“My nasolabial folds are getting deeper. Do I have to get filler?”
“I’m hesitant to add volume, but the lines seem to be getting more noticeable.”
These are questions we often hear from patients who visit us with concerns about deepening nasolabial folds, commonly known as smile lines.
It is easy to think of nasolabial folds as a simple volume problem: if there is a hollow or crease, fill it.
In reality, the cause can be more complex.
Loss of volume in the midface can make the folds appear deeper. The cheeks and surrounding tissues may descend, creating a more pronounced fold around the nasolabial area. In other cases, years of repeated folding can leave a deeply etched line within the skin itself.
This is why the first question in treating nasolabial folds should not simply be:
“What should we fill this with?”
It should be:
“Why has this line become more pronounced?”
At Timeless Dermatology Mapo, we recently introduced JUVGEN Autologous Dermal Regeneration Therapy as another option for treating deeply etched wrinkles with greater precision.
So how is JUVGEN different from conventional filler, and what types of nasolabial folds may be appropriate for this approach?
1. JUVGEN and Filler Approach the Problem Differently
Both dermal fillers and JUVGEN may be considered when treating nasolabial folds, but they are designed for different purposes.
Conventional hyaluronic acid fillers are primarily used to restore volume directly where structural support or fullness is lacking. When volume loss has created a hollow appearance or an area needs additional support, filler may be an appropriate option.
JUVGEN, on the other hand, focuses more specifically on deeply etched lines that remain within the skin.
The treatment uses very small amounts of hyaluronic acid and carbon dioxide just beneath the dermis to create controlled stimulation, encouraging the skin to produce its own collagen.
One of the distinguishing features of JUVGEN is the precision of its delivery system.
Rather than injecting a relatively large amount of material at once, the device delivers extremely small amounts intermittently, with the injection volume adjustable in increments as small as 0.001 cc.
This allows narrow, well-defined wrinkles to be approached with precision and can also be useful for localized depressions such as certain atrophic scars.
The injection volume can also be set through the device monitor and delivered automatically, allowing a predetermined amount to be administered more consistently.
Put simply:
Filler directly restores missing volume.
JUVGEN is designed to promote regeneration within skin where a crease has become deeply etched.
Neither approach is inherently better than the other.
The appropriate choice depends on whether the nasolabial fold is primarily related to volume loss or to a persistent line that has become established within the skin itself.
2. Not Every Nasolabial Fold Needs JUVGEN
JUVGEN is generally more relevant to deep, linear creases than to broad areas of facial volume loss.
Examples may include:
deeply etched nasolabial folds,
marionette lines extending downward from the corners of the mouth,
fine residual lines that remain on the skin even after filler or other volumizing treatments,
and horizontal neck lines that have become established through repeated folding over time.
By contrast, if there is significant volume loss across the lateral or anterior cheek, JUVGEN alone may not address the underlying issue.
In these cases, treatments intended to restore volume across a broader area—such as Juvelook Volume, Radiesse, or Sculptra—may also be considered.
In other words, even within the same face, an area that has lost volume and an area where the skin has developed a deep crease may represent two different problems.
This is why we do not evaluate the nasolabial line in isolation.
Midface volume, skin thickness, and the degree of descent in the surrounding tissues all need to be considered together.
3. If Sagging Is the Main Cause, JUVGEN Alone May Not Be Enough
A deep nasolabial fold does not always mean that the line itself is the main problem.
If the cheeks and surrounding tissues have descended and are folding over the nasolabial area, the underlying issue may be more closely related to tissue laxity and sagging.
Likewise, when substantial midface volume has been lost, it may be necessary to address the underlying volume deficiency before focusing on the crease itself.
In these situations, repeatedly treating the line with JUVGEN alone may not be the most appropriate approach. Instead, treatment can be divided according to the underlying cause.
If sagging is the primary concern, lifting treatments such as Ultherapy PRIME, Thermage FLX, or TuneFace may be considered.
If volume loss is more significant, treatments such as Juvelook Volume, Radiesse, or Sculptra may be planned first or incorporated into the overall treatment strategy.
If a distinct, deeply etched line still remains after the surrounding volume and tissue position have been addressed, JUVGEN can then be considered for more precise treatment of that residual crease.
A simple way to think about it is:
Lift what has descended.
Restore what has lost volume.
Treat the etched line separately when it remains.
This is why nasolabial fold treatment sometimes requires more than one type of approach.
Timeless Answers.
JUVGEN Uses Hyaluronic Acid. Does That Make It the Same as Filler?
No. They should not be considered the same type of treatment.
Hyaluronic acid filler uses the gel itself to directly restore lost volume.
JUVGEN uses extremely small amounts of hyaluronic acid together with carbon dioxide as part of an autologous dermal regeneration approach designed to stimulate collagen formation within the skin.
For this reason, its primary purpose is not to create broad facial volume. It is more specifically focused on treating deeply etched, linear wrinkles.
How Do I Choose Between JUVGEN and Filler for Nasolabial Folds?
The first step is identifying why the fold has become prominent.
If midface volume loss is the primary issue, a volumizing treatment may be more appropriate. If descent of the cheeks and surrounding tissues is creating the fold, lifting treatment may need to take priority.
If volume and sagging have already been addressed but a distinct, deep crease remains within the skin, JUVGEN may then be considered as another treatment option.
Is One JUVGEN Treatment Enough?
The number of treatments needed can vary depending on the depth of the wrinkle and the condition of the skin.
In general, satisfactory improvement may be achieved with approximately one to three treatment sessions, although the appropriate number should be determined individually.
JUVGEN also has a different treatment goal from conventional skin boosters that are commonly repeated at regular monthly intervals. The depth and extent of the wrinkle should therefore be assessed before determining the treatment schedule.
Some firmness may be noticeable in the treated area for a period after the procedure, and the recovery process can vary from person to person.
Treating Nasolabial Folds Starts With Understanding Why They Formed
Nasolabial folds are not simply lines that appear with age.
They can become more prominent because facial volume has decreased, because the surrounding tissues have descended and begun to fold, or because years of repeated movement have left a deeper crease within the skin itself.
That means the same-looking nasolabial fold does not always require the same treatment.
At Timeless Dermatology Mapo, our board-certified dermatologists personally assess facial volume, tissue descent, and the depth and characteristics of the crease before developing a treatment plan.
Our newly introduced JUVGEN Autologous Dermal Regeneration Therapy is therefore not a treatment we apply indiscriminately to every nasolabial fold.
Instead, it provides another option for deeply etched wrinkles that require a different approach from simply restoring volume with filler.
If your nasolabial folds are becoming more noticeable, it may be helpful to begin with a different question.
Instead of:
“What should I inject into this line?”
ask:
“Why has my nasolabial fold become deeper?”
The right treatment becomes much clearer once the reason behind the fold is understood.
