Nasolabial folds treatment Malaysia: why we often choose Ellansé instead of simply filling the line

If you are looking for nasolabial folds treatment Malaysia, it is tempting to think the solution is straightforward: there is a deep line beside the mouth, so inject filler into that line. We do not usually approach it that way. After treating a high volume of Ellansé cases, we have learned that a prominent nasolabial fold is often partly a support problem happening higher in the face. When collagen loss and midface ageing are contributing to the fold, Ellansé is one of the treatments we particularly like because it can provide structural correction while stimulating collagen over time.

For nasolabial folds treatment, we first look above the fold

Nasolabial folds run from the sides of the nose towards the corners of the mouth.

They are normal.

Everyone has some degree of folding in this area, especially when smiling. The objective of treatment should not be to create a completely flat, expressionless area around the mouth.

What changes with ageing is the support around it.

Over time, collagen decreases, facial fat compartments change and the middle of the face gradually loses some of its youthful support. Tissue begins to sit differently, and the fold below it can become deeper.

That distinction changes how we treat it.

If the problem were simply an empty groove, injecting directly into the groove every time would make sense.

But frequently, it is not.

We often assess the cheeks, the area beside the nose, overall midface projection and how the tissues move before deciding where Ellansé should actually be placed.

Why LS often prefers Ellansé for ageing-related nasolabial folds

Ellansé is different from a conventional hyaluronic acid filler.

It is made from polycaprolactone, or PCL, microspheres suspended in a carboxymethylcellulose gel carrier. The carrier provides initial correction, while the PCL microspheres stimulate new collagen formation over time.

That makes it particularly interesting when what we see is not just one isolated line, but a broader pattern of facial ageing.

Instead of thinking only:

“How do we fill this fold?”

We can think:

“Where has this face lost support, and how can we rebuild some of that support without making it look overfilled?”

This is a major reason Ellansé has become such an important treatment at LS Clinic.

After years of working extensively with the product, our preference is generally not to chase individual lines with large amounts of material.

We use it more as a facial-structure treatment.

The nasolabial fold then becomes part of the overall plan rather than the only target.

There is actual clinical evidence for PCL in nasolabial folds

Nasolabial folds are also one of the areas where PCL-based fillers have been studied directly.

In a randomised split-face clinical study, 40 patients received a PCL-based filler on one nasolabial fold and a hyaluronic acid filler on the other. At 6, 9 and 12 months, the PCL-treated folds showed statistically greater improvement on the study’s wrinkle and aesthetic-improvement scales. Both products were reported as well tolerated in that study.

Another prospective randomised study followed PCL treatment for nasolabial folds for up to 24 months and demonstrated sustained correction with the studied PCL formulations.

More recent research has continued to evaluate PCL fillers, including Ellansé-M, for moderate-to-severe nasolabial folds, with improvement maintained at 12 months in the studied patients.

This does not mean every nasolabial fold should automatically receive Ellansé.

But it does mean Ellansé is not simply being used because collagen stimulators are fashionable. There is clinical evidence supporting PCL-based treatment in this area.

Why we do not simply fill the entire line until it disappears

This is where aesthetic judgement becomes more important than syringe count.

Imagine a patient whose cheek support has gradually reduced.

More tissue now sits towards the centre and lower part of the face, making the nasolabial fold look heavier.

If we keep injecting directly into the fold without considering the midface, we may soften the groove but also add more bulk to an area that already looks heavy.

The result can become puffy rather than youthful.

That is not what we want.

With Ellansé, we may instead consider strategic support at selected areas of the midface or around the base of the nose, depending on the patient’s anatomy.

Then we reassess the fold.

Sometimes it is already significantly softer and very little additional correction is required.

This is why two patients with equally deep nasolabial folds may receive completely different injection plans.

We treat the cause of the fold as much as the fold itself.

The collagen-stimulation part is why Ellansé interests us

Immediate correction is only one part of Ellansé.

The CMC carrier gradually reduces after treatment, while the PCL microspheres support a process of neocollagenesis — the formation of new collagen around the microspheres. Human and preclinical evidence has demonstrated this collagen-stimulating effect.

This matters because facial ageing involves more than missing volume.

Skin and supporting tissue also change.

For a patient in their late thirties, forties or beyond who is beginning to notice deeper folds together with softer facial contours, we often find this approach more logical than simply replacing volume with conventional gel again and again.

It does not mean Ellansé stops ageing.

It does not mean one treatment permanently removes nasolabial folds.

But it gives us a way to combine initial structural correction with gradual collagen stimulation.

That is the reason we tend to favour it for the right patient.

When would we still choose HA filler instead?

We use HA filler too.

There are situations where it makes more sense.

A younger patient may have very little facial ageing but naturally prominent nasolabial folds. If there is one small local depression and the objective is a subtle, precise correction, HA filler may be appropriate.

HA also has one significant advantage: it can generally be dissolved with hyaluronidase if medically necessary.

Ellansé does not have an equivalent dissolving enzyme.

That is why we are more selective about where and how much Ellansé we inject.

With a longer-lasting collagen stimulator, planning conservatively matters.

Our preference for Ellansé does not mean forcing Ellansé into every face.

Experience with the product should make a clinic more selective, not less.

What if your nasolabial folds are mainly caused by sagging?

Sometimes neither Ellansé nor HA filler should be the first thing we discuss.

If the dominant problem is loose tissue rather than loss of structural support, adding injectable volume may not address enough of the problem.

In those cases, we may discuss a lifting treatment such as Ultherapy Prime or HIFU.

Some patients may eventually benefit from both approaches because ageing can involve both laxity and structural loss.

But we do not believe everybody needs a combination package.

We first decide which problem is contributing most.

How many syringes of Ellansé are needed for nasolabial folds?

There is no standard number.

We would be suspicious of any rule saying that every face needs exactly two or four syringes.

One person may have relatively good cheek support and need a limited correction.

Another may have substantial midface volume and support changes, where treating only the nasolabial folds would not make sense.

Our approach is usually to use enough product to restore appropriate support, then stop.

More Ellansé does not automatically create a better result.

In fact, one of the most important skills in injectable treatment is knowing when the face has enough.

How long can Ellansé last in nasolabial folds?

Clinical research on PCL fillers has demonstrated sustained nasolabial-fold improvement at 12 months, while earlier prospective research followed certain PCL formulations for up to 24 months.

However, individual results and duration vary.

The formulation used, injection area, quantity, facial movement, anatomy and individual biological response all matter.

We therefore would not promise every patient an exact number of months.

We would rather explain that Ellansé should be thought of differently from repeatedly topping up a temporary gel.

Its treatment effect involves both initial correction and the collagen response that develops afterwards.

The LS approach: restore support, don’t chase the line

LS Clinic has worked extensively with Ellansé over many years.

And one thing that experience has taught us is that a good Ellansé treatment is rarely about seeing a line and putting product directly underneath it until it disappears.

It is about understanding the architecture of the face.

Where did support change?

Where does the face actually need volume?

Where should we leave it alone?

And how much correction can we make without changing the patient’s natural expression?

For ageing-related nasolabial folds, Ellansé is often our preferred injectable approach because it allows us to think beyond temporary line filling and work on both structural correction and collagen stimulation.

But the final treatment still depends on the face in front of us.

Some people need very little.

Some may be better suited to HA filler.

Some need tightening rather than more injectable volume.

And some do not need their nasolabial folds treated at all.

A good result should make the face look better supported and less tired — not make every natural fold disappear.