Direct Skin Excision Fat Reshaping and Repositioning for Correction of Prominent Nasolabial Fold

Abstract

In addition to all the consequences mentioned elsewhere in the literature, the aging process causes the most dramatic changes in the midface and nasolabial complex. Genetic predisposition also plays a role in the final appearance of this area. The nasolabial complex in the aged face generally is accepted as a “hard-to-treat area” for which many different techniques have been described. Among the techniques described to date, direct excision still keeps its popularity for selected patients. However, some controversies in the technique are open to discussion. To overcome these problems, we did skin excision, reshaping and repositioning the fibrofatty tissue lateral to the fold, which is contrary to fat excision in the classical technique. It seems to be a better approach to reshape and reposition the ptotic tissue so as not to obliterate but rather to smooth out the nasolabial area. Excision of fat would decrease the amount of tissue in the already atrophic and ptotic face. This technique offers a new approach to nasolabial complex problems. The most significant drawback is the scar, which usually is imperceptible in selected patients.