Nasolabial Folds: Causes, Treatment, Exercises, And Prevention

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Medical News TodaySubscribeCauses and treatments for nasolabial folds

Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — Written by Zawn Villines — Updated on January 1, 1970

Overview
Causes
Treatments
Exercises
Prevention
Takeaway

Nasolabial folds are the indentation lines on either side of the mouth that extend from the edge of the nose to the mouth’s outer corners. They become more prominent when people smile.

These folds also tend to deepen with age. Some people develop wrinkles next to the nasolabial folds, which may be more visible during smiling. These sometimes called smile lines or laugh lines.

What are nasolabial folds?

Nasolabial folds. Image credit: Mikael Häggström, from original by Sue Campbell/U.S. Air Force, (2011, March 4) — Nasolabial folds are sometimes known as smile or laugh lines.Image credit: Mikael Häggström, from original by Sue Campbell/U.S. Air Force, (2011, March 4)

The nasolabial folds are lines located on either side of the mouth. They are more noticeable when a person smiles.

Except for newborns and people whose faces are paralyzed due to a medical condition, almost everyone has nasolabial folds.

The folds, which are made of dense bundles of fibrous tissue and muscles, tend to become more prominent with age.

As the skin becomes saggy and thinner, many people find that their nasolabial folds become more noticeable.

Causes

Nasolabial folds are a normal part of human anatomy, not a medical condition or a sign of aging. As people age, however, these folds can become deeper and may also sag.

With age, some people also develop lines next to the nasolabial folds. Others develop lines that extend down to the chin, which are sometimes referred to as marionette lines.

Nasolabial folds become more noticeable due to a variety of factors, including:

sun exposure, which damages the skin, causing wrinkles and changes in texture
loss of collagen with age, making the skin look weak and thin
loss of fat, which can make the cheeks and nearby regions appear saggy

As the skin ages, facial expressions can cause deeper wrinkles. Just as frequent scowling can cause lines near the eyebrows, smiling can make nasolabial folds deeper.

Other factors that play a role in skin aging include:

smoking
exposure to environmental pollutants
rapid weight loss or frequent fluctuations in weight

Treatment

Nasolabial folds are a cosmetic issue but are not a risk factor for any health condition and do not necessarily require treatment.

Some people who find that their nasolabial folds are especially pronounced may prefer to eliminate them. Some cosmetic procedures can reduce the appearance of nasolabial folds or eliminate them.

Treatment options include:

Dermal fillers

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While cosmetic procedures to treat nasolabial folds are available, nasolabial folds are a normal facial feature and do not require treatment.

Dermal fillers are implants that are placed just under the skin. They can plump up the skin, reducing the appearance of wrinkles.

A doctor can apply dermal fillers just under the skin in the nasolabial fold area or the upper cheek area to give the cheeks a lift, making the nasolabial folds less noticeable. The procedure can take place in a doctor’s office.

Fillers cannot make nasolabial folds disappear, but they can make them less pronounced. They can also be used to help nearby skin look fuller and more youthful.

Doctors can also inject fat into the nasolabial fold area to decrease their appearance. The fat is taken from another area of the body and injected to fill the area, similarly to the dermal filler.

Skin resurfacing treatments

Some skin resurfacing treatments can help the skin surrounding nasolabial folds look more youthful. Laser skin resurfacing, for example, can reduce the appearance of scars and age spots.

Microdermabrasion offers deep exfoliation that makes the skin look younger and thicker. These treatments can help offset the appearance of nasolabial folds, but they will not remove the folds.

Surgical removal

A doctor can greatly reduce the appearance of nasolabial folds using a surgical process called subcision.

This procedure is typically used to treat scars and acne marks but may also help with nasolabial folds.

During subcision, a doctor uses a needle to break up pockets of tissue. This can help restructure the area surrounding nasolabial folds, reducing the depth of the folds, and leaving the surrounding skin looking more youthful.

Another option called excision involves removing the affected skin and attempting to reshape the surrounding area. This approach requires the use of a scalpel but can offer more dramatic results.

Experimental treatments

Doctors are continually trying new strategies to reduce the appearance of nasolabial folds without surgery.

One option is the use of growth factor, a chemical that stimulates cell growth. A 2015 study evaluated growth factor concentrate injections in 80 people with nasolabial folds.

The researchers concluded that this treatment is a safe and potentially effective option.

Exercises for nasolabial folds

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Performing certain facial exercises regularly may help to make nasolabial folds less prominent.

The muscles of the face can be toned just like any other group of muscles. Strong facial muscles make it easier to control facial expressions. Just as a toned stomach may look less saggy, a toned face may look tighter.

While frequent smiling can worsen nasolabial folds, a person should not try to refrain from smiling. Laughter and smiling have positive effects on a person’s mental health and are important social cues.

Some people claim that facial exercises can strengthen the muscles surrounding nasolabial folds, potentially making them less noticeable.

There is little or no scientific research on the effectiveness of these exercises, but they are not harmful. Anyone who wishes to try them can do so safely and may find them beneficial.

Exercises for nasolabial folds include:

Puckering the lips in an upward motion, as if kissing the ceiling. Hold for 15 seconds and repeat 4–5 times.
Puckering the lips into a pouting motion, then pulling the corners of the mouth out. Hold for 15 seconds and repeat 4–5 times.
With the mouth slightly open, pull on its corners with both index fingers, pulling the corners of the mouth further apart. Hold for 2–3 seconds, and repeat 25–50 times.

A person can do these exercises every day.

Prevention

There is no method for preventing nasolabial folds — even children have them when they smile.

Those who would like to prevent them from getting deeper or more pronounced should wear sunscreen and protect their face from the sun. This can slow the damage of the sun’s harmful UV rays.

There is no other research-supported method for preventing nasolabial folds.

Takeaway

Nasolabial folds are a normal part of the face, not a defect. Although they can grow or deepen over time and as a result of smiling, there is no medical need to treat them.

People who are bothered by their nasolabial folds should speak with a skilled plastic surgeon or physician who specializes in aesthetic treatments.

The right treatment will depend on many personal factors, and what works for one person might not work for another.

Anyone considering cosmetic procedures should ask their healthcare professional a lot of questions and be clear about their expectations.

Dermatology
Cosmetic Medicine / Plastic Surgery
Seniors / Aging

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Rittié, L., & Fisher, G. J. (2015, January). Natural and sun-induced aging of human skin. Cold Spring Harbor Perspectives in Medicine, 5(1)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4292080/
Robati, R. M., Abdollahimajd, F., & Robati, A. M. (2015). Evaluation of subcision for the correction of the prominent nasolabial folds. Dermatology Research and Practice, 2015https://www.hindawi.com/journals/drp/2015/976153/
Rubin, M. G. (2004, September–October). Treatment of nasolabial folds with fillers [Abstract]. Aesthetic Surgery Journal, 24(5), 489–493https://www.ncbi.nlm.nih.gov/pubmed/19336201
Rubin, L. R., Mishriki, Y., & Lee, G. (1989, January). Anatomy of the nasolabial fold: The keystone of the smiling mechanism [Abstract]. Plastic & Reconstructive Surgery, 83(1), 1–10https://www.ncbi.nlm.nih.gov/pubmed/2909048
Rudkin, G., & Miller, T. A., (1999, October). Aging nasolabial fold treatment by direct excision [Abstract]. Plastic and Reconstructive Surgery, 104(5)https://journals.lww.com/plasreconsurg/Abstract/1999/10000/Aging_Nasolabial_Fold_and_Treatment_by_Direct.41.aspx.
Sevila, G. P., Dhurat, R. S., Shetty, G., Kadam, P. P., & Totey, S. M. (2015, September-October). Indian Journal of Dermatology, 60(5), 520https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4601439/
Soften your nasolabial folds with these simple facial exercises. (2014, April 14)http://www.borgesmedicalspa.com/soften-nasolabial-folds-simple-facial-exercises
What are dermal fillers? (n.d.)https://www.plasticsurgery.org/cosmetic-procedures/dermal-fillers
What is botulinum toxin type A? (n.d.)https://www.plasticsurgery.org/cosmetic-procedures/botulinum-toxin
What is laser skin resurfacing? (n.d.)https://www.plasticsurgery.org/cosmetic-procedures/laser-skin-resurfacing

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Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — Written by Zawn Villines — Updated on January 1, 1970

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