I have prominent cheeks and have developed nasolabial folds. I don't want to have any fillers, so I'm thinking of getting them surgically excised instead. Is this possible?
Surgical Excision of Nasolabial Folds
Doctor Answers 4
Nasolabial Folds: Fillers vs. Surgery
Nasolabial folds do not improve with time. If you are considered about these vertical lines around your mouth and nose, there is one option that you should seriously consider:
- Facial Fillers
Although surgical excision has been described, it is not the first option to consider in addressing this area. The quality and visibilty of the scar is unpredictable, and although well described, the procedure should not be advocated until less invasive options are explored.
Technique choices vs. the result you want
Thanks for your question.
In my practice I always take time to discuss what my patients are truly concerned about. From your question, clearly there are questions in your mind about the balance of your cheeks, nose and the area that divides the two, your nasolabial folds. It can always be a bit challenging when a patient states "I want a certain result but this is the technique you need to use to achieve it."
Placing significant unhidden scars on the face needs to be approached with caution. If your aversion to fillers is the temporary nature of the filler, then you could consider more permanent treatments like fat transfer or de-epithelialized dermis which works very well at achieving a permanent result while avoiding disfiguring scars.
Excision natural folds, especially in the face, can be particularly difficult as the scars that are left can contract and will likely not have the soft natural curve your native naso-labial fold has. The excision would need to excise the deeper connective tissue in addition to the skin to decrease the depth of the fold (which would be replaced with scar). This can give a flattened appearance to the face with the added negative of having permanent visible scars.
I would urge you to speak with a board certified plastic surgeon who should assess your entire facial structure and discuss options with you. I hope this helps.
Steven Williams, MD
Can be done but not often recommended
Excision of the nasolabial folds can be done in extreme cases, but is not offered for the majority of patients.
First, NL folds are normal. Not having them is bizarre. It doesn't mean that they should not be shallow and/or softened in any way. This can be accomplished with a variety of fillers.
Only in extreme cases in older patients with very deep folds should they be excised. Although in the majority of cases the scars heal well, they do leave permanent scars.
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It is possible
It is possible to have your nasolabial crease excised. However, before undergoing such an invasive procedure, please make sure that you look over all your options. While most surgeons do not perform direct excision, very nice results can be obtained. If you include a photograph with your question, we may be able to give you more specific advice.
David Shafer, MD