A deep fold beside the mouth is usually the end of a story that starts in the cheek. Medical Director Dr Sin Yong works out which part of that story is yours at IN Eternity Clinic on Orchard Road.
WhatsApp to Enquire →Key facts ↓Smile lines, or nasolabial folds, deepen when cheek fat descends, the ligaments holding it loosen, bone support recedes and skin thins. Filler placed only in the fold can make the area heavier. Treatment usually starts higher, with cheek support, lifting or skin-quality work, and fold filler is used sparingly, if at all.
The nasolabial fold is a natural boundary. On one side sits the cheek, with its layered fat compartments; on the other, the firmer tissue around the mouth. In youth the cheek fat is full and well supported, so the fold is a soft line. With time the deep cheek fat deflates, the superficial fat above it slides down and forward, and the ligaments that anchor it loosen. The cheek tissue then piles up against the boundary and the fold deepens.
Bone plays a part too: the upper jaw around the nose gradually recedes, removing some of the platform the cheek sits on. The skin itself thins and loses elasticity, so creases from smiling start to stay. Most people have a mix of these, in different proportions, which is why two people with similar folds may need quite different plans. Our ageing by decade guide shows how the mix changes over time.
Filler placed directly into the fold can soften it, but it is treating where the tissue has ended up rather than where it came from. In larger amounts, or repeated over years, it adds weight to the lower face and can produce the heavy, rounded look described on our pillow face page and in the pillow face guide.
Restoring support higher up often softens the fold indirectly. That may mean small amounts of cheek filler placed along the bone, explained in our cheek augmentation guide and on dermal fillers, with the dermal filler guide covering products and longevity.
If you have had filler in this area before and it now looks heavier, do not add more before a scan. Ultrasound shows what product is where, and the right step may be filler correction rather than more volume.
“A smile line is where the cheek ends, not where the problem starts. I assess the cheek before I touch the fold.”
Where loosened support is the main driver, lifting the cheek back along its line of descent addresses the cause. VF Lift – Vertical Facelift uses Volnewmer radiofrequency planned along vertical vectors; Ultraformer MPT HIFU works at the SMAS layer; Thermage FLX tightens the dermis; and Time Freeze Laser LCLR® combines laser lifting with remodelling.
For more visible descent, threads such as the Bliss Lift or the RVR ProLift protocol reposition tissue mechanically. Sagging face treatment compares the approaches, and thread lift vs HIFU vs filler sets them side by side.
Some smile lines are mainly a skin problem: fine, etched creases in thin skin, with good support underneath. Collagen-stimulating injectables build dermal thickness gradually; see Sculptra, Radiesse, Ellansé and Juvelook. Skin boosters such as Profhilo, Rejuran and hyaluronic acid boosters improve hydration and texture.
Our comparison of filler vs biostimulator vs skin booster explains which layer each acts on. The condition guides on fine lines and crepe and skin laxity describe how these are told apart.
Smile lines rarely appear alone. Marionette lines and jowls follow the same descent lower down and are covered under sagging face. Around the eyes, crow’s feet and under-eye changes often develop in parallel. A gummy smile is a separate, muscle-driven issue, covered on lip flip and gummy smile, and lip volume on lip rejuvenation. Overall proportions are discussed in face shape.
Yes. Everyone has a nasolabial fold, and it is visible in many people from their twenties, especially when smiling. It becomes a concern when it deepens at rest or makes the face look tired. Whether anything needs doing is a personal choice, discussed at consultation without pressure to treat.
Sometimes, in small amounts, but rarely on its own. Filler placed only in the fold can add weight to the lower face. Restoring cheek support, lifting descended tissue or improving skin quality often softens the fold more naturally, and the plan depends on which of these is driving your lines.
Generally not. The muscles that lift the upper lip and corner of the mouth create the smile itself, and weakening them can change your expression or make the smile uneven. Anti-wrinkle injections are used for some lines elsewhere on the face, but smile lines are usually managed with support, lifting or skin-quality treatment.
Do not add more before an assessment. An ultrasound scan shows which product is present, where it sits and how much remains. The plan may be to dissolve hyaluronic acid filler in small, staged amounts, to wait, or to treat the support above, rather than to add volume.
It varies with the approach and the person. Hyaluronic acid filler and collagen stimulators last months to a couple of years; energy-based lifting builds over a few months and is typically maintained periodically; threads last for a period that depends on type. Your expected timeline is explained at consultation.
Cost depends on what is driving the lines, which treatments are chosen, how many areas are included and how the plan is staged over time. Because the cause varies, a figure before assessment would mean little. IN Eternity Clinic sets out the plan and its cost at consultation before anything is booked.
IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, Singapore 228210. By appointment with Medical Director Dr Sin Yong. Monday to Saturday, 11am to 8pm. WhatsApp or call +65 8815 3008.
These sources describe mechanisms and general evidence. They are not a promise of any individual result; suitability is decided at an in-person assessment.