Liposuction and the treatment of nasolabial folds

Abstract

We investigate whether the application of liposuction to the nasolabial region is a useful adjunct to the rhytidectomy procedure. We have devised a system to grade the severity of the depth and the length of the nasolabial folds pre- and postoperatively. This grading system was used to evaluate the nasolabial region in 60 consecutive patients who underwent rhytidectomy. We compared two subgroups: those who underwent rhytidectomy alone (Group I) and those who underwent rhytidectomy augmented by liposuction in the region of the nasolabial folds (Group II). A change in the length of the fold occurred in 2% of Group I and in 30% of Group II. A change in depth of the fold occurred in 12% of Group I and in 70% of Group II. These results suggest that suction-assisted lipectomy consistently improves the results of rhytidectomy in the region of the nasolabial fold.

Lifting the Anterior Midcheek and Nasolabial Fold: Introduction to the Melo Fat Pad Anatomy and Its Role in Longevity and Recurrence

“… 22 , 38 Direct liposuction of the NLF fat was described by McKinney and Cook in 1989. 39 On the other side of the spectrum, augmentation of the NLC was utilized by volumizing the soft tissues or the bone ( Figure 10 ). Ranging from local de-epithelialized skin rolled up onto itself, 40 to autogenous tissue grafts (dermal, subcutaneous, aponeurotic/galeal, SMAS, etc), 41 , 42 GoreTex (W. L. Gore & Associates, Newark, DE), 43 , 44 and finally autologous fat grafting 45 were described.…”

Expanded Polytetrafluoroethylene (Gore-Tex) Augmentation of Deep Nasolabial Creases

“…3 Such limitations with rhytidectomy have prompted numerous modifications and adjunctive procedures to address the deep nasolabial crease. Direct excision of the redundant skin and subcutaneous tissue, 6,7 suctionassisted liposuction, [8][9][10][11] fat curettage, 12 and tissue advancement at the alar-facial groove 13 have all been described. Rhytidectomy modifications such as direct cheek fat excision, 14 sutured-in-place fat grafts, 15 extended sub-SMAS dissection, 5 deep-plane release of the ligamentous structures associated with the zygomaticus muscle, 16,17 resuspension of the malar fat pad, 18 and repositioning the midface musculature by the subperiosteal approach have all been promoted.…”

SMAS Graft of the Nasolabial Area during Deep Plane Rhytidectomy

“…2,3 Efforts to augment the crease have used implantation of fat autografts, 4,5 dermal fat autografts, 6 temporalis superficialis fascia, 7 silicone, 8 collagen, 9 hyaluronic acid, 10,11 or expanded polytetrafluoroethylene. 12 Other methods modify the fat of the fold by liposuction, 13,14 direct undermining, 15 fat sculpturing, 1,16 and open 17 or intraoral excision. 18 Internal support techniques have evolved from the superficial rhytidectomies 19,20 to more aggressive procedures such as the composite rhytidectomy 21 and subperiosteal lift.…”