Nasolabial folds — the lines that run from the sides of the nose down to the corners of the mouth — deepen over time for structural reasons that no topical product can fully address.
What produces them:
- Midface volume loss. The malar fat pad (cheek fat) descends and thins with age. As the cheek loses projection, the nasolabial fold becomes more visible by relative shadow.
- Bone remodeling. The maxillary bone (upper jaw) resorbs over decades. The supportive scaffold for facial soft tissue diminishes, and the fold deepens.
- Ligamentous laxity. The retaining ligaments that hold facial tissue in place stretch and loosen.
- Dermal collagen decline. Skin itself loses structural integrity, so the fold becomes more etched.
- Repeated expression. Every smile crease deepens the mechanical fatigue at the fold.
What actually addresses it:
- Restoring midface volume — hyaluronic acid filler placed high in the cheek reduces the appearance of the fold without directly filling it.
- Sun protection and retinoids — slow ongoing dermal decline.
- Facial resistance training or myofascial work — emerging but limited evidence.
- Address collagen environment — hs-CRP, HbA1c, estradiol all influence rate of loss.
Topical products marketed for smile lines produce minimal effect because the mechanism is deeper than any topical can reach. Manage expectations.