Is cutting and pulling the skin right on the nasolabial folds a good option?

Question

I have very deep nasolabial folds. Is it advisable to cut and pull the skin right on the folds to make them disappear? Do you think the scars would be visible and too evident? (there would be a minilift to follow)

Vincent N. Zubowicz, MD · Answer

Even though a facelift will disassemble the nasolabial fold they are generated by facial expression. Direct surgical excision, although an uncommon procedure, can you excellent results in the properly selected patient.

Dilip D. Madnani, MD, FACS · Answer

There are multiple options for improvement of the nasolabial folds and what you have mentioned is an option. Fillers, lasers, extended facelifts also help improve this area. Direct excision is an older technique, that still has some indications, however, most people do quite well with fillers and/or a facelift.

Steven L. Ringler, MD, FACS · Answer

Thank you for your question.  For most patients, a facelift and facial fat grafting would be a better option since there is no resulting scar. The final decision will be between you and your plastic surgeon.  Good luck to you.

Trevor M. Born, MD · Answer

Dear StevedefilThank you for your question!  Direct excision of the fold is an option- It is not my first option- a combination of a lift with micro liposuction of the prominence of the fold and fat grafting to restore the frame around the mouth works well.With Warm RegardsTrevor M Born MD

Luis A. Mejia, MD · Answer

Hi... thank you for the question... to treat the nasolabial fold are three options.. 1.- Dermal fillers, 2.- Fat transfer and 3.- Mid face facelift ...

Mark Prysi, MD · Answer

Direct excision of naso labial folds is rarely done anymore. With the advent of midfacelifts and fat grafting the direct excision method is almost never used anymore.

Robert S. Houser, DO · Answer

What your asking for is direct excision of the fold.  This is an old, but not outdated technique.  I've used this successfully on both men and women, but I am VERY selective in which patients I offer this.  True, most midface rejuvenation is done with fillers now, but not everyone wants that additional volume in their face (it changes the way you look).  Make sure that you've explored or discussed the alternatives because once that scar is there, it's permanent.  In my experience, it is usually a very acceptable scar with time.  Good luck!

Josh Surowitz, MD · Answer

I would advise against directly excising the nasolabial folds.  Modern facelift techniques and other adjuncts, such as fillers or fat transfer can give very natural results, while respecting the natural facial subunits.

Barry L. Eppley, MD, DMD · Answer

In the right patient direct excision of the nasolabial folds can be beneficial. Usually this is an older patient who can tolerate a fine line scar. But it may also be acceptable in the younger patient with very deep and inverted nasolabial folds.

Dean P. Kane, MD, FACS · Answer

Dear Stevedefil:Many, many decades ago in a galaxy close to our heart, direct excision of the nasolabial fold was performed when no other reasonable options existed. Patients, usually men with gaunt features and significant skin laxity were the primary patients. Wide undermining was not yet in use to lift and unfurl the nasolabial fold from incisions in front of the ear. With an expanding array of options including:wide undermined SMAS faceliftsfillerslasers Direct excision of the nasolabial fold is best used in patients who are limited in the amount of anesthesia or medical disability and are accepting of a sometimes unpredictable scar on the front of the face. Please consult with a Board Certified, well experienced Plastic Surgeon or ENT Facial Surgeon to consider a wider facelift technique to limit the 2 scars required and therefore circulation concerns of a direct excision combined with a mini-lift. I hope this was helpful. All the best!

Is cutting and pulling the skin right on the nasolabial folds a good option?

Answers (18)

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