Why is It So Difficult to Find a Competent Doctor to Reduce Nasolabial Fat?

I am 35 and I've had excess fat in my nasolabial area since I was a child, it is hereditary. Now that I'm older it's causing unsightly paunch. To make matters worse I also have very deep depressions under my eyes. I simply want to find a skilled surgeon who will REDUCE the excess fat in this area, and fill the depressed area with a fat graft, but I cannot find anyone knowledgeable about fat reduction in this area of the face. They all keep suggesting fillers for the NL fold. I don't need that. Why don't more doctors suggest reduction?

Doctor Answers 5

Acculift for Reduction of Nasolabial Fat

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Hi ErieGirl,

As we age, loss of facial fat is the main cause of skin folds and sagging skin.  Most physicians want to maintain facial volume rather than remove it.  By filling depressions, the "paunch" is supported and lifted.  There are a few select physicians (Daniel Rousso, Birmingham,AL and David Holcomb, Sarosota, FL) who use a laser technology called Acculift to remove facial fat with laser assisted microliposuction.  Good luck and be well.

Dr. P

Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Cheek Fat

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First of all, most people are likely suggesting adding volume since it is much easier than removing it.  Without pictures, it is impossible to give you suggestions about what you need.  In some cases, micro-liposuction is good for removing fat.  However, in many cases a cheek lift is required to rejuvenate the face.  Good luck.

Excision of prominent nasolabial folds

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Without a picture or an in person exam, it would be hard to accurately advise you. However, in cases of prominent overhanging nasolabial folds, especially in older or HIV patients, direct excision of the folds is quite effective and leaves minimally detectible scarring. This may not be the answer for your particular situation but is worth adding to this discussion

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon

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Removing fat is usually not the answer to nasolabial excess.

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It sounds like you need a good cheeklift to put the tissue with its volume back where it belongs. Removing the fat or filling the crease is not the answer to long term correction of the problem. It is difficult to say without seeing a photo.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Reducing the nasolabial folds

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Without an exam it is difficult to say.  However, the folds are often more prominent because of descent of the soft tissues of the cheek and really do not need reduction but actually need a lift of some sort. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.