Nasolabial folds—also known as smile lines—form as the midface loses volume, the cheek fat pads descend, and skin elasticity weakens.
In Korea, the two most common non-surgical treatments are:

1. Filler
2. Lifting devices (HIFU, RF, Ultrasound tightening)

Both improve the nasolabial area, but they work in completely different ways.
Here is a full comparison to help you choose the right treatment based on the cause of your folds, not just the appearance.

What Causes Nasolabial Folds?

Before choosing a treatment, it’s critical to understand the underlying cause:

1. Volume Loss in the Cheeks

The midface fat pads deflate → cheek support weakens → folds deepen.

2. Skin Laxity & Sagging

Cheeks slide downward → heaviness forms around the nasal area.

3. Deep Facial Anatomy

Strong fold structure or genetics.

4. Thin or Deflated Skin

Skin loses elasticity → lines crease more easily.

Because the causes differ, the best treatment also differs.

What Filler Does for Nasolabial Folds

Fillers use hyaluronic acid to soften the fold, replace lost volume, and smooth the crease.

How Filler Works

• Adds support under the fold
• Restores midface volume
• Softens shadowing
• Reduces depth of the line

Best For

• Volume loss
• Shadow-based folds
• Early to moderate depth
• People wanting instant improvement

Advantages

• Immediate smoothing
• Natural softening when done correctly
• Fast procedure with minimal downtime

Considerations

• Overfilling can make the midface puffy
• Doesn’t fix sagging—only masks the fold
• Needs maintenance every 9–12 months

What Lifting Devices Do for Nasolabial Folds

Lifting devices include HIFU (Shurink, Ultherapy, Liftera) and RF tightening (Oligio, Thermage).

How Lifting Devices Work

• Tighten and contract collagen
• Lift midface tissues upward
• Reduce the heaviness that pushes folds deeper
• Improve elasticity and firmness

Best For

• Sagging cheeks
• Early jowls contributing to fold depth
• Skin laxity around the midface
• People wanting a natural improvement

Advantages

• Lifts the cause of the fold (cheek descent)
• No needles or filler volume
• No downtime
• Results last 6–12 months

Considerations

• Won’t fill deep structural lines
• Results are gradual, not immediate
• Best for mild to moderate folds only

Filler vs Lifting Devices: Which Works Better?

1. If the fold is caused by sagging → Choose Lifting Devices

Examples:

• Heavy midface
• Dropping cheek fat pads
• Skin laxity

Lifting devices raise the tissue, making folds lighter without adding bulk.

2. If the fold is caused by volume loss → Choose Filler

Examples:

• Hollow cheeks
• Flat midface
• Shadowed fold that deepens when you smile

Filler restores support, reducing the appearance of lines.

3. If the fold is deep due to anatomy → Combination Treatment

This is the Korean dermatology approach:

• Lift the midface with HIFU or RF devices
• Add small, precise filler only where the crease remains

This creates:

• Natural contour
• No overfilled look
• Long-lasting improvement

Which Looks More Natural?

Lifting Devices → Most natural

• Slimmer, more lifted midface
• No added volume
• No chance of puffiness

Filler → Natural when used conservatively

• Best for structural deficits
• Should not be used to “fill everything”
• Best when combined with lifting

Duration of Results

Filler

• 9–12 months

Lifting Devices

• 6–12 months depending on device and collagen response

Combination treatments often last longer because the lifted tissue reduces filler migration and breakdown.

Korean Anti-Aging Strategy for Smile Lines

Most Korean dermatologists follow this sequence:

Step 1 — Lift the midface

(HIFU, Ultherapy, Liftera, Oligio, Thermage)

Step 2 — Use minimal filler

To soften the crease without adding a bulky look.

Step 3 — Maintain elasticity

With boosters or energy-based treatments.

This prevents the overfilled, unnatural effect seen in many Western-style treatments.

Final Verdict

Choose Filler If:

• Your folds come from volume loss
• You want immediate softening
• You have a deep crease with shadowing

Choose Lifting Devices If:

• Your folds come from sagging
• You prefer natural improvement
• You want to avoid filler volume

Choose Both If:

• You want the most complete and natural result
• You have both sagging + volume loss
• You want long-lasting correction