The nasolabial fold, this natural crease that runs from the side of the nose to the corner of the mouth, is an area of the face particularly sensitive to volume changes and the dynamics of aging. A common sign of altered facial harmony, it can deepen early or worsen over time. Many patients then wonder about the impact of their weight, or weight fluctuations, on the evolution of these folds. The question often arises: can weight loss reduce nasolabial folds, or, on the contrary, accentuate them ?
The answer cannot be stated simply. It depends on numerous anatomical, functional, and aesthetic parameters that must be analyzed. The balance between fat mass, skin tone, and volume distribution is complex, and any weight change affects the overall structure of the face, including the nasolabial folds.
The nasolabial fold is not a wrinkle in the strict sense. It is a structural crease corresponding to the junction between the cheek fat compartments (particularly the medial malar compartment) and the perioral region. With age, or under the influence of certain morphological factors, this line becomes more visible, deeper, or even permanent. Its depth results from several mechanisms: loss of skin density due to intrinsic and extrinsic aging, progressive sagging of the midface tissues, decreased bony and subcutaneous fat support, and repeated contraction of certain facial muscles.
In this process, fat plays a central role as it shapes the volumes of the face. Any significant weight change alters its distribution and visibly affects the nasolabial fold.
Contrary to what one might think, losing weight does not always make the face look younger. Significant weight loss, even when intentional and beneficial for overall health, can have an aging effect on certain areas of the face, notably the temples, the cheeks, the under-eye hollows, and the nasolabial folds.
Fat tissue is lost throughout the body, and both the superficial and deep fat compartments of the face are affected. Their reduction leads to a loss of cheek volume, accentuation of bony contours, and collapse of the tissues supporting the upper part of the fold.
Thus, the decrease of midface volume mechanically causes vertical sagging which, in the absence of good skin elasticity, accentuates the nasolabial fold. The face appears more hollowed, more marked, and the crease becomes more visible, especially when the skin does not adapt adequately to the weight loss.
In certain situations, moderate weight loss can have a positive effect on the nasolabial fold. This phenomenon mainly concerns young patients with still firm and toned skin, whose faces were initially very round. The reduction of cheek fat can then help redefine contours, reduce the pressure on the fold, and consequently lessen its visibility.
However, these cases remain exceptional. In most clinical situations, weight loss rather accentuates skin laxity, makes wrinkles more visible, and causes the face to lose the softness of its curves, which negatively affects its overall aesthetic balance.
The patient’s age is a determining factor in the effect of weight loss on the nasolabial fold. From the age of 40, the skin begins to lose its natural elasticity. The ability of the skin to retract after weight loss decreases significantly. Thus, in a patient aged 50 or 60, even moderate weight loss can result in sagging of the soft tissues, an increase in wrinkles, and an accentuation of the nasolabial fold and the marionette lines.
More than the weight itself, it is the quality of the skin and the face’s ability to maintain its volumes that determine how the nasolabial fold responds to weight loss. Young, thick, and well-vascularized skin will adapt. In contrast, mature, thin, or sun-damaged skin will adapt less effectively and could reveal more wrinkles than before the weight loss.
To limit the aesthetic impact that weight loss can have on the nasolabial fold, it is advisable to adopt a gradual approach, allowing the skin time to adapt. Proper hydration, both internal and cutaneous, plays an essential role, as does an adequate intake of proteins and micronutrients, which are indispensable for collagen production. An appropriate skincare routine, incorporating active ingredients such as retinol, peptides, and antioxidants, also helps preserve skin quality. Finally, in some cases, support with gentle technologies, such as radiofrequency, HIFU, or mesotherapy, can be considered to maintain skin firmness throughout the slimming process.
In cases of significant weight loss, particularly after bariatric surgery, changes in the face can sometimes be dramatic. The nasolabial fold may deepen rapidly. When this becomes a significant source of concern, targeted aesthetic correction can be considered.
In this context, aesthetic correction may be undertaken. It is not limited to directly filling the fold, as such an approach could weigh down the features or produce an unnatural result. The physician’s work first involves restoring the missing volumes, particularly in the cheekbones, and then gradually refining the treatment. This comprehensive and coherent approach allows for a harmonious result that respects the individual morphology of each patient.
Repeated weight fluctuations — typical of yo-yo dieting — have a particularly harmful effect on the structures of the face. With each slimming phase, the tissues retract partially; with each weight regain, fat is sometimes redeposited asymmetrically or in a disorganized manner. This phenomenon alters the architecture of the face, causes chronic skin laxity, and reduces the natural definition of volumes. The nasolabial folds become more visible, not only because the skin sags, but because it gradually loses its tissue memory. In the long term, these fluctuations affect facial dynamics far more than stable overweight, making the correction of the folds more complex and less durable.
Some studies have examined the relationship between fat mass and the appearance of facial aging signs. An article published in Plastic and Reconstructive Surgery (2015) shows that patients who lost more than 10% of their initial weight after the age of 45 experienced a marked accentuation of nasolabial folds, cheek grooves, and mandibular laxity. The study concludes that facial fat loss contributes, alongside collagen loss, to the appearance of aging signs. Another publication, in The Journal of the American Academy of Dermatology (2019), emphasizes that patients with naturally rounder faces maintain a youthful appearance for longer. These findings confirm that weight loss, while beneficial metabolically, should be accompanied by consideration of its aesthetic repercussions on the face, particularly on the nasolabial folds.
Article written by Dr Romano Valeria
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