Mouth Lines # Nasolabial Lines Around the Mouth # Nasolabial Folds # Wrinkles # How to Remove Facial Wrinkles # Getting Rid of Nasolabial Folds # Wrinkle Improvement # Youthful Face Surgery # Wrinkle Care # Nasolabial Fold Care # Facial Wrinkles

Nasolabial Fold Surgery # Figure-Eight Wrinkles # Facial Wrinkle Removal # Youthful Procedures # Mouth-Side Wrinkle Removal # Mouth-Side Wrinkle Care # How to Remove Nasolabial Folds # Lines Beside the Nose # Wrinkle Improvement Procedures # Mouth-Side Wrinkle Surgery

How to Remove Mouth Lines # Nasolabial Lines Around the Mouth # How to Remove Wrinkles # Wrinkles Around the Mouth # Wrinkle Removal Surgery # Gangnam Nasolabial Folds # Fine Facial Wrinkles # Deep Wrinkles # Mouth-Side Wrinkle Procedures

Aging Surgery # Mouth-Side Wrinkle Fat Grafting # Nasolabial Fold Fat Grafting # Lines Beside the Nose Fat Grafting # Wrinkle Procedures # Wrinkle Laser # Wrinkles # Endotine # Thread Lifting # Deep Nasolabial Folds

Fine Skin Wrinkles # Youthful Procedure # Famous Wrinkle Surgery Clinic # Anti-Aging Clinic # Nasolabial Fold Removal Surgery # Wrinkle Treatment # Wrinkle Botox # Men’s Nasolabial Folds # Facial Wrinkle Procedures

Proper Youthful Surgery # Youthful Face # Nasolabial Fold Procedure # Nasolabial Fold Surgery # Facial Wrinkle Surgery # Getting Rid of Figure-Eight Wrinkles # Getting Rid of Wrinkles # Male Nasolabial Folds # Anti-Aging Plastic Surgery

Men’s Wrinkle Improvement # Skin Wrinkles # Men’s Wrinkles # Mouth-Side Nasolabial Fold Fat Grafting # Wrinkle Correction Fat Grafting # Facial Wrinkle Improvement # Deep Wrinkle Fat Grafting # Mouth Fat Grafting # Mouth-Corner Line

Mouth-Side Nasolabial Fold Line # Fine Wrinkles Around the Mouth # Deeply Indented Wrinkles # Wrinkle Fillers # Fat Grafting and Fillers # Advantages of Fat Grafting # Wrinkle Correction with Fat Grafting # Precautions for Fat Grafting # Number of Fat Grafting Sessions

Expression Wrinkles # Expression Wrinkle Fat Grafting # Long-Lasting Effects of Fat Grafting # Side Effects of Fat Grafting # Correcting Side Effects of Fat Grafting # Repeat Fat Grafting # Reoperation After Fat Grafting # Micro Fat Grafting

Autologous Fat Grafting # Fat Injection # Facial Micro Fat Grafting # Facial Autologous Fat Grafting # Facial Fat Injection # Wrinkle Lines # Nasolabial Fold Lines # Mouth-Side Wrinkle Lines # Correcting Wrinkle Lines # Deep Wrinkle Lines

Fat and Injection # Uneven Fat Grafting # Swelling After Fat Grafting # Awkward Fat Grafting # Asymmetrical Fat Grafting # Mouth-Side Wrinkle Fillers # Nasolabial Fold Fillers # Magic Lift # Fat Grafting Clinic

Duhan # Duhan Plastic Surgery # Duhan Fat Grafting # Duhan Micro Fat Grafting # Duhan Autologous Fat Grafting # Dr. Shin Duhan # Place Famous for Fat Grafting # Place Famous for Fat Injection # Fat Plastic Surgery

Place Famous for Micro Fat Grafting # Place Famous for Autologous Fat Grafting # Plastic Surgery Clinic for Fat Grafting # Plastic Surgery Clinic for Autologous Fat Grafting # Plastic Surgery Clinic for Micro Fat Grafting # Famous Fat Grafting Clinic

Famous Hospital for Fat Grafting # Recommended Fat Grafting # Recommended Fat Grafting Hospital # Recommended Gangnam Fat Grafting Hospital # Recommended Apgujeong Fat Grafting # Gangnam Fat Grafting # Apgujeong Fat Grafting

Mouth Lines

Mouth-side nasolabial fold fat grafting is a procedure that corrects wrinkles formed along the sides of the nose and around the mouth. The deeper the wrinkles, the older you look, and they can also make the mouth appear protruded.

The correction effect includes a softening of wrinkles for a younger-looking appearance, as well as a visual effect that makes a protruding mouth look somewhat less prominent.

Indications for mouth-side fat grafting

◇ Mouth-corner line

◇ Mouth-side nasolabial fold line

◇ Cases where the front area of the face beside the nose is sunken and appears hollow

Fat grafting procedure for wrinkle removal

1. Fat is harvested from areas where your own fat is abundant, such as the lower abdomen, waist, or thighs.

For wrinkle correction, a large amount of fat is not needed, so harvesting from the lower abdomen is preferable.

• Because anesthesia is performed under local anesthesia (painless sedation anesthesia), there is no pain at all.

• A thin liposuction cannula is used to collect fat into a syringe.

2. The harvested fat is placed in a centrifuge to remove impurities (local anesthetic, serum, red blood cells, etc.).

The purpose of centrifugation is to remove impurities contained in the fat, increase the concentration of the fat, and improve the graft survival rate.

3. After centrifugation, the fat undergoes a secondary concentration process to remove water and oil.

By removing water and oil, nearly 100% concentrated fat is obtained.

4. The purified fat is transferred into a thin 1cc syringe and grafted into the desired area.

The fat is again transferred into a thin 1cc syringe and grafted into the desired area.

We use the micro needle (micro grafting cannula) developed in-house.

The micro needle is a special grafting cannula used only at our clinic, allowing ultra-precise grafting.

When grafting, subcutaneous tunneling should be performed in advance so that the fat can be placed accurately in the wrinkle area, allowing the wrinkles to be corrected effectively.

5. After fat grafting, you can return to daily life right away, and face washing and makeup are possible from the next day.

Examples of wrinkle correction with fat grafting

Mouth-side nasolabial folds

For fine wrinkles around the mouth, correction can be done with fillers (Restylane, Juvederm, Atrecol), but fillers have little to no effect on deeply indented wrinkles.

Also, these fillers should be injected only in small amounts for fine wrinkles, and if too much is used for deep wrinkles, not only will the procedure fail to show results, but side effects may also occur.

With fat grafting, even severely sunken wrinkles can show sufficient improvement.

Correction of deeply indented mouth-side nasolabial folds is one of the best uses of fat grafting.

Sometimes, combining fat grafting with fillers can be more effective.

Rather than injecting a large amount into one area with a tunneling technique, we perform three-dimensional micro fat grafting by evenly distributing 100% concentrated fat in multiple layers. A delicate and thorough injection method allows for custom design. Fat grafting also includes a process called “tunneling,” which helps the graft contact the surrounding abundant blood vessels as much as possible so that nutrients can be continuously supplied.
Tunneling means creating space for the fat under the skin using a micro needle. Since space is made as if making a tunnel and then the fat is injected, the graft does not sag in the direction of gravity or become lumpy even after all the fat has been placed.
Because the tunneling technique includes a dissection process of the wrinkle, fat is grafted under the dissected wrinkle area, so the wrinkles improve more clearly than with fat grafting at other hospitals.

Advantages of wrinkle correction with fat grafting

1. The procedure is simple.
2. Because no foreign material is used, unlike fillers (Restylane, Radiesse, Atrecol), there is no need to worry about side effects.
3. Since the skin is not incised, there is no need to worry about scars.
4. Because it uses your own tissue, the shape looks natural.
5. There is almost no swelling or bruising.
6. You can return to daily life immediately after the procedure.
7. Because the fat tissue takes hold, the effect can be maintained for a long time.

Precautions when correcting wrinkles with fat grafting

After the procedure, avoid laughing too hard or making strong facial expressions, as this can compress the grafted fat and increase absorption.
Do not press on the fat-grafted area or massage it strongly.
Avoid running exercise for about one month.

Number of fat grafting sessions for mouth lines

For mouth-side nasolabial folds, there are many variables in the treatment outcome.

If you laugh too hard or make strong facial expressions after the procedure, the fat cells can be compressed and the effect will be reduced.

For the grafted fat to take hold properly, there must be no external pressure compressing it.

Therefore, after fat grafting for wrinkles, facial expression control should be maintained well for about one month.

For fat grafting in the glabella or nasolabial folds,

generally one session, and at most two sessions, can produce a satisfactory result.

If needed after the first session, a second session is performed between 3 and 10 months later, and during the second session, the fat that had been stored after the initial grafting is thawed and used.

Long-lasting effects of fat grafting for mouth lines

Some people say fat grafting is ineffective because much of it is absorbed, but this applies to cases treated at places with little experience in fat grafting or cases that received poor fat grafting.

If fat grafting is done correctly, satisfactory results can be achieved, and once the grafted fat takes hold, it is no longer absorbed and remains as your own fat tissue for life, so it is considered one of the safest and most effective methods.

On average, after one to at most two fat grafting sessions, you can obtain a semi-permanent, satisfying wrinkle improvement effect.

However, no procedure lasts a lifetime.

Wrinkles form as a result of aging, so there is no way to prevent aging, and it is important to keep the wrinkle-improvement effect lasting as long as possible.

An area that has undergone fat grafting has its tissue beneath the skin reinforced, so it resists the forces that would cause wrinkles and does not wrinkle easily.

Although there are individual differences, the wrinkle-improvement effect of fat grafting can be said to last longer than that of any other procedure.

Side effects of fat grafting for wrinkle procedures

Fat grafting for wrinkles is one of the procedures that requires a very high level of precision.

To achieve wrinkle-smoothing effects by grafting along the wrinkle line, a proper amount of fat must be grafted at the right depth and in the right quantity after tunneling.

If fat grafting is done poorly, areas other than the wrinkle line may bulge more, there may be side effects such as protrusion beyond the wrinkle-correction effect, or, conversely, there may be almost no visible effect, and in some cases patients may suffer from severe swelling immediately after the procedure.

Also, fat grafting is not suitable for every wrinkle, so it should be applied only to wrinkles that can benefit from it. Unlike contour correction, wrinkle procedures are more difficult, so as a rule, they should not be performed by someone with insufficient experience or by a non-specialist in plastic surgery.

How to resolve side effects from overfilled fat grafting

When fat grafting is performed contrary to the principles because of insufficient experience, or when too much fat is grafted due to incorrect volume control, the grafted area may swell significantly, or even after the swelling subsides, the treated area may remain overly protruded and look awkward.

This is mainly a problem that occurs when a large amount of poorly purified fat with many impurities is injected forcefully.

In most cases it settles over time, but if the swelling is too severe, a swelling-reducing hyaluronidase injection may be given to the treatment area to bring it down more quickly, and if too much fat has been injected, a microcannula may be inserted to suction out and remove the grafted fat again.

If the overfilled fat is suctioned out again before 3 months have passed, it can be removed more easily.

In some cases, if the grafted fat has necrosed and calcified, becoming hard, it must be suctioned out and removed.

However, if fat grafting is done properly, these problems rarely occur.

Other treatment methods

1. Method using fillers (Juvederm, Atrecol, Teosyal, Evolence) There are cases where mouth-side wrinkles are corrected with fillers or collagen, but the use of fillers is very limited. Fillers may be tried for fine, hairline-like wrinkles. However, for deeply sunken wrinkles, fillers have almost no effect, and the injected filler may be pushed outward by the force of smiling, making the nasolabial folds even deeper. In severe cases, there is also concern about various side effects such as inflammation. Nasolabial folds are mostly deep sunken wrinkles. Therefore, it is difficult to expect a satisfying result from filler procedures.
2. Implant insertion method (silicone, Gore-Tex) Implants are often used for nose augmentation, but they are not suitable for wrinkle surgery. Small implants are sometimes inserted through the nose or an incision inside the mouth in so-called “noble surgery,” but this is intended to correct minor depression rather than wrinkles. However, it is not an appropriate surgical method for correcting long wrinkles, and various side effects may occur. Because it is a foreign body, you may feel discomfort when smiling, the contour may protrude, and the implant may shift position due to the force of smiling. Sometimes it can also cause problems such as inflammation, so inserting implants into the nasolabial folds is not a desirable method. In principle, implants should not be inserted into moving areas where facial expressions occur.
3. Magic lift (a procedure that pulls facial skin with threads) Some procedures called magic lift use threads to pull up the face, but they have almost no effect not only on overall facial wrinkles but also on nasolabial folds. There is a limit to pulling facial skin with thread tension, and because it quickly recurs or causes many side effects such as contour deformities on the face, caution is needed.
4. Insertion or injection of artificial dermis Alloderm (SureDerm) Correction may also be done using artificial dermis such as Alloderm, made by processing human dermal tissue, but precise treatment is difficult. In addition, liquid Alloderm is largely absorbed, making the correction effect difficult to predict, and dissatisfaction with the procedure is common. Solid Alloderm is mainly used for nasal tip surgery to create an upturned “bun” nose, and it is not a desirable procedure for correcting nasolabial folds.
5. Insertion of gold threads or gold needles There are clinics that entice patients by claiming that inserting gold needles into the face makes the skin elastic and firm and smooths wrinkles. These procedures are mainly performed by non-specialists, and because they are very expensive, they are often promoted as if the effect were excellent, so consumers need to be cautious.

Side effects of fat grafting

Of course, good results are expected, but depending on the surgeon’s skill and technique, some unavoidable problems may sometimes occur.

Poor results due to a low graft survival rate, awkward appearance, asymmetry, severe swelling, inflammation, fat necrosis, calcification, irregularity, sagging, and pigmentation may occur.

Inflammation	Bacteria invade during the procedure, or the fat fails to take hold during the grafting process and dissolves, causing inflammation
Necrosis	A state in which fat that failed to take hold because it did not receive proper blood supply during the grafting process decays and dissolves, leaving remnants
Calcification	A phenomenon in which fat fails to take hold because it did not receive proper blood supply during the grafting process, hardens, and calcium is deposited to form a hard mass
Irregularity	A phenomenon in which fat is not grafted evenly or is concentrated in one area, resulting in an uneven, bumpy shape
Sagging	If too much fat is grafted or it is not grafted in the proper location, facial sagging may occur.
Pigmentation	In cases of severe bruising or swelling, depending on the person’s constitution, iron components left in the bruise may deposit in the skin, oxidize, and turn brown. Depending on the constitution, this can sometimes occur after under-eye procedures.
Asymmetry	When the left and right sides have different graft survival rates, or the amount is not properly controlled during the initial procedure, resulting in imbalance between both sides
High absorption rate	A phenomenon in which the fat does not take hold enough to create the desired contour and much of it is absorbed, so the appearance before and after the procedure does not change much
Awkward shape	A phenomenon in which the fat takes hold excessively or is grafted into an inappropriate area, disrupting the overall balance of the face

Issues with fat grafting side effects

Because fat grafting uses autologous fat, unlike commercial filling materials (fillers), it has almost no side effects.

Except for slight swelling and bruising after the procedure, it can be said to have no side effects.

Therefore, it can be considered one of the safest procedures among plastic surgery treatments.

However, this is based on cases in which fat grafting is performed correctly, and if the procedure deviates from the principles, side effects may occasionally occur, such as an uneven, bumpy shape, hardening due to fat necrosis, inflammation, or an awkward shape due to excessive injection.

These are issues determined by the practitioner’s experience and skill, and are absolutely not a general problem of fat grafting itself.

Therefore, if the procedure is performed according to the principles, these side effects rarely occur.

Misconceptions and issues regarding fat grafting

You may think that fat grafting always produces good results, but that is absolutely not the case.

There is a tendency to think of fat grafting as easy, but it is by no means a simple or easy procedure.

As with any surgery, the outcome depends on the surgeon’s experience and know-how.

Fat grafting is more demanding than any other plastic surgery procedure, and in addition to a very complex process, it requires experience, know-how, and extremely precise manual skill.

How to perform fat grafting without side effects

Perform the procedure under sterile conditions	As with all surgeries, fat grafting must also be performed with completely sterilized instruments and materials. After the procedure, the inside of the suction cannula should be thoroughly cleaned with a brush so that no fat residue remains, and then disinfected with a steam sterilizer. Anesthesia drugs and saline should also be carefully managed so they are not contaminated. Thorough disinfection and material management can prevent bacterial infection and inflammation.
Several stages of fat purification	Fat purification must remove impurities completely through several stages to maximize the effect. Harvested fat usually contains about 80% impurities, and only about 20% is actually usable. If the remaining impurities (blood, serum, anesthetic, oil, water, etc.) are not removed, the results will not be good no matter how well the grafting is done.
Preliminary preparation before fat grafting	With a high graft survival rate, a satisfying result should ideally be achieved with one procedure. Fine fat should be placed evenly in multiple layers, and before that, space must be secured at the grafting site so the previously grafted fat is not compressed by surrounding tissue, allowing the fat to take hold well without pressure.
Precise and even grafting across multiple tissue layers	A soft and natural contour is the key to fat grafting. To achieve a soft contour, it is best to graft in a three-dimensional manner, distributing fat evenly across multiple layers. The grafting sites include the subcutaneous layer, muscle layer, and fascia layer, and the fat should be spread through the tissue as if sowing seeds evenly to obtain a smooth contour without irregularities.

Features of Duhan Plastic Surgery’s autologous fat grafting clinic

1. All anesthesia is performed with local anesthesia (sedation anesthesia). Local anesthesia is performed together with sedation anesthesia, and the procedure is carried out without any pain during or after anesthesia.
2. We have a systematic and advanced fat grafting system. To collect living fat cells and increase purity, we maximize purity through centrifuge purification and removal of unnecessary oil. Before grafting, subcutaneous tunneling at the graft site is performed to secure space for the grafted area. Precise grafting is performed using a micro fat grafting cannula. By grafting evenly in multiple layers in a three-dimensional manner, we maximize the graft survival rate and create a soft contour.
3. We select appropriate and various donor sites for fat harvesting. The most commonly used area is the lower abdomen, which is often chosen first because it has less pain after the procedure, less swelling and bruising, and is easier to live with. The next preferred area after the lower abdomen is the inner thighs, followed by the outer thighs. If there is insufficient fat to harvest from the thighs, the lower buttocks or flanks may also be used. There is no fixed answer as to which area provides the best graft survival rate. The results are similar, and the ideal donor site is the area with the most excess fat, but the donor site should be chosen by considering the amount of fat to be harvested and post-procedure activity.
4. We maximize the graft survival rate through a two-step purification process for harvested fat. The highest proportion of impurities in harvested fat is local anesthetic, followed by oil. Other impurities such as serum and red blood cells are also included. In the first step, the fat undergoes centrifugation for about 3 to 4 minutes before entering the second oil-removal process. Oil is removed manually through natural absorption. Through the second purification step, nearly 100% concentrated fat is obtained, maximizing the effect of fat grafting while increasing the graft survival rate as much as possible.
5. We secure space for fat grafting through subcutaneous tunneling. Subcutaneous tunneling is the process of securing space in advance for the area where fat will be grafted, and it is an essential and important step for high graft survival and even grafting. Using a thin probe, the tissue under the skin is moved repeatedly in a fan-like pattern to create space for the fat to be grafted. The effect of subcutaneous tunneling is to increase graft survival and prevent fat from clumping, creating a uniform and soft contour.
6. With three-dimensional micro fat grafting, a soft and even facial contour can be achieved. Although there are exceptions depending on the area, the basic grafting method is three-dimensional. Fat is distributed in multiple layers in small amounts and evenly across each area.
7. We use a micro fat grafting cannula for precise grafting. In the past, methods using fat injection machines forced fat under the skin at high pressure, which caused various problems. The absorption rate of the fat was high, graft take was inconsistent, the contour became uneven, and it was difficult to graft into delicate areas such as under the eyes. To solve these problems, the fat is transferred again into a thin 1cc syringe and grafted into the desired area. Duhan Plastic Surgery’s autologous fat grafting clinic uses the in-house developed micro needle (micro grafting cannula). The micro needle is a special grafting cannula used only at our clinic, enabling ultra-precise grafting. Fat grafting can be performed on the upper eyelids, lower eyelids, forehead wrinkles, glabella wrinkles, nasolabial folds, and bridge of the nose, making fat grafting possible in almost all cases except fine wrinkles.
8. Post-grafting molding helps create a uniform and soft facial contour immediately after the procedure. Right after fat grafting, delicate molding is performed to create a soft shape and spread the grafted fat evenly. Molding is the final step of fat grafting and one of the most important steps.
9. Rapid freezing and sterile storage of remaining fat simplifies the second procedure. If a second procedure is performed more than 3 months after fat grafting, the remaining fat from the first procedure is used instead of harvesting fat again. The leftover fat after the first procedure is rapidly frozen, sterilized, and stored. During the second procedure, the stored fat is thawed and the treatment can be performed more conveniently. The storage period for the fat is up to 10 months, and if you visit within 10 months, the stored fat will be used for the procedure.
10. Based on more than 20 years of rich clinical experience and know-how, Duhan Plastic Surgery’s autologous fat grafting clinic performs multilayer (layer-by-layer) fat grafting. The key to fat grafting is enabling living fat cells to achieve a high graft survival rate. To increase graft survival, a large amount is not injected into one spot; instead, it is evenly distributed across multiple layers. Between the skin and bone there are various tissue layers such as the fat layer and muscle layer, and fat must be injected in a multilayer structure so it does not overlap, such as between the periosteum above the bone and between the muscles and fascia. Multilayer fat grafting lasts 3 to 4 times longer than conventional methods and also has a higher fat survival rate. Duhan Plastic Surgery’s autologous fat grafting clinic also includes a process called “tunneling,” which helps the graft contact surrounding abundant blood vessels as much as possible so nutrients can be continuously supplied. Tunneling means creating space for the fat under the skin using a micro needle. Since space is made as if making a tunnel and then the fat is injected, the graft does not sag in the direction of gravity or become bumpy even after all the fat has been placed. In addition, delicate injection methods allow for customized design. After fat grafting, we provide thorough aftercare and carefully monitor progress until the fat has fully taken hold. During follow-up, if necessary, we try to minimize dissatisfaction by using swelling-reducing injections or by adjusting the shape and molding.

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