Would you suggest pyriform filler or Sculpra to treat nasolabial folds?

Question

I'm 44 (f) with good skin and decent cheek volume. It does sound like there may be slight benefits for Sculptra, but there is a bigger cost and time investment. It appears nasolabial filler has a bad reputation and could possibly migrate. Is migration and issue with pyriform filler? Or any other downsides? Thanks in advance.

Anna Chacon, MD, FAAD · Answer

Thank you for your thoughtful question — you’ve clearly done your research and are asking the right things. At 44, with good skin quality and maintained cheek volume, you’re already starting from a very favorable position, which means subtle enhancements can go a long way.

When it comes to nasolabial folds, the key is understanding why they appear. In most cases, it’s less about the fold itself and more about support loss in the midface and pyriform (base of the nose) area. This is why a pyriform filler can make such a natural difference — it restores that foundational support and gently softens the fold without overfilling or distorting facial balance.

To address your concern, migration is not a typical issue when filler is placed properly in the pyriform region. That area is deeper and more structural, so the filler sits beneath the fold rather than superficially under the skin, which makes migration quite unlikely. The most important factor here is the injector’s precision and technique.

As for Sculptra, you’re right — it’s more of a collagen stimulator than a filler. It works gradually and provides a subtle lift and tightening effect over time, improving overall facial firmness and skin texture. The results are long-lasting but require patience and a few sessions spaced weeks apart. It’s a wonderful option for someone looking for a gradual, natural rejuvenation rather than instant volume.

In short:

Pyriform filler → More immediate softening and lift of the nasolabial area.

Sculptra → Long-term collagen stimulation and overall facial rejuvenation, though less targeted to a single fold.

Both can be excellent, and sometimes a combination — structure first, collagen later — offers the best of both worlds.

Would you suggest pyriform filler or Sculpra to treat nasolabial folds?

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