The treatment of nasolabial folds with hyaluronic acid injections ranks among the most requested procedures in aesthetic-oriented medicine. These two vertical lines, which start from the alae of the nose and descend toward the corners of the mouth, deepen over time. Their accentuation can give the face a tired, harsh, or sad appearance, often out of step with the patient’s inner energy. It is precisely this mismatch that we aim to soften through hyaluronic acid injections.
But what does the before/after of this treatment really show ? What is the scope of the result ? Is the improvement visible without being excessive ? This text offers a serious, rigorous, and objective analysis of what the observation of the « before/after » reveals, both in consultation and in photography.
The nasolabial fold is primarily a marker of facial mechanics. It reflects the loss of support in the midface, particularly at the level of the cheekbones, the malar fat pad, and the deep subcutaneous fat. It can also reveal a decrease in dermal density, tissue ptosis, or muscular hyperactivity in this anatomical area.
The appearance of the fold varies : it can be subtle yet deep, broad and shadowed, or associated with an overall sagging of the lower and midface. Before any procedure, the physician therefore assesses not only the depth of the fold, but also the adjacent volumes, the facial dynamics at rest and in motion, and the skin’s elasticity. This careful observation is essential to achieve a natural result.
The goal of treating nasolabial folds with hyaluronic acid is not to erase them completely, but to reduce their visibility both at rest and during facial expressions. The ideal result is one that goes unnoticed by others, yet allows the patient to recognize themselves in the mirror, with a visibly less marked, more rested, and fresher face.
After the injection, the fold appears less deep and regains a harmonious place within the face. The overall appearance remains supple and mobile, without stiffness or heaviness. This subtle approach softens the features without altering them, while respecting the balance and individuality of each face.
The injection of nasolabial folds can be performed using a soft cannula or a fine needle, depending on the chosen strategy and the patient’s morphology. Dr. Romano exclusively favors the use of a cannula, a technique that helps reduce the risk of bruising and ensures optimal comfort. In most cases, a moderately cross-linked hyaluronic acid is used. Its consistency provides good support within the fold while maintaining the natural suppleness and mobility of the face.
The effect of the injection is immediately visible, but the final result is evaluated between 5 and 10 days later. This period allows the gel to integrate harmoniously with the tissues and for any minor swelling to subside. The face then regains a more relaxed and natural appearance, without stiffness or overcorrection.
In a medical practice, before/after photos are a valuable tool for both the physician and the patient. They make it possible to visualize the extent of the improvement achieved, the symmetry of the result, and the restored softness of the features. However, it is important to remember that their interpretation must remain nuanced : a still photograph cannot capture facial dynamics, expressiveness, or the positive psychological impact of the treatment.
In most cases, the “after” result is characterized by a partial softening of the nasolabial fold and a smoother transition between the cheek and the mouth. The effect remains subtle, preserving the natural mobility of the face.
Many patients report that those around them notice a change without being able to identify its exact cause. This is often the sign of a successful treatment : the improvement is noticeable, yet remains discreet and natural.
Beyond the visible result, the “before/after” of nasolabial fold treatment has a significant psychological impact. The patient, often marked by a fold that made the face look heavier or gave a displeased expression, discovers a face more in harmony with their inner feelings.
This return to oneself, this sensation of self-recognition, is one of the most powerful effects of the treatment. It explains why the “after”, though imperceptible to some, is experienced as profoundly restorative.
If the treatment of nasolabial folds with hyaluronic acid is performed without discernment — using an overly volumizing product, injecting too superficially, or neglecting symmetry — the result may lack harmony. The face may appear frozen, the overcorrected fold can form a visible bump when smiling, or create an unusual light reflection. These side effects, though rare, serve as a reminder that injecting this delicate area requires a perfect understanding of anatomy and impeccable technique.
This is why the physician’s expertise plays a crucial role in achieving a natural and balanced result. An experienced doctor will know how to adapt the choice of product, the injected volume, and the injection depth according to each face. The goal is not merely to fill a crease, but to restore facial harmony and preserve the mobility of expressions.
In Geneva, Dr. Romano favors a personalized approach that combines technical precision with a refined sense of aesthetics. This high standard helps avoid excessive corrections and ensures patients a discreet, harmonious, and lasting result.
The scientific literature devoted to hyaluronic acid in the treatment of nasolabial folds provides an objective perspective on the effectiveness of these injections. Several studies published in aesthetic dermatology and plastic surgery journals have evaluated results through standardized photographic analyses, using validated wrinkle severity scales such as the WSRS (Wrinkle Severity Rating Scale).
Overall, these publications demonstrate a significant reduction in fold depth in more than 85 % of patients, with overall satisfaction rates often exceeding 90 %. Results are assessed at different intervals — one week, one month, and six months after injection. Improvement is evaluated not only by physicians but also by patients themselves, through facial change perception questionnaires such as the GAIS (Global Aesthetic Improvement Scale).
The before/after photographs included in these studies consistently show a visible softening of the fold, improved light reflection on the cheeks, and a more harmonious facial volume distribution, without altering features. These findings corroborate what patients report : the feeling of a more relaxed face, with no change to their natural expressions.
Patients often ask whether the result obtained after an injection changes over time, and in what way. The answer is yes — and this is actually one of the main advantages of this treatment, as it remains reversible, progressive, and long-lasting.
During the first three months, hyaluronic acid remains well in place. Thanks to its hydrophilic properties, it maintains the filling of the fold and improves local hydration. The result stays stable and may even slightly improve in some patients, due to the gradual integration of the product into the surrounding tissues.
From the sixth month onward, a slow and gradual resorption begins. It remains subtle but can be objectively observed through photographic comparison. Around twelve months, depending on the type of gel used and each patient’s metabolism, the effect starts to diminish. Many patients then choose to repeat the treatment before complete fading, in order to maintain a relaxed and harmonious facial appearance.
In men, correcting nasolabial folds with hyaluronic acid requires special attention. The male face is characterized by firmer and more defined lines, and most patients express the desire to maintain this natural look without making the treatment noticeable.
Before the injection, the fold often appears less deep than in women but more tense, as facial musculature is generally stronger. The goal is not merely to fill a crease, but to soften signs of fatigue while preserving the structure and strength of masculine features. The desired result is a rested and balanced face, without completely erasing the fold.
The approach must therefore be measured. Overcorrection can make the features appear heavy or feminized, while undercorrection may not achieve the expected improvement. Success depends on precise dosing that provides a visible yet discreet effect, ensuring a natural and harmonious appearance.
The nasolabial fold is not merely a superficial wrinkle. It represents a true anatomical boundary between two muscular and fatty planes of the face. Its formation is linked on one hand to the descent of the medial malar compartment and on the other to the action of the levator muscle of the upper lip. This area, being subject to repeated movements, thus reflects both volume relaxation and muscular dynamics.
When an inappropriate hyaluronic acid is used, there is a risk of disturbing this natural mobility. A gel that is too firm may freeze expression, while one that is too fluid may migrate into neighboring tissues. Since this region is highly mobile—especially during smiling or speaking—the risk of product displacement is increased.
The choice of hyaluronic acid must therefore be made with precision. It should take into account the depth of the fold, the quality and mobility of the surrounding tissues, and the muscular strength of each patient. Only a rigorous selection of the gel allows for a harmonious, long-lasting, and natural correction while avoiding undesirable effects.
Le choix de l’acide hyaluronique injecté dans le sillon nasogénien dépend de plusieurs paramètres, notamment de l’âge du patient et de la qualité de ses tissus cutanés. Un produit ne conviendra pas de la même manière à un visage jeune qu’à un visage plus mature, car les causes de l’apparition du sillon diffèrent avec le temps.
Chez un patient autour de la trentaine ou de la quarantaine, le sillon naît le plus souvent d’une hyperactivité musculaire ou d’un début de relâchement des tissus. Dans cette situation, un gel souple et faiblement volumateur suffit généralement à atténuer le pli tout en respectant la mobilité du visage.
À partir de la cinquantaine, le sillon nasogénien s’accentue en raison d’une perte de support structurel global. Le traitement doit alors aller au-delà d’un simple comblement, il faut utiliser un acide hyaluronique plus dense, mais restant suffisamment flexible pour s’adapter aux mouvements du visage.
Adapter la densité et la souplesse de l’acide hyaluronique à chaque profil patient garantit ainsi un résultat naturel, durable et personnalisé, en respectant l’anatomie et l’évolution propre de chaque visage.
In some cases, directly treating the nasolabial fold is not the most appropriate solution. The fold is often the consequence of an overall relaxation of the facial tissues. Restoring only this area may lead to a partial or even artificial result. To achieve a harmonious improvement, it is often preferable to restore support to the deeper facial structures, particularly the cheekbones, the cheeks, and sometimes the temples.
This approach, known as medical lifting through injection points, aims to reposition lost volumes and lift the tissues that tend to sag toward the fold. By restoring the face’s natural anchor points, the depth of the nasolabial fold is mechanically reduced while maintaining the mobility and balance of the features.
The medical lifting with hyaluronic acid therefore does not aim to erase a single wrinkle in isolation, but to act on the entire facial structure. This global strategy achieves a more relaxed and harmonious face, with results that are visible yet always natural.
Le choix du plan d’injection joue un rôle déterminant dans le traitement des sillons nasogéniens. Il dépend à la fois de la profondeur du pli et de la tonicité de la peau, et oriente directement le type d’acide hyaluronique utilisé.
Lorsque l’injection est réalisée en sous-dermique, le médecin privilégie généralement des gels cohésifs, modérément réticulés, capables d’apporter du soutien sans rigidifier la zone. Cette technique permet de combler le sillon tout en respectant la mobilité naturelle du visage.
Dans les cas où l’injection est effectuée en pré-périosté, c’est-à-dire au contact de l’os, on opte pour un acide hyaluronique à fort pouvoir volumateur. Ce type de produit permet de restaurer la structure profonde du visage et de créer un effet liftant indirect, en réduisant mécaniquement la profondeur du sillon.
Enfin, lorsqu’il s’agit de corriger des microcassures superficielles ou de redonner de l’élasticité à la peau, l’injection se fait plus en surface, dans le derme. Le médecin utilise alors un Skinbooster, injecté en nappage avec une microcanule. Cette approche ne vise pas uniquement à combler, mais aussi à améliorer la qualité cutanée et la luminosité du visage.
Ainsi, le plan d’injection et le choix du produit sont intimement liés. Bien maîtrisés, ils permettent d’obtenir un résultat naturel, personnalisé et durable, en respectant l’anatomie et les besoins spécifiques de chaque patient.
Not all hyaluronic acids are suitable for treating nasolabial folds. Some highly cross-linked gels tend to stiffen the area and can freeze facial expressions, resulting in an unnatural appearance. Conversely, products that are too fluid—designed for the eye contour or for smoothing fine lines—lack the consistency needed to effectively fill the fold and may migrate into surrounding tissues due to the high mobility of this facial region. It is also important to remember that non-resorbable products should never be used, as their use is prohibited because of the risk of complications.
A harmonious result therefore depends on choosing a gel suited to the depth of the fold and the dynamics of the tissues. Selecting a hyaluronic acid that is neither too firm nor too fluid allows the fold to be corrected with a natural result, while preserving facial mobility and overall balance.
The “after” is not limited to noticing a change in the mirror. It also corresponds to an intimate, often unexpected dimension that goes beyond simple aesthetic improvement. For many patients, it represents a moment of reconciliation with their face — a calm encounter with their own image. Some had no specific expectations before the injection, yet discover a sense of well-being they had not anticipated.
They describe a more peaceful relationship with their reflection, an expression aligned with the energy they feel within, a newfound freedom to smile or be photographed. For some, this evolution brings quiet relief; for others, a renewed confidence that manifests in everyday life.
This personal experience cannot be measured in numbers and is not always captured in photographs. Yet it often embodies the deepest success of the treatment — the one that subtly unites physical appearance and inner balance.
Article written by Dr Romano Valeria
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