Why do some doctors say yes to nasolabial fold fillers while others say no?

Question

Some Drs say yes to nasolabial fillers some say no. Is there a reason there's a discrepancy between yes and no? Thank u as I am on the fence!

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. Based on your concerns, treatment with dermal filler in the nasolabial folds is considered a high risk area and must be administered by a qualified and trained professional. If you are interested in treating your nasolabial folds with filler, I encourage you to be seen by a provider with knowledge of facial anatomy. I hope this helps and best of luck!

Anna Chacon, MD, FAAD · Answer

There is ongoing debate among physicians regarding the use of fillers for nasolabial folds, largely due to differences in training, experience, and individual patient factors. High-quality evidence, including systematic reviews and meta-analyses, demonstrates that hyaluronic acid (HA) fillers are effective and generally safe for improving nasolabial folds, with significant reductions in Wrinkle Severity Rating Scale (WSRS) and Global Aesthetic Improvement Scale (GAIS) scores maintained for up to 12 months after treatment. Most patients experience satisfactory results, and adverse events are typically mild and transient, such as swelling, bruising, or tenderness. However, rare but serious complications—such as vascular occlusion—can occur, especially in this anatomically complex area, underscoring the importance of injector expertise and proper technique.

Some physicians are enthusiastic about nasolabial fold fillers due to their reversibility, immediate results, and favorable safety profile when performed by experienced injectors. Others are more cautious, citing the risk of unnatural appearance, the need for ongoing maintenance, and the potential for complications, particularly in patients with thin skin, deep dynamic folds, or unique anatomical considerations. Additionally, evolving aesthetic philosophies and cultural preferences may influence recommendations, as well as the increasing diversity of patient populations, which may require tailored approaches.

Ultimately, the discrepancy reflects a balance between evidence-based benefits, individual risk tolerance, and the provider’s clinical judgment. Patients should be evaluated holistically, with a personalized plan that considers anatomy, expectations, and alternative treatments. A thorough discussion of risks, benefits, and realistic outcomes is essential for optimal patient satisfaction and safety.

Camille Cash, MD · Answer

HA fillers are a great tool to soften the appearance of deep folds in the nasolabial area.  Your injector will evaluate you to determine if you are a good candidate for fillers to this area.  If your skin laxity in the nasolabial folds is too great it may not give you the results you are wanting, or it may be recommended to combine fillers with other treatments for a more desirable result.  The key is to get an experienced expert injector for your treatment.

Leonard Grossman, MD · Answer

Every single individual has nasolabial folds but that doesn’t mean you need to have them reduced with fillers. Even babies have them. All the best from NYC Plastic Surgery

Why do some doctors say yes to nasolabial fold fillers while others say no?

Answers (4)

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