Which is better for nasolabial folds, Botox or Juvederm?

I need to get rid of the nasolabial folds that I'm sure age me by at least ten years - even if my husband doesn't think it's true I'm still going to do it. I've heard that Juvederm is the standard treatment for nasolabial fold issues but apparently also has the side effect of messing up your smile and making you look really unnatural. So I have two questions. Firstly, if Juvederm really has this side effect why is it the standard treatment? And secondly, if it's really true what they say about Juvederm making you look weird when you smile - which really seems doubtful to me - can nasolabial folds instead be treated with Botox?


F, 42, California

Nasolabial folds and lines start to deepen relatively early in life. It’s really not a good idea to attempt to completely erase them. Think of plastic surgery examples gone wrong—that’s why you want to soften, not eradicate, nasolabial folds. 

Juvederm is a facial filler and botox relaxes muscles beneath the skin. It’s really not a question of which of the two works better. Sometimes it makes sense to use both to achieve the results you want. I use Juvederm.

Juvederm is a clear gel that adds volume beneath the skin. It’s a minimally invasive procedure that can help you look younger. Adding Juvederm or another facial filler can plump up your skin and remove the appearance of some lines and folds, such as those around the nose and between the nose and mouth.

Botox can be used with facial fillers like Juvederm with good results. For instance, you might want to treat vertical lines that have formed around your lips over time. Although you could inject filler into your lips to plump them, your doctor would probably recommend botox treatments for that area. Both treatments offer almost instant results with little downtime, too.

Juvederm is the best treatment for nasolabial folds, and in my experience, does not affect your smiling ability. Botox is not generally used in the folds, but more so around the lips, in the DAOs, and chin muscles. 

Nasolabial folds are generally treated with a filler- I personally prefer Radiesse for this area. agents such as Botox really do not play a role in this region as it is not a matter of weakening muscle activity. 

When placed judiciously and in proper and reasonable correction it should be very natural with no visual asymmetry or anomaly.


Hi 321Goldice,

I see this very often in my practice. Many women, beginning in their late twenties, start to notice their nasolabial folds deepening. What I most often recommend is filler into the cheeks. This gives the cheeks a lift and results in softer nasolabial folds. What we are trying to do here is replace the volume you have lost over the years. This gives very subtle results and our patients are thrilled with the results!

Sachin M. Shridharani has 3 Botulinum toxin A before & afters:

Botulinum toxin A before image performed by Dr. Sachin M. ShridharaniBotulinum toxin A after image performed by Dr. Sachin M. ShridharaniBotulinum toxin A before image performed by Dr. Sachin M. ShridharaniBotulinum toxin A after image performed by Dr. Sachin M. ShridharaniBotulinum toxin A before image performed by Dr. Sachin M. ShridharaniBotulinum toxin A after image performed by Dr. Sachin M. Shridharani

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You don't want to completely get rid of your nasolabial folds! Even young, healthy people have those folds, but you don't really notice them until they start getting deeper with age. The deeper they become, the more hallow your cheeks may appear. Juvederm can look really natural when applied in the right amount and in the right place, but the goal is to lessen the appearance of the folds rather than completely eliminating them. If you pump enough Juvederm into the fold to eliminate it entirely, you're probably going to look very stiff and unnatural.

Botox is a neurotoxin that doesn't work the same as fillers like Juvederm, so this really isn't an either-or scenario. Consult with a trained practitioner who knows how to evaluate your skin and come up with an effective plan that will look natural while delivering the more youthful appearance that you want. They may suggest filling in your cheeks rather than going into the lines directly.