Yes, it is most important to first distinguish whether the cause of nasolabial folds is the sagging type or the volume-loss type. This is because, even if they look similar on the surface, the approach differs depending on whether the problem is caused by fat sagging downward or by a loss of cheek volume creating the fold.
The sagging type occurs when the SMAS and ligaments loosen, causing fat to descend and deepen the nasolabial line; it is treated with lifting that pulls the structure upward. In contrast, the volume-loss type occurs when fat and collagen in the cheek and anterior cheekbone decrease, leading to a loss of support and a depression above the nasolabial fold; it is treated by restoring volume to reduce the step-off.
In practice, the two factors are often mixed, so a comprehensive diagnosis is important. Since this judgment requires visual inspection, palpation, and observation of facial expressions and movement, we recommend consulting a specialist rather than self-diagnosing.
