Limitations of Juvederm in Nasolabial Folds? What Can I Expect?

I recently consulted with a plastic surgeon about juvederm for my nasolabial folds. He said that the juvederm is not injected all the way to the corners of the mouth; rather it should stop about halfway down the fold from the nose to avoid any issues with smile irregularities. This concerns me because it would not erase the pronounced line on the left side of my mouth. Is this true?

Doctor Answers 9

Injecting Juvederm aound the mouth

I see no problem injecting fillers in the nasolabial folds and frequently extend my injections when treating this area very close to the corners of the mouth.  In fact it is customary when injecting hyaluaronic acid fillers (such as Juvederm) for lip augmentation or treatment of the marionette lines that one inject in the corner of the mouth.

Long Island Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Best fillers for nasolabial folds

Radiesse has been proven to be much more effective than hyaluronic acid fillers like Juvederm for treatment of the nasolabial folds. Several years ago a study was done where Radiesse was injected into one nasolabial fold and, in the same patient, fillers containing hyaluronic acid such as Juvederm were injected onto the other nasolabial fold. The majority of patients and observers picked the Radiesse side as more natural looking. This is because Radiesse is injected more deeply beneath the skin, and will generate more volume to create a much better lifting effect. It works by stimulating your skin to produce more collagen, which is why it is so effective, and gives longer-lasting results too. I will often use one of the superficial hyaluronic acid fillers such as Juvederm or Restylane for the lines at the corners of the mouth and have not seen any "issues" with smile irregularities.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Juvederm And Nasolabial Folds

Juvederm is a type of injectable hyaluronic acid manufactured as gel dermal filler. This smooth consistency   gel is then injected in targeted areas of the skin for example the lines from the nose to the corners of the mouth which is known as nasolabial folds. Like other cosmetic treatments, there have been several complaints of negative side effects that most patients had to experience.These side effects are nagging pain after injections, pain during the procedure, redness and soreness, swelling, bruising, and especially the gel spreading to unwanted areas.

Of course, these negative effects will occur only if the patient is incompatible with the substance. The body rejects the product and will prevent itself to acclimate to the gel. The most serious side-effect reported so far is the lump formation which is known as granulomas. Always remember that not everybody will react similarly to cosmetic procedures especially to substance such as Juvederm. Each person has a specific physical makeup, and his or her body’s reactions may not stick with the expected norm. Keep an open mind if ever you think of giving this treatment a try.

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 45 reviews

Expectations and limitations of fillers for nasolabial folds

Hyaluronic acid fillers such as juvederm, restylane, and perlane are terrific options for many people with volume loss which occurs with aging. The nasolabial folds will improve to varying degrees based on how much and what type of volume loss you have, and in what location, and who the injector is (ideally a dermatologist or plastic surgeon for optimal results). The area closest to the nose will generally improve the most, while the area/line closer to the mouth (the "commas") will improve less. Dr. Benjamin Barankin, Toronto Dermatology Centre.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.8 out of 5 stars 50 reviews

Limitations of Juvederm in Nasolabial Folds? What Can I Expect?

  Restylane and Juvederm are very thin fillers, so the volume added to the nasolabial folds which means the degree of correction would be less than a thicker filler like Perlane...which is my filler of choice for that area.  There's no inherent magic in any filler.  The magic resides in the MD's ability to understand and follow the proper aesthetics of facial beauty for the creation of a naturally, more attractive face.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Juvederm and nasolabial folds

I do not restrict use in the way you describe. I think that is should be tailored to each individual based upon their needs. 

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Smoothing the Nasolabial (Nose to Corners of Mouth) Folds

As we age, with millions of facial contractions, with sagging facial structures especially descent of the cheek inferiorly, the deep skin along the advancing edge where the upper lip is densely attached to the deep facial structures, a void in support is created forming visible creases which gradually deepen.

Smoothing the nasolabial lines / folds depends on understanding this anatomy and adding THE right filler at THE right depth along THE whole length of the deficiency. There is no reason to stop filler at any set point. Instead, the Plastic surgeon needs to place it wherever it is needed and in whatever quanitity it is needed. This calls for customizing the treatment to every single person AND often calls for using more than just one filler. Some people may benefit from the use of thicker fillers, such as Radiesse or Perlane, in the deeper layers of the wrinkle to give more support and using Juvederm or Restylane in the more superficial layers of the fold to achieve a much better longer lasting correction.

I do think you should get a second opinion from another Plastic surgeon.

Peter A. Aldea, MD

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Fillers for NLF

I agree with Dr. Finder. What to inject and how to inject it should be determined by someone with lots of experience with all fillers. The choice would depend on the depth of your creases and several other characteristics. Restylane is softer for finer lines and Radiesse and Perlane could be used for tougher creases. Filler can certainly be placed up to and around the mouth. I do it ll the time. 

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 18 reviews

Is Juvéderm best for nasolabial folds?

The short answer: filler can be injected to the corners of the mouth by someone who is experienced with the right technique.

But, the choice of filler and the way it is placed in the nasolabial folds depends on each person's unique problem. The best way to figure that out is to have a consultation with an experienced physician who uses all the available fillers and Sculptra (an injectable that stimulates collagen production). 

Many surgeons don't spend very much time perfecting filler injection expertise if they spend most of their time operating. Seek another face-to-face consultation with a physician who spends a lot of their time injecting fillers. I believe that only an experienced physician who regularly injects fillers has the needed expertise in understanding facial anatomy to do the best job.


Kimberly Finder, MD
San Antonio Dermatologic Surgeon
4.7 out of 5 stars 62 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.