The difference between cases where nasolabial fold botox is effective and cases where it is not

The wrinkles on the nasolabial folds are not simply a problem of the wrinkle lines alone.
It is often a complex phenomenon that involves the overlapping of under-eye volume, fat mass, skin folds, and muscle movement.

 

So even though it's the same wrinkles on the arms
✔ Some people are satisfied with fillers
✔ Some people feel there is little or no difference in effect.

 

The purpose is to divide the wrinkles on the forehead into four types and understand why the approach is different for each type.
(The key is to provide criteria by which you can judge for yourself.)

 

Why treating nasolabial folds is difficult

• Wrinkles on the forehead are often not caused by just one thing.

• In many cases, the cause is more structural problems above and below the wrinkles than the visible wrinkles.

• So, there are repeated cases where filler treatment alone is limited.

 

Type 1: Nasolabial folds with under-eye hollows

How can we tell the difference?

• When I looked in the mirror, I saw hollow bags under my eyes.

• If the cheek above the nasolabial fold appears pressed down

Why does this phenomenon occur?

As the volume under the eyes decreases, the fat lump underneath is pushed toward gravity.
The wrinkles on your forehead will appear deeper.

Approach Principle

• In this case, an approach that prioritizes improving the volume under the eyes rather than the nasolabial folds themselves is considered.

• As the volume under the eyes is filled, the nasolabial folds may also appear to be relieved along with the support from above.

Even if you are concerned about wrinkles on your nasolabial folds, here is why you should look at the structure under your eyes first.

 

Type 2: Nasolabial folds with prominent fat lumps

characteristic

• The under eye bags are not that big,

• If the fat above the nasolabial folds appears to be thick and protruding

• Often observed in cases with previous fat grafting experience

Why is it difficult with just fillers?

This type is closer to a problem of organizing protruding structures rather than a problem of 'filling in the gaps'.

Approach Principle

• Rather than using filler alone, the direction of combining treatment to reduce or organize the fat lump itself is being discussed.

• In some cases, injection therapy may also be considered.

⚠️ Caution
In cases where the amount of fat is originally high, a simple solution may not be possible and multiple approaches may need to be considered together.

 

Type 3: Shallow but distinct 'knife wrinkles'

How will it look?

• The wrinkles on my forehead aren't that deep.

• If you pull the skin, a thin, sharp line remains.

• Commonly observed in wrinkles that have been folded for a long time

Limitations of common fillers

These shallow dermal wrinkles often do not disappear when volume is added to the deep layers.

Approach Principle

• An approach is described that uses dilute hyaluronic acid fillers in the dermal layer rather than deep volume augmentation.

• In this case, there are cases where the wrinkle impression is alleviated without the commonly thought of 'nasolabial fold filler'.

💡 If you “don’t have very deep wrinkles on your arms, but you’re really concerned about the lines,” you need to check this type first.

 

Type 4: Large muscle movements (spider smile)

How to self-check

• When you smile brightly, your gums are excessively visible, not just your teeth.

cause

• The movement of the muscles used when smiling is large, causing the nasolabial folds to fold together.

Approach Principle

• This type is often more about controlling muscle movement than structural issues.

• There are cases where nasolabial folds were alleviated with just Botox treatment.

📌 Note: If wrinkles remain even after muscle adjustment, then additional approaches are suggested.

 

✔️ Summary: Think about wrinkles on your arms like this

• It is difficult to conclude that wrinkles on the nasolabial folds can be resolved with a single procedure.

• First, it is important to determine which type of wrinkles your forearm has.

• Even though it's the same 'palm wrinkle'
  ▶ Is it a problem under the eyes?
  ▶ Is it a problem with local structure?
  ▶ Is it a skin wrinkle?
  ▶ Depending on whether it is muscle movement
  Approach strategies can vary significantly

I hope this article will serve as a guide for you to look in the mirror and calmly think about the cause of your wrinkles.