Nasolabial Fold Correction with Dermal Filler

A patient presented at Redefine Clinic with a visible and longstanding concern about deep nasolabial folds on both sides of her face. The folds running from the base of the nose to the corners of the mouth had deepened noticeably with age and were making her look consistently tired and older than she felt. After a thorough facial assessment by Dr. Harikiran Chekuri, 0.5 ml of hyaluronic acid filler was distributed equally across both nasolabial folds using a targeted NL1 zone injection technique. The result was immediate visible softening with no downtime.

The nasolabial fold is the groove that runs from the outer edge of each nostril down to the corner of the mouth. A shallow version is normal and often softens facial expression. When the fold becomes deep, forming a prominent shadow line that persists even at rest, it is one of the most visible signs of facial ageing.

This patient had prominent bilateral nasolabial folds that had deepened over the years. The folds gave her a drawn, tired expression even when she was not. She had tried topical treatments without meaningful improvement and came in wanting to explore whether dermal fillers could help soften the folds without making her face look filled or unnatural.

What Was Assessed During the Consultation

• Fold depth and prominence assessed bilaterally at rest and on smiling
• Skin quality and tissue volume in the mid-face evaluated
• Patient goal confirmed: softening of the fold depth, not elimination
• Medical history reviewed with no contraindications identified
• Prior filler or facial treatment history checked: none noted
• Allergy history confirmed: hyaluronic acid filler deemed appropriate

Why the NL1 Zone Was Targeted

The nasolabial fold can be treated at different depths and positions. The NL1 zone refers to the deep base of the fold, the area where the groove originates from loss of structural support in the soft tissue below. Injecting into this zone with a bolus technique lifts the fold from its base, reducing the shadow and softening the crease without changing the natural movement or expression of the face. Superficial injection or overfilling in this area can produce an unnatural result; treating the NL1 zone at the correct depth avoids both.

Why 0.5 ml Was Chosen

0.5 ml distributed across both sides, approximately 0.25 ml per fold, was appropriate for this patient based on the moderate depth of her folds and her preference for subtle, natural-looking correction. The goal was softening, not obliteration. Patients with deeper folds or those seeking more dramatic correction may require 1 ml to 2 ml across both sides.

Baseline photographs show the depth and prominence of bilateral nasolabial folds before treatment. Post-procedure photographs show immediate softening after 0.5 ml of hyaluronic acid filler was injected bilaterally into the NL1 region.

The improvement was visible immediately on the treatment table. The deep groove on both sides was visibly softer, and the harsh shadow that had run from nose to mouth corner was noticeably reduced. The patient reported the result looked natural and that the change was apparent to her but not obvious or overdone to others.

There was no significant swelling or bruising on the day of the procedure. At a review 10 days later, the filler had fully settled and the improvement was sustained.

Feedback recorded at the 2-week follow-up visit at Redefine Clinic, Hyderabad.

• Avoid pressing, massaging, or applying pressure to the treated area for 24 hours
• Avoid hot beverages, saunas, steam rooms, and direct sun for 48 hours
• Do not apply heavy makeup directly over injection sites for 24 hours
• Refrain from strenuous exercise on the day of the procedure
• Sleep with head slightly elevated on the night of the procedure if possible
• A review appointment is recommended at 2 weeks to assess the settled result
• A touch-up can be performed at 2 weeks if additional volume or symmetry correction is desired