Nasolabial Fold Filler vs. Fat Reduction,

Why It Looks Deeper When You Treat Only One Side

Last Friday, an office worker in their early 30s

came to the clinic.

At another clinic, they had 1 cc of filler injected into the nasolabial fold,

and said, "After it was injected, the side cheek

looked even more swollen."

I said while we looked in the mirror together.

It wasn't that the filler was placed incorrectly,

it was a case where the lateral fat also needed to be considered.

Nasolabial Fold Filler vs. Fat Reduction,

They look similar, don't they? But

Nasolabial fold filler is

a procedure that fills the sunken groove beside the philtrum (nasolabial fold)

with hyaluronic acid to reduce the step-off.

Fat reduction is the opposite.

It reduces the fat that has sagged outward from the groove, toward the cheek,

using medication or radiofrequency

to trim the side volume itself.

A filling procedure and a trimming procedure,

they go in completely opposite directions.

Nasolabial folds are more about

the difference in height with the side

Director Wi Young-jin's

Core Insight

The nasolabial fold is a step-off problem caused by 3–10 mm of excess side fat

+ philtrum hollowing —

if you only fill the philtrum with filler, the side volume stands out more,

and if you only do fat reduction, the hollow looks deeper.

You need both procedures to eliminate the step-off.

"Nasolabial Fold Filler vs. Fat Reduction"

If you searched for it and came here,

you're probably wondering which one works better

and want to compare them.

But that comparison itself starts from a slightly wrong premise.

The two procedures are not in competition,

they're tools for solving different problems.

The reason the nasolabial fold looks deep is

not that the groove got deeper,

it's that the side fat has sagged or become thicker,

creating a step-off.

Because the philtrum side is sunken and the side is bulging,

that difference in height looks like a wrinkle line.

We should briefly talk about hyaluronic acid types here.

Not all fillers used in the nasolabial area are the same.

• Belotero

  
  
  

  Fine particles and a soft texture, suitable for shallow lines

• Juvéderm Volift/Voluma

  
  
  

  High cohesiveness, used to fill deep grooves

• Neuramis/Restylane

  
  
  

  Correction for the middle range

MD Codes (Maurício de Maio code)

According to the design guide,

the nasolabial area is assessed together with the Ck1·Ck2 (cheekbone-cheek) points

and the NL1·NL2 (nasolabial line) points.

First, you build up the sagging support

and then correct the nasolabial fold.

If you don't know this and pour 1 cc only into the fold line,

only the philtrum looks bloated

and the side stays the same, so it looks even more swollen.

A 29-year-old patient who came last month

also had thick side fat,

and filling only the philtrum

just moved the step-off to a different location.

Only after reducing the side fat twice with medication

did it finally become natural.

Director Wi Young-jin's Key Takeaway

Nasolabial folds are often not a matter of a 'deep groove'

but of a 'higher side'.

Don't compare filler vs. fat reduction on their own,

and first look at which side is causing the problem in your face.

Many people need both.

People for whom nasolabial fold filler is right,

and people for whom fat reduction is right

Press firmly on the side of your philtrum with your finger.

If the pressed area sinks in deeper than the groove

it's a sign that the side fat is thick,

and if not, and only the groove is clearly visible,

filler alone is enough.

If you've read this far

this is probably what you're wondering

Q1. If you do both procedures, can you get them on the same day?

A. We don't recommend doing it on the same day.

Fat-reduction medication causes swelling for about a week.

If you design filler while that swelling is present, after the swelling goes down

the amount or position may not fit.

Usually, you finish fat reduction first

and complete the treatment with filler 4–6 weeks later.

Q2. If both cost twice as much,

is there a way to see results in one go?

A. If the lateral fat is only slightly thick,

you can fill the cheekbone-cheek area with filler

to lift the step-off upward.

However, if the lateral fat is definitely

thick and you use this method,

the whole face can look larger,

so I don't recommend it.

Q3. If the fat-reduction medication dissolves too much,

won't it make the area hollow?

A. Honestly, that's a possible concern.

That's why I prefer splitting it into

2–3 sessions rather than doing it all at once.

Bruising or swelling lasts about a week,

and for the first week after the procedure, intense saunas

are best avoided.

If you take only one thing away today

— nasolabial folds are not a matter of choosing one or the other,

but a matter of how to

flatten the 'step-off' between the philtrum and the side cheek.

In the next article,

'When combining filler and fat reduction for the nasolabial area,

I'll break down the difference between 4-week vs. 6-week intervals.'

This was Wi Young-jin.

Read also

• Hongdae filler "Who performs it matters more than the price" (the difference when the lead doctor does the procedure directly)

• The claim that filler can fix dark circles is only half true (it might be vascular?)

• The real reason doctors never recommend Botox for nasolabial folds