닫기

Ex) Article Title, Author, Keywords

Case Report

Split Viewer

J Cosmet Med 2021; 5(2): 103-107

Published online December 31, 2021

https://doi.org/10.25056/JCM.2021.5.2.103

Correction of nasolabial fold by combination of polydioxanone thread and hyaluronic acid filler: a case report

Kyoungjin Kang, MD, PhD1 , Hanwool Choung, DDS, PhD2 , Uekyoung Hwang, MD, MPh3

1Department of Plastic Surgery, Seoul Face 21 Dental Hospital, Seoul, Rep. of Korea
2Department of Maxillofacial Surgery, Seoul Face 21 Dental Hospital, Seoul, Rep. of Korea
3Yeline Esthetic Clinic, Seongnam, Rep. of Korea

Correspondence to :
Uekyoung Hwang
E-mail: yjukhome@daum.net

Received: November 19, 2021; Accepted: December 15, 2021

© Korean Society of Korean Cosmetic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Deep nasolabial folds (NLFs) are a common concern among aging patients. Hyaluronic acid (HA) filler is the first treatment choice. However, migration, spread to the surrounding space, and unnatural contours with lateral bulges occur frequently. Polydioxanone (PDO) thread has also been used by insertion of cogged PDO threads in the midface and the fold. Unfortunately, lifting lasts for only a few weeks. In the present case, a combination procedure using HA filler and PDO thread in the shape of the mesh tube was performed to improve the deep NLF in a 67-year-old woman. The intention of this combination was to unfold the NLFs and restore their volume without lateral migration of the injected filler. NLFs were divided into three parts: the lateral folded part (LFP), medial depressed part (MDP), and central crease part (CCP). Five PDO threads (6.0 cm length) were sequentially inserted into the LFP, MDP, and then under the CCP of each NLF. Total 4.0 ml of the filler was also sequentially injected into the both NLFs in a manner similar to the mesh thread insertion. They were mainly placed at the subdermal and superficial fat layer in the entire NLF and at the submuscular layer in the regions of the lateral part of the NLF, mouth corners, and submalar area. Three months after PDO thread insertion and HA filler injection, softened NLFs without filler migration, restored volume and lifted midface with a natural and charming smile, and reduction of perioral wrinkles were observed. These changes could be explained by the suppression of laughter movement accompanied by myo-modulation and increased firmness of the NLFs by the restoration of midface volume. These results suggest that the combination of PDO insertion and HA injection may be useful for correction of NLF.

Keywords: hyaluronic acid filler, mesh tube type, myo-modulation, nasolabial fold, polydioxanone thread

Fig. 1.Schematic position of facial muscle related to nasolabial folds. LLSAN, levator labii superioris alaeque nasi; LLS, levator labii superioris; Zmi, zygomaticus minor; Zmj; zygomaticus major; OOr, orbicularis oris muscle. Revised from the article of Hur MS, et al. (PLoS One 2020;15:e0237043) [3].
  1. Han SE, Go JY, Pyon JK, Oh KS. A prospective evaluation of outcomes for midface rejuvenation with mesh suspension thread: “REEBORN lift”. J Cosmet Dermatol 2016;15:254-9.
    Pubmed CrossRef
  2. Fitzgerald R, Graivier MH, Kane M, Lorenc ZP, Vleggaar D, Werschler WP, et al. Update on facial aging. Aesthet Surg J 2010;30 Suppl:11S-24S.
    Pubmed CrossRef
  3. Hur MS, O J, Yang HM, Kwon HJ, Lee S, Lim HS, et al. Heights and spatial relationships of the facial muscles acting on the nasolabial fold by dissection and three-dimensional microcomputed tomography. PLoS One 2020;15:e0237043.
    Pubmed KoreaMed CrossRef
  4. Beer GM, Manestar M, Mihic-Probst D. The causes of the nasolabial crease: a histomorphological study. Clin Anat 2013;26:196-203.
    Pubmed CrossRef
  5. Chung C, Lee JH. A single-center, randomized, double-blind clinical trial to compare the efficacy and safety of a new monophasic hyaluronic acid filler and biphasic filler in correcting nasolabial fold. Aesthetic Plast Surg 2021;45:2902-8.
    Pubmed CrossRef
  6. Raspaldo H, Baspeyras M, Bellity P, Dallara JM, Gassia V, Niforos FR, et al.; Consensus Group. Upper- and mid-face antiaging treatment and prevention using onabotulinumtoxin A: the 2010 multidisciplinary French consensus--part 1. J Cosmet Dermatol 2011;10:36-50.
    Pubmed CrossRef
  7. de Maio M. Myomodulation with injectable fillers: an innovative approach to addressing facial muscle movement. Aesthetic Plast Surg 2018;42:798-814.
    Pubmed KoreaMed CrossRef
  8. Hwang UK, Kwon YH, Cho YJ, Kang KJ. Improvement of aged lower eyelid by insertion of polydioxanone threads. J Cosmet Med 2017;1:57-9.
    CrossRef

Article

Case Report

J Cosmet Med 2021; 5(2): 103-107

Published online December 31, 2021 https://doi.org/10.25056/JCM.2021.5.2.103

Copyright © Korean Society of Korean Cosmetic Surgery.

Correction of nasolabial fold by combination of polydioxanone thread and hyaluronic acid filler: a case report

Kyoungjin Kang, MD, PhD1 , Hanwool Choung, DDS, PhD2 , Uekyoung Hwang, MD, MPh3

1Department of Plastic Surgery, Seoul Face 21 Dental Hospital, Seoul, Rep. of Korea
2Department of Maxillofacial Surgery, Seoul Face 21 Dental Hospital, Seoul, Rep. of Korea
3Yeline Esthetic Clinic, Seongnam, Rep. of Korea

Correspondence to:Uekyoung Hwang
E-mail: yjukhome@daum.net

Received: November 19, 2021; Accepted: December 15, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Deep nasolabial folds (NLFs) are a common concern among aging patients. Hyaluronic acid (HA) filler is the first treatment choice. However, migration, spread to the surrounding space, and unnatural contours with lateral bulges occur frequently. Polydioxanone (PDO) thread has also been used by insertion of cogged PDO threads in the midface and the fold. Unfortunately, lifting lasts for only a few weeks. In the present case, a combination procedure using HA filler and PDO thread in the shape of the mesh tube was performed to improve the deep NLF in a 67-year-old woman. The intention of this combination was to unfold the NLFs and restore their volume without lateral migration of the injected filler. NLFs were divided into three parts: the lateral folded part (LFP), medial depressed part (MDP), and central crease part (CCP). Five PDO threads (6.0 cm length) were sequentially inserted into the LFP, MDP, and then under the CCP of each NLF. Total 4.0 ml of the filler was also sequentially injected into the both NLFs in a manner similar to the mesh thread insertion. They were mainly placed at the subdermal and superficial fat layer in the entire NLF and at the submuscular layer in the regions of the lateral part of the NLF, mouth corners, and submalar area. Three months after PDO thread insertion and HA filler injection, softened NLFs without filler migration, restored volume and lifted midface with a natural and charming smile, and reduction of perioral wrinkles were observed. These changes could be explained by the suppression of laughter movement accompanied by myo-modulation and increased firmness of the NLFs by the restoration of midface volume. These results suggest that the combination of PDO insertion and HA injection may be useful for correction of NLF.

Keywords: hyaluronic acid filler, mesh tube type, myo-modulation, nasolabial fold, polydioxanone thread

Fig 1.

Figure 1.Schematic position of facial muscle related to nasolabial folds. LLSAN, levator labii superioris alaeque nasi; LLS, levator labii superioris; Zmi, zygomaticus minor; Zmj; zygomaticus major; OOr, orbicularis oris muscle. Revised from the article of Hur MS, et al. (PLoS One 2020;15:e0237043) [3].
Journal of Cosmetic Medicine 2021; 5: 103-107https://doi.org/10.25056/JCM.2021.5.2.103

References

  1. Han SE, Go JY, Pyon JK, Oh KS. A prospective evaluation of outcomes for midface rejuvenation with mesh suspension thread: “REEBORN lift”. J Cosmet Dermatol 2016;15:254-9.
    Pubmed CrossRef
  2. Fitzgerald R, Graivier MH, Kane M, Lorenc ZP, Vleggaar D, Werschler WP, et al. Update on facial aging. Aesthet Surg J 2010;30 Suppl:11S-24S.
    Pubmed CrossRef
  3. Hur MS, O J, Yang HM, Kwon HJ, Lee S, Lim HS, et al. Heights and spatial relationships of the facial muscles acting on the nasolabial fold by dissection and three-dimensional microcomputed tomography. PLoS One 2020;15:e0237043.
    Pubmed KoreaMed CrossRef
  4. Beer GM, Manestar M, Mihic-Probst D. The causes of the nasolabial crease: a histomorphological study. Clin Anat 2013;26:196-203.
    Pubmed CrossRef
  5. Chung C, Lee JH. A single-center, randomized, double-blind clinical trial to compare the efficacy and safety of a new monophasic hyaluronic acid filler and biphasic filler in correcting nasolabial fold. Aesthetic Plast Surg 2021;45:2902-8.
    Pubmed CrossRef
  6. Raspaldo H, Baspeyras M, Bellity P, Dallara JM, Gassia V, Niforos FR, et al.; Consensus Group. Upper- and mid-face antiaging treatment and prevention using onabotulinumtoxin A: the 2010 multidisciplinary French consensus--part 1. J Cosmet Dermatol 2011;10:36-50.
    Pubmed CrossRef
  7. de Maio M. Myomodulation with injectable fillers: an innovative approach to addressing facial muscle movement. Aesthetic Plast Surg 2018;42:798-814.
    Pubmed KoreaMed CrossRef
  8. Hwang UK, Kwon YH, Cho YJ, Kang KJ. Improvement of aged lower eyelid by insertion of polydioxanone threads. J Cosmet Med 2017;1:57-9.
    CrossRef

Stats or Metrics

Share this article on :

  • line
  • mail

Related articles in JCM

Most KeyWord ?

What is Most Keyword?

  • It is most registrated keyword in articles at this journal during for 2 years.

Journal of Cosmetic Medicine

eISSN 2586-0585
pISSN 2508-8831
qr-code Download