple observations. No equipment is needed; you can try them at a mirror.
| What to look at | If this happens | Direction |
|---|---|---|
| Lying down | The line fades noticeably | Weight side — tightening is relevant |
| Lying down | It stays much the same | Groove side — filling is relevant |
| Lifting the cheek by hand | The line flattens with it | Closer to settled cheek tissue |
| At rest, no expression | The line is not visible | An expression line — observe before treating |
This is the order we use in clinic, and we should say plainly that it is our way of deciding, not a validated scale. What is certain is that the answer changes the plan for the same area entirely.
What is established on the filler side
The defining feature of filling is that the change shows quickly. In 54 subjects injected with hyaluronic acid, grade fell from 3.74 to 1.63 at one month; in 30 Asian women, length, width and depth had all decreased at three months.
But both studies have no control arm, and follow-up stops at one and three months. So we do not use that data to say “it lasts a year.” When duration comes up, we say plainly that the figure comes from clinical experience and product characteristics rather than trial results.
What is established on the lifting side
The tightening side stands differently. Human data comparing settings on the nasolabial area itself is sparse. In a 31-subject split-face comparison of monopolar radiofrequency tip sizes, the smaller tip was significantly better around the eyes, while the nasolabial and marionette areas showed a direction but no statistical significance.
Anatomy suggests why. Facial superficial fat thickness carries a standard deviation around 36% of the mean, and varies more than threefold by region. One fixed setting cannot target the same plane in everybody. Retaining ligaments are often invoked as the target, but that evidence is still at the level of an uncontrolled 45-subject case series.
So we do not say “the fold will be N millimetres shallower” about a tightening treatment. There is no basis for it yet. What we do say is that it bears on the step created by cheek tissue settling.
When both apply, which first?
In practice most people have some of each. When that is the case we prefer to address the weight first and look at the remaining groove afterwards, because filling first can leave the volume looking excessive once the area is tightened.
One caveat, stated clearly: we could not find a human study comparing that sequence with the reverse. It is a clinical judgement, not a trial result. For someone with a distinct groove and little laxity, the order is better reversed.
How we decide
At Miso Clinic we do not treat nasolabial folds as a single thing to be filled. We first separate hollowing, settling and expression, and judge suitability from there.
- Once lying down, once sitting up. The difference between the two tells us the most.
- Lift the cheek by hand. If the line flattens with it, weight is carrying more of the fold.
- Check what is already there. Material that is hard to reverse changes the plan.
- No rush with expression lines. A line invisible at rest is a different problem.
- Set expectations in words, not numbers. We say beforehand that the photograph and the fingertip may not agree.
Which treatment suits you depends on your skin condition, how much change you want, and what you have already had. The same findings often lead to different plans once schedule and daily life are taken into account.
Frequently asked
Is filler or lifting better for nasolabial folds?
There is no general winner. If the area beside the nose is genuinely hollow, filling is relevant; if cheek tissue has settled and created a step, tightening is. Whether the line fades when you lie down helps separate the two.
Why does lying down point toward lifting?
Because lying down removes much of the weight resting on the cheek. If the line fades noticeably then, settled tissue is contributing more than the groove itself. This is an observation we use in clinic, not a validated scale.
How long does filler last there?
The published injection studies stop following up at one and three months, so duration cannot be quoted from trial data. We say plainly when a figure comes from clinical experience and product characteristics instead.
How many millimetres will lifting shallow the fold?
There is no basis for that number. Human studies comparing settings on the nasolabial area are sparse, and in a 31-subject comparison the nasolabial and marionette areas did not reach statistical significance.
Can both be done on the same day?
Sometimes, but we usually separate them. Settling the weight side first and then assessing the remaining groove helps avoid overfilling. We could not find a human study comparing that sequence with the reverse.
What about folds that only show when I smile?
A line invisible at rest is closer to an expression mark. Filling a crease that folds can make the area look bulkier, so we generally suggest observing before treating.
Why does the photo look better when the fold feels the same?
Because the common grading scale reads depression and shadowing together. Softening the step at the edge lowers the grade in a photograph even when the depth of the groove has changed less.
Which clinic is best for nasolabial folds in Daegu?
Public data cannot answer that. No metric compares injector skill and testimonials do not establish efficacy. What you can compare is whether a consultation separates hollowing from settling before naming a treatment.
Read next
Who wrote this
Lee Chi-Hak, Director, Miso Clinic Daegu
4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, Korea (Exit 1, Kyungpook National University Hospital Station)
+82-53-428-2700 · www.clinicmiso.co.kr
References
- Lorenc ZP, et al. J Drugs Dermatol. 2024;23(1):1319–1324. PMID 38206141 (five-point nasolabial scale — grades the presence of depression and shadowing; 73 subjects, three board-certified raters)
- Long X, et al. J Craniofac Surg. 2025;36(3):966–969. PMID 39730116 (100 healthy subjects, grade versus 3D grey value r = 0.985; 54 HA injections, 3.74 to 1.63 at one month, no control)
- Wang D, et al. Aesthetic Plast Surg. 2022;46(5):2189–2193. PMID 35034152 (75 Asian women; grade correlated with length, width and depth; 30 injected, three months, no control)
- Day DJ, et al. Am J Clin Dermatol. 2004;5(1):49–52. PMID 14979743 (original scale validation — inter-rater agreement 67.7% and 72.3%)
- Yang YS, et al. J Clin Aesthet Dermatol. 2024 (31 subjects, randomised split-face, monopolar tip size — smaller tip significant periorbitally, nasolabial and marionette not significant)
- Lee KW, et al. Clin Anat. 2021;34(7):1050–1058. PMID 33583088 (30 cadavers — facial skin 2.1 mm, superficial fat 5.2 mm, SD around 36% of the mean)
- Cohen S, et al. J Cosmet Dermatol. 2020;19(8):1948–1954. PMID 32543088 (retaining ligament account — 45-subject case series, no control)
- Medical Service Act art. 56(2) — restriction on testimonial advertising
What we could not verify
- A human study comparing filler against lifting on the same measure.
- Whether treating the weight first and the groove second outperforms the reverse — our judgement, not a trial result.
- Follow-up beyond six months for nasolabial injection.
- Any validated scale built on the lying-down change or the cheek-lift manoeuvre.
- Any public metric comparing case volume or skill between clinics in Daegu — none exists.
Everything in this column is general information and does not replace medical diagnosis or treatment. Effects and side effects vary with individual skin condition, age and underlying illness, and the same result is not guaranteed for everyone. Any decision to proceed should be made in an in-person consultation with a physician.
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