Will filler work for the dent in my cheek/ nasolabial fold? (Photo)

Question

There’s a spot on the left side of my face between my lower cheek and my jowl or perioral mound (not sure which) where it seems like there’s not enough fat? It’s always been there but it’s gotten more pronounced over time. I don’t know if filler would work because it’s more of a dent or dimple than a line, seems like too big of an area to fill. The nasolabial fold on my right side is more of a regular crease.

Anna Chacon, MD, FAAD · Answer

What you’re describing is actually a very common but often misunderstood facial contour issue. The fact that you’ve noticed it for many years and that it has become more pronounced with time suggests that this is probably not simply a nasolabial fold, but rather a localized volume deficiency or tethered hollow in the transition zone between the lower cheek, perioral mound, and early jowl area.

Based on your description, I suspect you’re talking about an area that is often referred to as:

the pre-jowl sulcus,
the labiomandibular hollow,
or a mid-to-lower cheek volume depression.

That is different from a typical nasolabial fold, which is usually a crease running from the side of the nose to the corner of the mouth.

The important distinction: crease vs. dent

You’ve already made a very insightful observation:

Your right nasolabial fold behaves like a regular crease.
The left side feels more like a dent, dimple, or area lacking support.

That distinction matters because filler works differently in those two situations.

Can filler work for a dent?

Yes — often surprisingly well.

A dent caused by volume loss or a contour deficiency is actually sometimes a better filler candidate than a sharp fold, because the goal is to restore support beneath the depression rather than trying to fill a moving wrinkle directly.

The key is that the filler is usually not placed directly into the visible dent itself. In many cases, the best improvement comes from treating the surrounding support structures, such as:

the mid-cheek,
the lower cheek fat compartments,
or the pre-jowl area adjacent to the hollow.
Why it may seem “too big to fill”

That’s a very common concern, but experienced injectors often use small amounts distributed strategically across a broader area rather than trying to “plug” the entire depression.

Think of it less like filling a pothole and more like supporting the surrounding terrain so the transition becomes smoother.

What might be causing the asymmetry?

Since it is more pronounced on one side, possibilities include:

Natural facial asymmetry (extremely common)
Slight differences in fat distribution
Stronger retaining ligaments on one side
Early jowl descent accentuating a pre-existing hollow
Less commonly, a true congenital soft tissue deficiency
Would a chin or jawline treatment help instead?

If the hollow is located just lateral to the corner of the mouth and above the jawline, sometimes a small amount of filler in the chin or jawline can improve the overall contour and make the dent less noticeable indirectly. However, if the depression is truly in the lower cheek/perioral transition, treating only the chin would probably not fully address it.

My overall impression

From your description, I would not dismiss filler simply because it is a dent rather than a line. In fact, the area you’re describing sounds more like a localized contour hollow, and those often respond well to carefully placed structural filler in the lower cheek and pre-jowl region.

I would be less enthusiastic about injecting large amounts directly into the visible dimple, because that can create an unnatural fullness around the mouth. A more natural approach is usually:

Assess mid- and lower-cheek support
Treat the pre-jowl hollow conservatively
Reassess the nasolabial fold afterward, since improving the surrounding support often softens adjacent creases as well.

The encouraging part is that because this has been long-standing and asymmetric, it is less likely to be a temporary swelling issue and more likely to be a structural contour concern that can potentially be improved with thoughtful volumization rather than requiring surgery.

Will filler work for the dent in my cheek/ nasolabial fold? (Photo)

Answers (1)

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