Localization and Histological Characterization of Injected Hyaluronic Acid inExcised Nasolabial Fold Tissue

Objective: To describe a technique for surgical correction of a prominent nasolabial fold (NLF) and use of the excised fold to assess the histology and localization of injected hyaluronic acid (HA) fillers.

Methods: Surgical correction was achieved by direct excision of the NLF, followed by advancement of the nasolabial fat compartment into the nasolabial crease. Excised tissue samples were injected with HA fillers (Restylane®, Perlane®, or layered Restylane®/ Perlane®), sectioned, and treated with histological stains.

Results: Surgical correction of NLF resulted in highly satisfactory results. HA localized primarily in the lower reticular dermis and subcutis of the excised NLF. Localization appeared similar regardless of the HA product employed.

Conclusion: Direct excision of the NLF with advancement of the nasolabial fat compartment is a successful treatment for patients with deep NLF. HA injected into the excised tissue localized near the site of injection, emphasizing the importance of proper placement of HA fillers during soft tissue augmentation.