Patrick Hudson MD, FACS

The nasolabial fold is the crease that runs from the nose to the corner of the mouth. It separates the cheek from the upper lip. As we grow older this fold can become more prominent due to several factors. The most significant are excess skin, thinning of skin and ptosis or drooping of cheek fat.

There is no perfect method to treat this problem. A facelift alone will not completely remove the crease so other treatments must be used either alone or in conjunction with a facelift.

The most effective method is to surgically remove the crease but this leaves a scar which in some patients may be worse than the original crease.

A simple method is to remove the excess fat that lies in the area just above the fold. This can be done using liposuction. The scarring that is created beneath the area may also have a beneficial effect. To smooth the transition between the fatty cheek and the lip, fat grafts or artificial prosthetic material have been placed beneath the crease. The fat is either injected into the area or used as a graft.

During a facelift it is common to tighten the underlying muscle layer called the SMAS. However if this layer is simply tightened it may make the nasolabial fold worse. For tightening to have any benefit this muscle layer must first be released from some of its attachments, especially those to the muscle around the eye, the orbicularis muscle. Unfortunately this increases the risk of surgery and may create an unnatural appearance.

At this time there is no consistently effective method which can completely remove this fold and produce a good cosmetic result.