Does Sunekos Work for Nasolabial Folds? A Doctor Explains Who It Is—and Isn’t—Right For

Author:
Specialized Clinic for Nasolabial Folds and Wrinkle Treatment
Osaka Houreisen Cosmetic Dermatology / Tokyo Houreisen Skin Clinic / Nagoya Houreisen Skin Clinic
Shinya Sasagawa, MD
Representative Director, Shingetsukai Medical Corporation
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Many patients want to soften their nasolabial folds without creating an overfilled appearance. This is one reason skin boosters such as Sunekos attract interest.

However, nasolabial folds are rarely caused by age alone. They often reflect a combination of reduced skin elasticity, cheek descent, facial fat distribution, bone structure, hollowing beside the nose, and repeated facial movement.

In clinical practice, this distinction matters. Two people may have folds that look similar in a photograph but require completely different treatments. At our clinic, we assess the relative contribution of the skin, fat, bone structure, and facial movement before recommending a treatment.

Does Sunekos Work for Nasolabial Folds?

The most accurate answer is: Sunekos can help some nasolabial folds, but only when the problem it is designed to treat is an important part of the fold.

Sunekos Performa is intended for mild to moderate skin imperfections and depressions, including the nasolabial area. It contains non-crosslinked hyaluronic acid and a specific combination of six amino acids, and is designed to support hydration, elasticity, and the extracellular matrix of the skin.

Unlike a conventional crosslinked dermal filler, Sunekos is not primarily used to create firm projection or replace a clear loss of structural volume. Its effect is usually more gradual and subtle.

Therefore, Sunekos may soften the appearance of a fold when thinning, dryness, loss of elasticity, or superficial creasing is making the area look more tired. If the fold is mainly caused by a deep groove, hollowing beside the nose, cheek sagging, or facial structure, Sunekos alone is unlikely to create a substantial correction.

In practical terms, Sunekos can be part of a nasolabial fold treatment plan, but it is usually best understood as a treatment for the quality of the skin rather than the main correction for a deep fold.

What Is Sunekos?

Sunekos is an injectable treatment that combines non-crosslinked hyaluronic acid with a specific cluster of six amino acids in an internationally patented formulation.

At our clinic, we use Sunekos Performa. The formulation is designed to support the skin’s extracellular matrix and physiological hydration while encouraging pathways involved in collagen and elastin production.

Because Sunekos does not behave like a conventional firm, crosslinked filler, it is generally used to improve skin quality without deliberately creating obvious projection or changing the contours of the face.

It can be used in areas such as the forehead, around the eyes, around the mouth, the cheeks, the nasolabial area, and the neck. Treatment in delicate facial areas requires careful anatomical assessment and an appropriate injection technique.

For a broader explanation of its benefits, limitations, and other treatment areas, see our detailed guide to Sunekos treatment.

Reference Cases Showing the Skin-Quality Effects of Sunekos

Sunekos for Under-Eye Fine Lines and Blue Dark Circles

This patient received Sunekos for fine lines and blue-toned dark circles beneath the eyes.

View the full treatment details and progress

The change was consistent with improved firmness and dermal support. This may have made the underlying vessels less visible and helped the under-eye area appear brighter and more refreshed.

Sunekos and Botox for the Forehead, Glabella, and Eye Area

This patient received a combination of Sunekos and Botox for fine lines involving the forehead, glabella, and eye area.

View the full treatment details and progress

In this case, Sunekos was used to address skin firmness and fine static lines, while Botox was used to reduce excessive muscle movement. The photographs therefore show the result of a combination treatment rather than the effect of Sunekos alone.

Sunekos and Botox for Forehead Fine Lines

This patient received Sunekos together with Botox for fine lines and reduced firmness across the forehead.

View the full treatment details and progress

Fine lines visible at rest appeared softer, and the forehead showed a smoother, firmer appearance. Because Botox was also used, the improvement should be understood as the result of treating both skin quality and muscle movement.

What Can Sunekos Improve?

Skin Firmness, Hydration, and Texture

Sunekos works within the skin to support hydration and the extracellular matrix. It may help skin feel more supple and resilient, particularly when the goal is a subtle improvement in texture rather than added facial volume.

As the overall texture improves, fine lines and enlarged pores may also look less noticeable. Individual responses vary, and the treatment should not be described as a replacement for structural filler, lifting treatment, or surgery.

Fine Lines Around the Eyes, Forehead, and Mouth

Sunekos may soften superficial lines by supporting the condition of the dermis. It can be particularly useful in thin or delicate areas where visible added volume is not the goal.

For expression lines on the forehead or between the brows, Botox may still be needed because the underlying muscle movement remains active. Sunekos and Botox address different causes: one focuses on skin quality, while the other reduces excessive muscle activity.

Blue and Shadow-Type Under-Eye Circles

When injected around the eyes, Sunekos may improve the quality and support of thin under-eye skin, which can make underlying vessels less visible in suitable patients.

However, under-eye concerns may also be caused by fat prolapse, tear-trough hollowing, pigmentation, or bone structure. These causes require different treatment approaches.

Redness and Uneven-Looking Skin

In our clinical experience, some patients also notice an improvement in diffuse redness as the overall condition of the skin improves. However, the response varies, and Sunekos is not a treatment for every cause of facial redness. Persistent or localised redness should be medically assessed before treatment.

Which Nasolabial Folds Are Most Likely to Respond?

Many patients have a combination of these features. For example, a person may have both declining skin quality and structural hollowing. In that situation, Sunekos may improve the superficial component, but another treatment may still be needed to address the depth or shadow.

How Many Sunekos Treatments Are Needed?

Some patients notice early changes after one session, but a course of treatment is usually recommended for a more consistent result.

At our clinic, a typical starting course with Sunekos Performa is three sessions at intervals of approximately two weeks. Depending on the treatment area, skin condition, and response, the number of sessions or interval may be adjusted.

The improvement develops gradually and should be assessed after the treatment course rather than immediately after an injection, when temporary swelling may influence the appearance.

The duration of improvement varies between patients. Maintenance treatment may be considered when the effects begin to diminish; in some cases, this is assessed at around six months. The timing should be based on your skin condition and treatment goals rather than a fixed schedule for everyone.

Side Effects, Risks, and Downtime

Sunekos is generally associated with limited downtime, but it is an injectable medical treatment and is not completely free of risk.

Temporary Swelling and Small Injection-Site Bumps

Swelling or small raised areas may appear immediately after injection. These usually settle as the product disperses and the local reaction improves, often within a few days.

Redness, Tenderness, Warmth, or Itching

Temporary redness, tenderness, warmth, or itching can occur at the injection sites. These reactions usually improve within a few days. Please contact the clinic if symptoms are severe, worsening, or lasting longer than expected.

Bruising

Bruising can occur with any injectable treatment. We apply careful pressure after injection, but bruising cannot be completely prevented, particularly in patients who bruise easily or in areas with delicate skin.

Most bruising improves within approximately one to two weeks.

Infection or Hypersensitivity Reactions

Infection is possible whenever the skin is punctured, although it is uncommon when appropriate antiseptic and aseptic techniques are used. Local inflammatory or hypersensitivity reactions may also occur. Patients with a known allergy to any component should not receive the treatment.

Rare but Serious Injection-Related Complications

Unintended injection into a blood vessel can cause embolism, vascular occlusion, reduced blood flow, tissue damage, or skin necrosis. In severe cases, facial injections involving hyaluronic acid-containing products have been associated with visual disturbance, blindness, or neurological injury.

The current instructions for use state that these serious events have not been reported specifically in relation to Sunekos Performa. At our clinic, we have also not experienced vascular occlusion following Sunekos treatment to date. However, this does not mean that the risk can be described as zero. Careful anatomical assessment and injection technique remain essential.

Who May Not Be Suitable for Sunekos?

Sunekos Performa may not be appropriate for people who are under 18, pregnant or breastfeeding, have active inflammation or infection in the treatment area, have a known allergy to its components, or are receiving ongoing anticoagulant therapy. It may also be unsuitable for patients with certain systemic autoimmune soft-tissue diseases, active cancer, or those receiving immunosuppressive treatment or chemotherapy.

Previous filler, implants, or other procedures in the same area should be disclosed during consultation so that the timing and suitability of treatment can be assessed safely.

How Does Sunekos Compare with Other Nasolabial Fold Treatments?

There is no single best treatment for every nasolabial fold. The most suitable option depends on what is driving the fold in your case.

At our clinic, Growth Factor Therapy is often one of the first options considered when a patient wants to improve the nasolabial fold itself rather than only the surface quality of the skin. Hyaluronic acid is an important option when immediate correction of a defined hollow is needed. Sunekos is selected when skin quality is a meaningful part of the concern or when subtle textural improvement is the main goal.

For a more detailed comparison, see the difference between Growth Factor Therapy and hyaluronic acid filler.

Frequently Asked Questions

Can Sunekos completely erase nasolabial folds?

No treatment can guarantee that a nasolabial fold will disappear completely. Sunekos may soften a mild fold when reduced skin quality is contributing, but it is unlikely to erase a deep structural fold on its own.

Can I see enough improvement after one treatment?

Some patients notice an early change after one session, but Sunekos is generally planned as a course. At our clinic, a typical starting course with Sunekos Performa is three sessions at approximately two-week intervals, adjusted when medically appropriate.

Is Sunekos a dermal filler?

Sunekos contains non-crosslinked hyaluronic acid, but it is not used in the same way as a firm, crosslinked volumising filler. Its main role is to improve hydration, elasticity, and overall skin quality rather than to reshape the face or replace substantial volume.

Which is better for nasolabial folds: Sunekos or Growth Factor Therapy?

The answer depends on the cause and the treatment goal. Sunekos is more suitable when superficial skin quality is the main issue. Growth Factor Therapy is often considered when the aim is to treat the fold itself more directly and achieve a gradual, longer-lasting improvement in the skin’s supporting structure. A medical assessment is needed because mixed causes are common.

Is Sunekos suitable just before an important event?

Sunekos is not usually the best choice when an immediate and highly predictable correction is required. Its effects develop gradually, and temporary swelling or bruising may occur. If you have an important event, discuss the timing and your desired degree of change with the doctor in advance.

Summary

Sunekos is a useful skin-quality treatment, but it is not the right standalone option for every nasolabial fold.

It is most likely to help when reduced elasticity, dryness, thinning skin, or superficial creasing is making a mild fold look more noticeable. In these cases, improving the condition of the skin may create a softer, fresher, and natural-looking result without obvious added volume.

When the main cause is pronounced hollowing beside the nose, cheek descent, bone structure, facial fat distribution, or a fixed deep crease, another treatment is usually required. Growth Factor Therapy, hyaluronic acid filler, or a thread lift may be more appropriate depending on the dominant cause.

The most important question is therefore not “Is Sunekos a good treatment?” but “Is Sunekos the right treatment for the cause of my nasolabial folds?”