Injerto de grasa autóloga con lipofiltración en surco nasolabial

Introducción: La profundización de los surcos nasolabiales es uno de los signos más tempranos del envejecimiento natural del ser humano y puede ser atenuado con el empleo de materiales de relleno, entre ellos el injerto de grasa autóloga. Objetivo: Describir los resultados de la infiltración de grasa autóloga en el surco nasolabial para el rejuvenecimiento facial. Métodos: Se realizó un estudio observacional, descriptivo, de corte longitudinal y prospectivo, para describir la infiltración de grasa autóloga en el surco nasolabial para el rejuvenecimiento facial en 40 pacientes. Los pacientes se siguieron durante seis meses de forma trimestral (un mes, tres meses y seis meses) y se evaluaron las variables: tiempo de recuperación, aparición de complicaciones, grado de satisfacción de los pacientes y resultados estéticos. Resultados: La edad media fue de 47 años, con predominio del sexo femenino. El 92 % de los pacientes se recuperó en menos de 10 días, con la aparición de seis complicaciones. La disminución del defecto posterior al procedimiento fue significativa respecto al momento inicial; sin embargo, con el tiempo (tres a seis meses) el defecto en el surco nasolabial reapareció en algunos pacientes. El grado de satisfacción de los pacientes vario entre un 95 % (un mes) a un 90 % a los seis meses y los resultados estéticos catalogados como buenos disminuyeron de un 90 % (un mes) a un 65 % (seis meses). Conclusiones: Se demostró que el injerto de grasa autóloga en el surco nasolabial es un procedimiento con resultados estéticos buenos, sin embargo, este disminuye en los meses posteriores, lo que puede estar relacionado con la reabsorción del injerto graso.

Introduction: The deepening of the nasolabial folds is one of the earliest signs of natural aging in humans and can be mitigated with the use of filler materials, including autologous fat grafting. Objective: To describe the results of autologous fat infiltration in the nasolabial fold for facial rejuvenation. Methods: An observational, descriptive, longitudinal and prospective study to describe the infiltration of autologous fat in the nasolabial fold for facial rejuvenation was carried out in 40 patients. The patients were followed up for 6 months: one month (1M), three months (3M) and six months (6M) and the evaluated variables were: recovery time, appearance of complications, degree of patient satisfaction and aesthetic results. Results: The average age was 47 years, with a female prevalence. 92% of patients recovered in less than 10 days, with the only appearance of six complications. The decrease in the defect after the procedure was significant compared to the initial moment; however, over time (3-6M) the defect in the nasolabial fold reappeared in some patients. The degree of patient satisfaction varied between 95% (1M) to 90% at 6M and the aesthetic results classified as good decreased from 90% (1M) to 65% (6M). Conclusions: It was shown that autologous fat grafting in the nasolabial fold is a procedure with good aesthetic results, however it decreases in subsequent months, which may be related to the reabsorption of the fat graft.

The application of nasolabial fold flap in the nasal ala subtotal defect after nasal ala tumor operation / 中国医师进修杂志

Objective:To explore the effect of nasolabial fold flap in the treatment of nasal ala subtotal defect nasal afte ala tumor operation.Methods:The clinical data of 7 nasal ala subtotal defect patients underwent nasal ala basal cell carcinoma operation in the First People′s Hospital of Lianyungang City from February 2018 to September 2020 were retrospectively analyzed.Results:Seven patients with nasal ala subtotal defect were successfully repaired with nasolabial fold flap. The patients were followed up for 19 to 52 months, the flaps survived, the color was good, the contour was not bloated, the nasal ventilation was not affected, and good results were achieved.Conclusions:The nasolabial fold flap repair of the nasal ala subtotal defect after nasal ala tumor operation has the advantages of simple method, rich materials, no need for vascular anastomosis, no need for secondary surgery, accurate effect and so on, which is suitable for clinical promotion in clinical.

Clinical outcomes of personalized PEEK prosthesis in correcting nasolabial fold depression / 中华医学美学美容杂志

Objective:To investigate the clinical outcomes of personalized polyetheretherketone (PEEK) implant in the correction of nasolabial fold depression.Methods:A total of 30 patients with nasolabial fold depression (5 males, 25 females, aged 26 to 52 years, mean 36.3 years) admitted to the Affiliated Friendship Plastic Hospital of Nanjing Medical University who want to undergo nasolabial fold augmentation from January 2019 to January 2021. All patients underwent CBCT scan and three-dimensional simulation, the personalized PEEK implant was designed and produced with CAD/CAM technique, the personalized PEEK was implanted during the operation. The patients were followed up for 3-12 months, and the wrinkle score and satisfaction were compared before operation and 3 months and 6 months after operation.Results:The depressions of nasolabial fold were significantly improved in all patients, and there were no complications such as hematoma and infection after operation. During the follow-up, there was no implant displacement or exposure, and the effect was stable and lasting. The scores of wrinkles at 3 months after operation (2.30±0.47) and 6 months after operation (2.17±0.38) were significantly lower than those before operation (4.03±0.67), and the scores of satisfaction were significantly higher than those before operation ( P<0.05). The scores of satisfaction at 3 months after operation (3.97±0.56) and 6 months after operation (4.23±0.57) were significantly higher than those before operation (1.70±0.60). The difference was statistically significant ( P<0.05). Conclusions:3D printing personalized PEEK prosthesis is effective in correcting nasolabial fold depression, and it is safe and stable, so it is recommended for clinical application.

Manejo oftalmológico en parálisis facial refractaria mediante tira tarsal y suspensión del pliegue nasolabial / Ophthalmological management of refractory facial palsy using tarsal strip and suspension of the nasolabial fold

INTRODUCCIÓN. La parálisis facial refractaria produce ectropión paralítico secundario, que predispone a la queratopatía por exposición y otras complicaciones oculares, que deben ser manejadas con cirugía. OBJETIVO. Describir el manejo quirúrgico oftalmoló-gico en parálisis facial refractaria mediante tira tarsal y suspensión del pliegue nasolabial. MATERIALES Y MÉTODOS. Estudio observacional, retrospectivo. Población y muestra conocida de 8 Historias Clínicas, en el Hospital de Especialidades Carlos Andrade Marín, período enero 2016 a diciembre 2018. Criterios de inclusión: registros de parálisis facial y ectropión paralítico. Los datos fueron tomados del sistema AS400, y se analizaron en el programa estadístico International Business Machines Statistical Package for the Social Sciences, Versión 25.0. RESULTADOS. La etiología tumoral fue 62,5% (5; 8), A los 6 me-ses postquirúrgicos se observó resolución de: lagoftalmos, lagrimeo, ardor ocular y quera-titis en el 87,5% (7; 8); el ectropión se resolvió en todos los casos y se obtuvo una mejoría en la ptosis. La agudeza visual mejoró en el 75,0% (6; 8). DISCUSIÓN: La literatura evi-denció que las técnicas quirúrgicas si bien no abordan el aspecto oftalmológico y estético a la vez, aún es incierto su manejo de manera conjunta dado que ha sido poco descrita pero ha adquirido importancia por los resultados en la Unidad de Oftalmología del hospital.CONCLUSIÓN. La descripción del manejo quirúrgico oftalmológico en parálisis facial re-fractaria mediante la técnica de tira tarsal y suspensión del pliegue nasolabial fue asertiva como experiencia local.

INTRODUCTION. Refractory facial paralysis produces secondary paralytic ectropion, which predisposes to exposure keratopathy and other ocular complications, which must be managed with surgery. OBJECTIVE. Describe the ophthalmic surgical management of refractory facial paralysis using tarsal strip and suspension of the nasolabial fold. MATE-RIALS AND METHODS. Observational, retrospective study. Population and known sam-ple of 8 Clinical Histories, at the Carlos Andrade Marín Specialty Hospital, period from january 2016 to december 2018. Inclusion criteria: records of facial paralysis and paralytic ectropion. The data were taken from the AS400 system, and analyzed in the statistical pro-gram International Business Machines Statistical Package for the Social Sciences, Version 25.0. RESULTS. The tumor aetiology was 62,5% (5; 8). At 6 months after surgery, resolu-tion of: lagophthalmos, lacrimation, ocular burning and keratitis was observed in 87,5% (7; 8); ectropion resolved in all cases and ptosis improved. Visual acuity improved in 75,0% (6; 8). DISCUSSION: The literature showed that the surgical techniques, although they do not address the ophthalmological and aesthetic aspects at the same time, their joint mana-gement is still uncertain since it has been little described but has acquired importance due to the results in the Ophthalmology Unit of the hospital. CONCLUSION. The description of ophthalmic surgical management in refractory facial paralysis using the tarsal strip techni-que and suspension of the nasolabial fold was assertive as a local experience.

Clinical efficacy and safety of hyaluronic acid dermal filler in treating nasolabial folds in Chinese population / 中华整形外科杂志

Objective@#To investigate the clinical efficacy and safety profile of hyaluronic acid dermal filler(Restylane®) in treating nasolabial folds in Chinese population.@*Methods@#103 subjects in this study were recruited from five Chinese clinical trial centers between July 2014 and December 2015. Subjects were treated with hyaluronic acid dermal filler in correcting nasolabial folds and an optional re-treatment was performed after 12 months according to the subjects′wishes. The improved of nasolabial folds was evaluated by the change of severity (wrinkle severity rating scale, WSRS) and aesthetic improvement (global aesthetic improvement scale, GAIS). Satisfaction of subjects on treatment was evaluated using subject satisfaction questionnaires (SSQ). Safety indicators such as pain, skin and soft tissue presentation at the injection site were continuously evaluated throughout the whole treatment process.@*Results@#Significant improvement in scores of WSRS and GAIS of all subjects was observed after treatment. Nine months after treatment, the scores of WSRS in 80 subjects (77.7%) and GAIS in 96 subjects (93.2%) were still improved. The 68 subjects (95.8%) received re-treatment after 12 months gained further improvement in nasolabial folds. Most adverse events were mild or moderate (transient/reversible local manifestations) and all resolved before study end, no severe adverse event related to products observed.@*Conclusions@#Hyaluronic acid dermal filler is effective and safe in treatment of nasolabial folds in Chinese population and the effect can last up to 12 months.

Clinical efficacy of injected autologous fat and buried polydioxanone threads for nasolabial fold filling / 中华医学美学美容杂志

Objective@#To investigate the clinical application of injected autologous fat and buried polydioxanone threads for nasolabial fold filling.@*Methods@#From April 2016 to October 2017, 64 cases of mild and moderate nasolabial fold beauty seekers from the First People＇s Hospital of Jiande were divided into group A and group B with their attitude. Group A (28 cases) were only treated with buried polydioxanone threads for nasolabial fold filling; Group B (36 cases) were treated with injected autologous fat and buried polydioxanone threads for nasolabial fold filling. The surgical effect was recorded for 18 months.@*Results@#The most common complications were swelling, bruising and pain immediately after the surgery. Polydioxanone threads exposure occurred in two cases in each group 2 weeks after the surgery. There were satisfactory results in skin color and skin texture in both groups. 9 cases showed inadequate correction in group A while only 2 cases showed inadequate correction in group B in long-term follow-up (>3 months).@*Conclusions@#Combined treatment of autologous fat and polydioxanone threads is safe and effective for nasolabial fold filling.

Efficacy of nasolabial flap in repairing inferior nasal defect / 中华医学美学美容杂志

Objective To investigate the clinical effect of retrograde nasolabial fold flap pedicled with angular artery in the repair of inferior nasal defect .Methods According to the location and size of inferior nasal defect ,the reverse island flap or axial flap pedicled with the inner canthus artery was de-signed to repair the defect at the nasolabial fold of the affected side .Results Eighteen patients were followed up for 6-36 months ,of which 2 cases had partial necrosis at the distal part of the flap ,healed by dressing change ,and the rest of the flaps survived .The flaps were not bulky and the color and tex-ture were similar to those of the surrounding skin .All patients were satisfied with the appearance im -provement .Conclusions The blood supply of the retrograde nasolabial fold flap pedicled with the in-ner canthus artery is reliable ,using flaps from the nasolabial sulcus is surgically convenient ,flexible in design and covert in donor site .It is one of the ideal methods for the repair of inferior nasal defects .It is worthy of clinical application .

A Case of Huge Nasolabial Cyst in 56 Year-Old Patient

A nasolabial cyst is a rare, non-odontogenic cyst that develops within the area adjacent to the ala of the nose around the uppermost portion of the nasolabial crease. The origin of such a cyst is unclear but may be due to developmental problems. Clinical characteristic of asymptomatic nasolabial swelling and radiological findings are important for diagnosis. Treatment is usually surgical resection via a sublabial approach but can also involve incision and drainage or marsupialization. Unlike the typical clinical features reported in other cases, we experienced a case of a giant nasolabial cyst of 4.4 cm in a 56-year-old male with elevation of the nasal cavity base, gingival swelling, and perilesional bony destruction. In this case, we discussed the growth potential of a nasolabial cyst and proper timing of treatment.

The modified nasolabial flap with facial subcutaneous pedicle advanced flap for repairing the defects after midcheek tumor resection / 中华整形外科杂志

Objective@#To evaluate the clinical effect of the modified nasolabial flap with facial subcutaneous pedicle advanced flap in repairing the defects after midcheek tumor resection.@*Methods@#From June 2012 to June 2017, 27 patients with facial tumors were treated, and according to the nature of the tumor, the tumor tissue was enlarged, frozen pathological examination was performed during the surgery. Once the edge and the base were reported to be negative, the nasolabial flap with facial subcutaneous pedicle advanced flap with a maximum 1 cm wider than the defect width was designed according to the position and size of the wound. The proximal border of the flap was designed at the cured edge of the circular wound. The curved bottom edge of the circular wound was the proximal end of the flap. The defects ranged from 2.0 cm×3.0 cm to 2.5 cm×4.0 cm. The donor site was directly sutured after subcutaneously loosening.@*Results@#The operation was smooth, and the flaps were about 3.0 cm×6.0 cm to 3.5 cm×7.0 cm. The flaps were well transported after surgery, and there was no bruising at the tip. The suture was removed 1 week after surgery. After 6-36 months of follow-up, postoperative scar was not obvious, which were most hidden in the nasolabial folds. There was no ectropion and mouth deformity. The flaps were not swollen, and the color and texture were close to that of normal skin. The appearance was satisfactory. Sensation of skin were well recovered.@*Conclusions@#The modified nasolabial flap with facial subcutaneous pedicle advanced flap is suitable for repairing the facial defects with satisfactory skin sensation and good appearance.

Clinical efficacy of facial artery perforation nasolabial flap in reconstruction of nasal defect / 中华医学美学美容杂志

Objective To evaluate the effects of nasolabial flap with facial artery and its branches perforator for reconstruction of nasal defect.Methods Between March 2013 and April 2017,21 patients underwent operations for the reconstruction of nasal defect,caused by trauma,surface tumors,moles and infection.The size of the defect was 1.5 cm × 2.0 cm to 3.0 cm × 3.0 cm.Designed various nasolabial perforator flap was pedicled with the facial artery.The pulsed blood flow detector determined the location of the facial artery and its perforation position,which was the rotation point,and the rotation of the nasolabial fold flap covered the nasal defect area to repair.Results 21 flaps survived.Surface artery perforation nasolabial fold flap was good blood supply,of which 1 case of flap was congested and recovered after treatment.After 1 month to 3 years follow-up on 21 cases,20 cases showed good results and 1 case had generally accepted.The color,shape and function of the flap were significant,similar to the normal skin.Conclusions A small area defect in the nose is preferred by using facial arterial perforation nasolabial fold flap repair,which does not need secondary repair,and is worthy of clinical application.

Delayed bipedicled nasolabial flap in facial reconstruction

BACKGROUND: The nasolabial flap is ideal for reconstruction of the nasal alar subunit due to its proximity, color and contour match, and well-placed donor scar. When raised as a random-pattern flap, there is a risk of vascular compromise to the tip with increased flap length and aggressive flap thinning. Surgical delay can greatly improve the chances of tip survival, allowing the harvest of longer flaps with greater reach. METHODS: We describe our technique of lengthening the nasolabial flap through multiple delay procedures. A bipedicled flap was first raised and then transferred as a unipedicled flap with a 6:1 length-to-width ratio. During the delay process, the flap tip was thinned to the subdermal layer. RESULTS: In our case series of seven patients, defects as far as the medial canthal area and contralateral ala were reconstructed successfully with no incidence of tip necrosis or flap loss. The resultant flaps were thin enough to be folded over for the reconstruction of alar rim defects. CONCLUSIONS: We highlight the success of our surgical technique in creating thin and robust nasolabial flaps for the reconstruction of full-thickness defects around the nose.

Efeitos da radiofrequência no rejuvenescimento facial: estudo experimental / Effects of radiofrequency in facial rejuvenation

Introdução: A radiofrequência é um recurso que têm sido frequentemente utilizados na prática clínica para o tratamento da flacidez facial e aparecimento de rugas. Objetivo: Investigar os efeitos da radiofrequência no rejuvenescimento facial. Métodos: Trata-se de um ensaio clínico controlado. A amostra foi composta por 40 voluntárias do sexo feminino, com a faixa etária entre 35 a 55 anos, dispostos em 02 grupos, sendo grupo controle e grupo tratado com radiofrequência. Resultados: Nos valores individuais das medidas do ângulo do sulco nasogeniano é possível verificar um aumento e consequente melhora da qualitativa da flacidez facial. Conclusão: A radiofrequência promoveu uma melhora clínica ao nível do ângulo do sulco nasogeniano. (AU)

Introduction: Radiofrequency is a feature that has been frequently used in clinical practice for the treatment of facial flaccidity and appearance of wrinkles. Objective: To investigate the effects of radiofrequency on facial rejuvenation. Methods: This is a controlled clinical trial. The sample consisted of 40 female volunteers, with the age group between 35 and 55 years, arranged in 02 groups, being the control group and the group treated with radiofrequency. The control conducted 2 months of guidance on skin care and exercises for facial flaccidity. Results: Increase quality improvement of facial flaccidity In the treated group, but statistically there was no result in the comparison between groups. Conclusion: In the qualitative analysis, it was verified that the radiofrequency promoted a clinical improvement at the angle of the nasogenian sulcus. (AU)

Lateral Nasal Artery Perforator Flaps: Anatomic Study and Clinical Applications

BACKGROUND: Previous studies have investigated facial artery perforators, but have reported inconsistent results regarding lateral nasal artery (LNA) perforators. Although several authors have described the use of LNA perforators for ala nasi and nasal sidewall reconstruction, the literature contains little information regarding the cadaveric dissection of LNA perforators, and most previously published studies have focused on facial artery perforators. METHODS: Sixteen hemifaces from eight fresh cadavers were dissected to study the LNA perforators. After the dissection was performed, the total length and diameter of the LNA and its perforators were measured. The quantity and the distribution of the LNA perforators supplying the overlying skin were then assessed. LNA perforator flaps were used for reconstruction in 10 nasal and perinasal defects. RESULTS: The mean total lengths of the LNA and its perforators were 49.37 mm and 16.06 mm, respectively. The mean diameters of the LNA and its perforators were 2.08 mm and 0.91 mm, respectively. Based on our findings, we mapped the face to indicate zones with a higher probability of finding perforators. No infection, hematoma, or complete flap necrosis were observed after the procedures. CONCLUSIONS: Nasal reconstruction is a challenging procedure, and LNA propeller/V-Y perforator flaps are an excellent reconstructive option in certain cases. Based on our cadaveric study, we were able to identify an area in the upper third of the nasolabial groove with a high density of perforators.

A Randomized, Evaluator-Blinded, Split-Face Comparison Study of the Efficacy and Safety of a Novel Mannitol Containing Monophasic Hyaluronic Acid Dermal Filler for the Treatment of Moderate to Severe Nasolabial Folds

BACKGROUND: Mannitol containing monophasic filler with higher crosslinking has not been well studied for moderate and severe nasolabial fold (NLF) correction. OBJECTIVE: To compare the efficacy and safety of a novel mannitol containing hyaluronic acid (HA) filler (HA-G) with biphasic HA filler (HA-P) for moderate and severe NLF correction. METHODS: Thirteen subjects with symmetric moderate to severe NLF received HA-G (in one NLF) and HA-P (in other NLF) and were evaluated for 24 weeks. RESULTS: At both 12 and 24 weeks, the mean improvement in Genzyme 6-point grading scale from baseline was significantly greater in the side of face that was treated with HA-G than HA-P (1.96±0.91 vs. 1.54±0.73 at week 12; p=0.044, 1.88±0.78 vs. 1.3±0.79 at week 24; p=0.027, respectively). At 12 weeks, the mean Global Aesthetic Improvement Scale score was 2.92±0.93 for HA-G and 2.31±0.95 for HA-P (p=0.008). Both fillers were well tolerated. CONCLUSION: The HA filler HA-G provides better efficacy and similar local tolerability compared with HA-P in 6 months following treatment for moderate and severe NLF.

Analysis of the complementary measurement of nasogenian wrinkles using Radiocef 2.0® software in the evaluation of facial chronoaging among women of different age groups / Análise da mensuração complementar de rítides nasogenianas pelo software Radiocef 2.0® na avaliação do cronoenvelhecimento facial de mulheres em diferentes faixas etárias

Objective : To evaluate the facial aging of women of different ages using a software program to assist in the classification of wrinkles and sagging in the nasogenian region. Method : A descriptive observational study of 100 female volunteers was performed. The women were aged between 20 and 70 years old and were sorted by age group into five groups of 20 volunteers each. The instruments used were the Facial Assessment Protocol, a cephalostat for the standardization of photos, a 14.1 megapixel Sony digital camera, and the Radiocef 2.0® software program. The Kolmogorov-Smirnov (KS) test was used for confirmation of normality and all data was statistically analyzed using ANOVA and Tukey's post hoc analysis. The Chi-squared and Pearson's correlation tests were also performed. A significance level of 5% and a p value of ≤0.05 were adopted. Results : It was observed that all age groups had wrinkles in the nasolabial fold region. There was an association between age and the Goglau, Lapiere and Pierard scale. This incidence increased progressively with aging. A moderate correlation (r=0.67) was observed between age and distance from the nasolabial folds, while angle represented only a weak correlation (r=0.3), with the most significant age group that with the shortest distance and the widest angle. Conclusion : The present study demonstrated the importance of the Radiocef 2.0® software program in providing a more detailed analysis of the nasolabial folds. It is therefore a complementary assessment to the Facial Assessment Protocol, representing a research protocol for identifying the effectiveness of treatments and improving the evaluative procedure.

Objetivo : Analisar a relevância da mensuração objetiva de rítides nasogenianas de mulheres em diferentes faixas etárias, utilizando-se osoftware radiocef 2.0® como ferramenta complementar na avaliação do cronoenvelhecimento facial. Método: Trata-se de um estudo observacional descritivo envolvendo 100 voluntárias do sexo feminino, com idade entre 20 e 70 anos, dispostas em cinco grupos de 20 voluntárias de acordo com a faixa etária. Os instrumentos utilizados foram o Protocolo de Avaliação Facial, o cefalostato para padronização das fotos, câmera digital e o software radiocef 2.0®. Foi aplicado o teste Kolmogorov-Smirnov para a confirmação da normalidade e todos os dados foram submetidos à análise estatística, usando o teste ANOVA e post hoc de Tukey. Foi realizado o teste Qui-quadrado e a correlação de Pearson. Foi adotado um nível de significância de 5% (p≤0,05). Resultados : Foi observado que todas as faixas etárias apresentaram rugas na localização do sulco nasogeniano. Observou-se também uma associação entre a idade e as escalas de Goglau e Lapiere e Pierard. Essa incidência surgiu progressivamente com o aumento da faixa etária. Foi verificada correlação moderada (r=0,67) entre a idade e a distância do sulco nasogeniano, enquanto o seu ângulo diminui com correlação fraca (r=0,3), sendo mais significativa a faixa etária que obteve a menor distância e o maior ângulo. Conclusão: O estudo demonstrou relevância do software radiocef 2.0®. para a análise mais detalhada do sulco nasogeniano, surgindo assim como uma complementação da avaliação, podendo se tornar um protocolo de investigação para identificar a eficácia dos tratamentos realizados, otimizando o método avaliativo.

A Phase III, Randomized, Multi-Center, Double-Masked, Matched-Pairs, Active-Controlled Trial to Compare the Efficacy and Safety between Neuramis Deep and Restylane in the Correction of Nasolabial Folds

BACKGROUND: We conducted this clinical study to compare the efficacy and safety between Neuramis Deep and Restylane in the correction of nasolabial folds. METHODS: In this phase III, randomized, multi-center, double-masked, matched-pairs, active-controlled trial (ClinicalTrials.gov Identifier: NCT01585220), we evaluated a total of 67 subjects (n=67). All the subjects underwent Neuramis Deep treatment on one side and Restylane on the contralateral side of the bilateral nasolabial folds at a ratio of 1:1. To compare the efficacy of Neuramis Deep and Restylane, we evaluated the Wrinkle Severity Rating Scale scores and those of the Global Aesthetic Improvement Scale. In addition, we compared the safety of Neuramis Deep and Restylane based on adverse events, physical examination, and clinical laboratory tests. RESULTS: Neuramis Deep was not inferior in improving the nasolabial folds as compared with Restylane. In addition, there was no significant difference in the efficacy between Neuramis Deep and Restylane. There were no significant differences in safety parameters between Neuramis Deep and Restylane. CONCLUSIONS: In conclusion, our results indicate that Neuramis Deep may be a safe, effective material for improving the nasolabial folds. However, further studies are warranted to compare the tolerability of Neuramis Deep and Restylane based on histopathologic findings.

A Case of Neurofibroma Presenting as a Nasolabial Mass

Neurofibroma is a benign neurogenic tumor thatmost often occurs in the head and neck region. However, a solitary neurofibroma on the nasolabial fold is extremely rare, with only a few reported cases reported in the English literature. A 45-year-old woman with a nasolabial mass visited our department, and we performed an excisional biopsy using asublabial approach. The histopathology of the mass revealed it to be neurofibroma. We report a unique case of neurofibromain thenasolabial region with an associated literature review. To the best of our knowledge, no such case has previouslybeen reported in Korea.

Efficacy and Safety of Porcine Collagen Filler for Nasolabial Fold Correction in Asians: A Prospective Multicenter, 12 Months Follow-up Study

Recently, injectable dermal fillers have become important alternatives to surgical procedures for the correction of facial wrinkles. Bovine collagen is the first approved material for filler injection, and several studies have shown its efficacy. However, the risk of developing an allergic reaction and xenogenic transmission of bovine spongiform encephalopathy remain among its disadvantages. In this randomized, double-blinded, split-face study, we compared the efficacy and safety of a porcine collagen filler (TheraFill(R)) with that of a bovine collagen filler (KOKEN(R)) for nasolabial fold correction. A total of sixty one patients with mild to severe nasolabial fold were randomized to receive TheraFill(R) and KOKEN(R) on contralateral sides of the face. During the 12-month follow-up period, improvement in the Wrinkle-Severity Rating Scale score was slightly higher in TheraFill(R) group than KOKEN(R) group, although the difference was not statistically significant. No serious adverse reactions were observed and both materials were tolerable in most cases. In conclusion, the long-term effect of TheraFill(R) on nasolabial fold correction was comparable to that of KOKEN(R), and it may be a good alternative to bovine collagen filler.

Anatomical foundation of smiling and mid-lower facial rejuvenation / 中华医学美学美容杂志

Objective To investigate the forming mechanism of smile anatomically,and to analyze the changes of aging characteristics of mid-lower face.Methods Ten (with 20 sides) adult fresh cadaveric heads were fixed by formalin,and then nasolabial fold morphology was observed under 10X operating magnifying glass,and compared with alteration of the middle and lower face aging features under the state of smiling and static according to observation from 50 doctors' and out-patients' photos.Results The nasolabial fold was the boundary between fatty and fat-free zone in the middle face,the lateral side of which was malar fat pad.The nasolabial fold was the linear area,which was formed by the insertions of seven mimetic muscles on the skin.When smiling,the nasolabial fold and cheek groove,got deep and extended,cheek stripe became obvious.While smiling,malar fat pad shifted up,and tear trough became deformity..64％ disappeared and 36％ getting shallow and appearance improved; orbit-malar fold showed 100％ horizontal part disappeared,74 ％ vertical part became shallow and improved,and 26％ stayed stable; mid-cheek fold showed 78％ dissovled,22％ getting shallow and improved; Labiomandibular fold showed 100％ Ⅲ degree disappeared,100％ Ⅱ degree dissovled,74％ Ⅰ degree disappeared,and 26％ getting shallow and ameliorated; submaxilla line showed 18％ getting smooth and 82％ remained.Conclusions Smiling is produced by movement of mimetric muscles,and its orgin is from nasolabial fold.A smile could make malar fat pad upwards to mask some aging characteristics of middle and lower face,which is helpful to form a younger face.

Clinical application of the nasolabial fold wrapped perforator flap in repairing pinna nasi defect / 中华医学美学美容杂志

Objective To explore the feasibility of nasolabial fold wrapped perforator flap in repairing pinna defects to produce the relative perfect appearance.Methods We treated 10 cases of pinna nasi defects by the nasolabial fold wrapped perforator flap.We examined the blood vessel distribution and exit of the blood vessel before surgery,and designed the nasolabial fold wrapped perforator flap according to the pinna defects.The flap with reasonable thickness was able to repair the both sides of defect after being cut properly.Meanwhile,the flap could be folded to form a local flap covered or lined with skin,and rotately transfered to repair nasal alar defect.Results All the flaps survived with incisions of donor sites healed primarily.Following up for 4 to 24 months showed that the color,texture and thickness of the flaps were similar to those of recipient sites.The scar in donor site was concealed and not obvious.Those cases who kept neurocutaneous branch had good sense.Satisfactory appearance was received without secondary repair.Conclusions The nasolabial fold wrapped perforator flap has abundant blood circulation and easily survives.It can also afford ample tissues to repair major area of pinna nasi defects,The blood vessel peduncle is too long to be survived easily.And the donor has not clear scar.Second reconstruction can be avoided in this procedure.The nasolabial fold wrapped perforator flap is one of the best choices to repair pinna defects.