Is skin ageing the main cause of the nasolabial fold ?
Over time, facial skin undergoes a series of biological changes. Collagen and elastin production declines, dermal vascularisation diminishes and the dermis's water-retaining capacity decreases. These changes, characteristic of intrinsic ageing, directly affect skin suppleness, elasticity and thickness in the nasolabial region.
This phenomenon is accentuated by extrinsic ageing, mainly caused by chronic UV exposure, air pollution, smoking or nutritional deficiencies. The skin becomes thinner and drier and loses mechanical resistance. In this weakened context, the nasolabial fold, previously visible only when smiling, becomes permanent even at rest, leaving a lasting facial mark.
Does facial volume loss encourage the nasolabial fold ?
One of the main causes of nasolabial fold deepening is gradual loss of midface fat compartments. With age, deep fat tissue above the malar bone and around the orbicularis muscle loses volume and moves under gravity.
This volume resorption causes loss of cheekbone fullness and downward tissue sagging. This vertical movement mechanically accentuates the natural crease between cheek and upper lip : this is how the nasolabial fold deepens.
This is even more pronounced in people with rapid fat loss, whether associated with substantial weight loss, intense physical activity or genetic factors. The face loses its youthful softness and becomes more angular and harsh.
Why does facial laxity deepen the nasolabial fold ?
The face is supported by a complex network of ligaments and fibrous septa holding soft tissues in place. Over time, these structures lose tone and anchoring capacity. This laxity particularly affects the zygomatic arch ligaments and malar and nasolabial septa, which are essential in supporting the nasolabial region.
When these anchoring points give way, even partially, malar fat slides downwards, causing localised tissue sagging around the fold. This displacement contributes to a more pronounced, sometimes asymmetric fold that cannot be corrected by surface action alone.
This mechanism explains why aesthetic approaches limited to superficial fold injection often produce insufficient results. To restore facial harmony, many cases require lost volume to be rebuilt and support structures repositioned to treat the fold's actual cause.
Do facial expressions accentuate the nasolabial fold ?
The nasolabial fold is also influenced by repeated contraction of certain facial muscles. The levator labii superioris alaeque nasi and orbicularis oris muscles are involved in smiling, speaking and grimacing.
In particularly expressive patients, repeated use of these muscles accentuates the nasolabial fold, which gradually becomes imprinted in the dermis through mechanical creasing. This factor is even more decisive when skin is already weakened by ageing or dehydration.
Although not a cause of fold formation, this muscular factor aggravates it. This explains why some nasolabial folds become visible early, sometimes from 30, particularly in highly expressive people.
Can facial structure cause a pronounced nasolabial fold ?
The shape and structure of the maxillary bone play a key role in nasolabial fold development and visibility. Some patients have upper jaw hypoplasia, meaning insufficient projection of the underlying bone. This structural feature creates a more pronounced crease between cheek and upper lip, even in young people.
In these cases, the nasolabial fold may be present congenitally or develop earlier without necessarily being associated with skin ageing. This anatomical configuration is common in certain Asian facial structures or people with flat or minimally projected faces. It requires an adapted aesthetic approach, as simple superficial filling would be insufficient and risk an unnatural result.
Do smoking, sun and lifestyle encourage the nasolabial fold ?
An indirect but significant cause of nasolabial fold deepening is oxidative stress, meaning the damage experienced by skin cells because of environment and lifestyle. Chronic UV exposure, smoking, pollution, insufficient sleep, a deficient diet or inadequate hydration accelerate skin ageing.
These factors reduce natural collagen production, weaken the skin barrier and promote wrinkles. The nasolabial fold, already weakened by the mechanical causes discussed above, becomes more visible. This is therefore not an isolated factor, but an accelerator of tissue degradation to consider in every prevention or correction strategy.
Why do some people have a nasolabial fold from 30 ?
Young patients, sometimes under 30, frequently have a visible nasolabial fold without actual skin laxity or pronounced ageing. This reflects a combination of genetic, structural and functional factors predisposing the area's tissues to premature creasing.
Limited malar projection, muscular hyperactivity, thin skin, a broad, powerful smile or rapid weight loss can contribute. In these situations, the fold is an aesthetic facial characteristic rather than a sign of ageing and can be corrected if the patient wishes.
Does stress encourage nasolabial folds to develop ?
Stress significantly influences skin quality and accelerated facial ageing, including more pronounced nasolabial folds. Biologically, chronic stress causes persistent cortisol release, a hormone that impairs skin microcirculation, inhibits collagen production and weakens the epidermal barrier. This cascade promotes thinner, less elastic skin more prone to mechanical creasing during facial movement. Stress is also often accompanied by reflex facial muscle contractions — particularly around the mouth and eyes — that deepen expression wrinkles, including the nasolabial fold, over time. It is therefore an aggravating factor contributing to premature marking of this fragile facial area.
Does alcohol accentuate nasolabial folds ?
Regular alcohol consumption, even moderate, adversely affects the skin's physiological balance, with visible medium-term consequences, particularly for wrinkles. Alcohol causes transient vasodilation followed by deep skin dehydration, impairing dermal density and tissue firmness. It also interferes with liver metabolism and hormonal regulation, essential elements in collagen synthesis and cellular repair. By impairing skin quality, accelerating glycation of supporting fibres and disrupting oxidative balance, alcohol indirectly promotes skin laxity and loss of facial volume definition. Although alcohol alone does not cause nasolabial folds, it hastens and accentuates their formation, particularly in patients already exposed to other ageing factors.
What sleeping position can limit nasolabial folds ?
Sleeping position directly influences the formation and progression of certain mechanical facial wrinkles, including nasolabial folds. Habitually sleeping on one side exerts prolonged pressure on the half-face compressed against the pillow, repeatedly creasing cheek and fold skin. Over the years, this asymmetric compression contributes to a more pronounced dermal crease on one side. To prevent this nightly mechanical wear, sleeping on the back is recommended where possible, distributing pressure evenly. Ergonomic memory foam pillows designed to limit pressure points, and silk or satin pillowcases, can also reduce friction and skin deformation during sleep. These measures help preserve volume and prevent wrinkles.
