Legal disclaimer

This guide provides general information about cosmetic nasolabial fold injections for adults aged eighteen years and over and does not replace individual medical advice, diagnosis, or treatment.^{1 9}

Any decision to have nasolabial fold filler should follow a consultation with a suitably qualified health practitioner, including discussion of risks, benefits, alternatives, and the option not to proceed.^{2 10}

Products used for nasolabial fold injections are usually prescription-only medicines. Their use and advertising are regulated under the Health Practitioner Regulation National Law and the Therapeutic Goods Act and associated regulations.^{1 3}

This document is written to align with AHPRA advertising guidelines and TGA guidance on advertising health services by avoiding medicine names, promotional claims, discounts, testimonials, or guaranteed outcomes.^{1 3}

1. Scope of this guide

This guide covers cosmetic use of hyaluronic-acid-based injectable gels to the nasolabial folds (“smile lines”) in adults, focusing on mechanism, likely appearance changes, governance, risks, and typical recovery.^{2 7}

It does not cover reconstructive or therapeutic indications, permanent or non-hyaluronic fillers, surgical face-lift or thread-lift procedures, or treatment during pregnancy or breastfeeding, all of which require individual medical advice.^{2 9}

The content is intended as neutral patient education about a regulated health service, not as promotion of a specific clinic, practitioner, or product, and is consistent with AHPRA and TGA expectations for health-service information.^{1 3}

2. What is nasolabial fold filler?

2.1 Plain-language description

Nasolabial fold filler is a cosmetic injectable procedure where a registered health practitioner places hyaluronic acid gel into or near the folds running from the sides of the nose to the corners of the mouth to soften their appearance.^{2 9}

Hyaluronic acid is a sugar molecule that occurs naturally in the body and binds water; in regulated injectable form it can provide volume and support under the skin, which may reduce the depth and shadow of nasolabial folds in suitable patients.^{3 7}

In clinically led practice, the goal is to soften and blend the fold while preserving normal facial expression, rather than to remove the fold completely, as some definition in this area is a natural part of facial anatomy.^{2 9}

2.2 Regulatory context in Australia

Nasolabial fold treatments use Schedule 4 prescription-only medicines which must not be advertised to the public by product or brand name.^{1 3}

TGA guidance explains that advertising of health services can describe cosmetic injection services in general terms but must not directly or indirectly promote specific prescription-only injectables, or use coded terms or inducements.^{3 4 12}

AHPRA’s cosmetic-procedure guidelines and related Medical Board documents set expectations for consultation, assessment, consent, psychological screening, and cooling-off periods for non-surgical cosmetic procedures, including facial fillers.^{2 10 11}

Clinical pearl

If nasolabial fillers are promoted with phrases like “instant line eraser” or “wrinkle-free guarantee”, that style of advertising is out of step with current Australian regulatory guidance.

3. How does hyaluronic acid filler work in the nasolabial folds?

3.1 Volume support and smoothing

In nasolabial fold treatment, hyaluronic acid gel is placed in deeper tissue planes to provide support to the fold, reducing its depth and the shadow it casts.^{2 7}

Because the fold often deepens as a downstream effect of volume loss in the mid-face and cheeks, practitioners commonly address mid-face support first and then add smaller volumes to the fold itself.^{2 9}

This layered approach aims to improve the overall facial structure so that the fold becomes less prominent without creating a padded or over-filled look around the mouth.^{2 7}

3.2 Anatomy and technique

The nasolabial region contains important structures including branches of the facial artery and vein, superficial fat pads, and muscles of facial expression, so injections must be placed with care.^{7 10}

Practitioners may use needle or cannula techniques, often combining deep structural support with more superficial blending threads, while using small amounts and slow injection to minimise vascular and tissue risks.^{2 10}

Australian cosmetic-procedure guidelines recommend that higher-risk cosmetic injections be carried out by trained, registered practitioners who understand facial anatomy, have escalation pathways, and practise within appropriate clinical governance frameworks.^{2 10}

Clinical pearl

Deep “lift and support” is often more effective and natural than repeatedly filling directly into the fold itself.

4. What results should patients expect?

4.1 Visual changes

Nasolabial fold filler can soften the fold, reduce its depth, and lessen the shadow that can make the lower face look tired or drawn.^{2 9}

When planned well, improvements appear as a gentle smoothing of the area around the nose-to-mouth lines while still allowing natural expression when speaking and smiling.^{2 9}

4.2 Time course of change

In the first few days, swelling and mild asymmetry are common and may make the folds look uneven or more noticeable before they improve.^{6 7}

Most patients see a more realistic impression of the final outcome after one to two weeks once swelling subsides, and optimal assessment is usually made around four weeks when the filler has integrated.^{7 15}

4.3 Limits and expectations

Nasolabial folds cannot be removed entirely because they are part of normal facial anatomy and result from expression, soft-tissue descent, and skin elasticity changes.^{2 9}

Filler can soften and blend the fold but will not prevent facial movement, stop ageing, or completely remove all creases, especially in very animated or photo-heavy areas of the face.^{2 9}

Clinical pearl

A softer, less harsh fold usually looks better and more natural than a completely flat lower face that no longer moves in a realistic way.

5. How long does nasolabial fold filler last?

5.1 Typical duration

Nasolabial fold filler is temporary, and hyaluronic acid gradually breaks down and is cleared by the body.^{3 7}

Many patients experience benefits for around nine to eighteen months in this area, but actual longevity can vary widely depending on individual factors.^{8 9}

5.2 Factors influencing longevity

Longevity depends on the amount and type of gel used, depth of injection, facial movement, skin quality, age, metabolism, and whether underlying mid-face support has also been addressed.^{2 7}

Because the mouth area moves frequently with speaking, eating, and facial expressions, filler in or near nasolabial folds may wear off more quickly than filler placed in less mobile areas.^{7 10}

5.3 What happens when it wears off?

As the filler degrades, the added support reduces gradually, and the folds slowly return towards their previous depth rather than changing overnight.^{3 7}

Correctly performed hyaluronic acid filler in the nasolabial region has not been shown to accelerate the natural ageing process once it has worn off.^{9 10}

Clinical pearl

Top-up treatments are usually planned according to visible changes and clinical assessment, not fixed time intervals.

6. Is nasolabial fold filler painful?

6.1 Sensation during treatment

Some discomfort is expected because injections occur in a mobile, sensitive area involved in smiling and speaking, but most patients tolerate the procedure with appropriate numbing measures.^{7 10}

People often describe a sensation of pressure or pinching rather than continuous sharp pain as the filler is placed.^{7 10}

6.2 Comfort strategies

Clinics often use topical anaesthetic creams, cool packs, distraction techniques, and hyaluronic acid products that contain local anaesthetic to improve comfort.^{3 4}

Where clinically appropriate, additional local anaesthetic methods can be used, provided they fall within practitioner scope and clinic protocols.^{2 10}

6.3 Tenderness after treatment

Mild tenderness, tightness, or a bruised feeling around the folds is common in the first few days, particularly when smiling or touching the area.^{6 7}

These symptoms usually improve with time and can often be managed with simple measures such as cool compresses and appropriate analgesia if recommended by the practitioner.^{7 15}

Clinical pearl

Severe or worsening pain, particularly with changes in skin colour or unusual firmness, should be assessed promptly.

7. What are the risks and side effects of nasolabial fold filler?

7.1 Expected short-term effects

Short-term effects such as swelling, bruising, mild redness, and temporary asymmetry in the nasolabial region are common and usually resolve over several days.^{6 7}

The folds may feel firmer or more pronounced initially due to swelling and tissue response before they settle to a softer, more blended appearance.^{7 15}

7.2 Less common issues

Less common issues include prolonged swelling, persistent lumps, or visible irregularities that may require clinical review and tailored management.^{2 7}

Options can include observation, practitioner-guided massage, small adjustments, or dissolving the filler with hyaluronidase if appropriate.^{3 13}

7.3 Serious but rare complications

Because the nasolabial area lies close to branches of the facial artery, there is a rare risk of vascular compromise if filler enters or compresses a blood vessel.^{3 10}

Clinics providing nasolabial filler should have protocols for recognising and managing complications, access to hyaluronidase and other emergency measures, and must comply with NSW Health infection-control and skin-penetration requirements.^{2 5}

Clinical pearl

The safest results come from conservative volumes, correct planes of injection, and a practitioner who can clearly explain how they handle complications.

8. Who is a suitable candidate for nasolabial fold filler?

8.1 Potentially suitable adults

Nasolabial fold filler may be considered for adults who are concerned about moderate folds or shadows in the nose-to-mouth area and who want subtle softening rather than complete removal.^{2 9}

Suitable candidates usually have realistic expectations, stable general health, and understand that folds are a normal ageing feature that can be improved but not fully erased.^{2 10}

8.2 When treatment may be delayed or avoided

Treatment may be unsuitable in cases of very deep folds caused primarily by significant skin laxity or heavy tissue descent, where other interventions may be more appropriate.^{2 9}

Filler is usually postponed if there is an active infection, recent surgery or trauma in the area, uncontrolled systemic illness, or in pregnancy and breastfeeding in line with a precautionary approach.^{3 9}

8.3 Psychological and ethical considerations

Australian cosmetic guidelines highlight the importance of psychological screening, realistic expectations, and voluntary consent for all cosmetic procedures.^{2 10}

Practitioners should decline or delay nasolabial filler when expectations are unrealistic (for example, wanting a completely line-free lower face) or when emotional distress is disproportionate to the clinical concern.^{9 10}

Clinical pearl

Patients who see nasolabial filler as a modest part of a broader ageing plan, not a complete solution, tend to have more satisfying outcomes.

9. What is recovery like and what aftercare is recommended?

9.1 Early recovery (first 72 hours)

Most people can resume light normal activities soon after treatment, but visible swelling and bruising are common in the first few days, particularly around the fold and mouth area.^{6 7}

The folds may appear uneven or more obvious temporarily as swelling and small haematomas settle, especially when talking and smiling.^{7 15}

9.2 First 2–4 weeks

Over the following one to two weeks, swelling and bruising typically reduce, and the filler softens, with the folds appearing more blended and less harsh.^{7 8}

By about four weeks, the result is usually stable enough for a meaningful review and discussion of whether any minor adjustments are appropriate.^{7 15}

9.3 Typical aftercare advice

Aftercare advice commonly includes avoiding strenuous exercise, saunas, steam rooms, hot yoga, and significant alcohol intake for at least 24–48 hours to minimise swelling and bruising.^{3 14}

Patients are usually advised not to undergo strong facial massages, facials, or peels around the nasolabial area for at least two weeks, and to avoid pressing or repeatedly manipulating the folds.^{5 6}

Clinical pearl

Allow time for swelling to settle before making a judgement on the final result; a four-week review generally gives the clearest picture.

10. Common myths and misconceptions about nasolabial fold filler

“Nasolabial filler removes the fold completely.”

Nasolabial folds are normal anatomical features; filler is designed to soften them, not erase them entirely.^{2 9}

“Filling the fold is always the first step.”

Often the underlying cause is mid-face volume loss, so treating the cheeks or mid-face first can improve the fold more naturally than direct filling alone.^{2 9}

“More filler gives a smoother result.”

Excessive filler can create a bulky or “muzzle-like” appearance; correct volume and placement are more important than sheer quantity.^{2 7}

“Nasolabial filler is the same as lip or cheek filler.”

The nasolabial area has different anatomy, movement, and vascular patterns, so it requires its own techniques and dose planning.^{2 10}

Clinical pearl

Thoughtful planning of the mid-face and jawline often does more for nasolabial folds than simply treating the fold itself.

Sources

1. Ahpra (2024), Guidelines for advertising a regulated health service (Advertising hub — guidance document), Australian Health Practitioner Regulation Agency, viewed 2025. https://www.ahpra.gov.au/Resources/Advertising-hub/Advertising-guidelines-and-other-guidance/Advertising-guidelines.aspx ↩
2. Medical Board of Australia & Ahpra (2023), Guidelines for medical practitioners who perform cosmetic surgery and procedures (cosmetic surgery and procedures guidelines), Medical Board of Australia, viewed 2025. https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Cosmetic-medical-and-surgical-procedures-guidelines.aspx ↩
3. Therapeutic Goods Administration (2025), Advertising health services and cosmetic injections: Frequently asked questions and answers (specialised advertising issues and topics), Australian Government Department of Health and Aged Care, viewed 2025. https://www.tga.gov.au/products/regulations-all-products/advertising/specialised-advertising-issues-and-topics/advertising-health-services-and-cosmetic-injections-frequently-asked-questions-and-answers ↩
4. Therapeutic Goods Administration (2024), Advertising a health service (online guidance on advertising health services involving therapeutic goods, including cosmetic injections), Australian Government Department of Health and Aged Care, viewed 2025. https://www.tga.gov.au/resources/guidance/advertising-health-service ↩
5. NSW Health (2025), Beauty, body art and skin penetration industries (fact sheet — Public Health Act 2010 and Public Health Regulation 2022), NSW Government, viewed 2025. https://www.health.nsw.gov.au/environment/factsheets/Pages/beauty-treatment.aspx ↩
6. NSW Health (2023–2025), Skin penetration — information and resources (overview and infection-control requirements for skin penetration procedures), NSW Government, viewed 2025. https://www.health.nsw.gov.au/environment/skinpenetration/Pages/default.aspx ↩
7. Australian Commission on Safety and Quality in Health Care (2021), National Safety and Quality Health Service (NSQHS) Standards, second edition (clinical governance and safety standards), ACSQHC, Sydney, viewed 2025. https://www.safetyandquality.gov.au/standards/nsqhs-standards ↩
8. Australian Commission on Safety and Quality in Health Care (2017–2023), NSQHS Standards — Partnering with Consumers Standard: overview and factsheets), ACSQHC, Sydney, viewed 2025. https://www.safetyandquality.gov.au/standards/nsqhs-standards/partnering-consumers-standard ↩
9. RACGP (2015–2022), Submission to Medical Board consultation – Regulation of medical practitioners who provide cosmetic medical and surgical procedures, Royal Australian College of General Practitioners, viewed 2025. https://www.racgp.org.au/advocacy/reports-and-submissions/view-all-reports-and-submissions/2022-reports-and-submissions/submission-to-medical-board-consultation-regulatio ↩
10. Medical Board of Australia (2023), FAQs: New guidelines for cosmetic surgery and procedures (FAQ web page), Medical Board of Australia, viewed 2025. https://www.medicalboard.gov.au/Codes-Guidelines-Policies/FAQ/FAQ-New-standard-and-guidelines-for-cosmetic-surgery-and-procedures.aspx ↩
11. Therapeutic Goods Administration (2024), Health service advertising and cosmetic injectables — key messages for advertisers (topic page), Australian Government Department of Health and Aged Care, viewed 2025. https://www.tga.gov.au/products/regulations-all-products/advertising/specialised-advertising-issues-and-topics/advertising-health-services-and-cosmetic-injections-frequently-asked-questions-and-answers ↩