Wrinkle correction # wrinkle removal # removing wrinkles # how to remove wrinkles # wrinkle surgery # wrinkle removal procedure # wrinkle removal surgery # wrinkle treatment # facial wrinkles # deep wrinkles # wrinkle lines # wrinkle-line correction

wrinkle-line removal # expression wrinkles # facial expression wrinkles # glabellar wrinkles # crow’s feet # forehead wrinkles # wrinkle-correction Botox # wrinkle-correction filler # wrinkle filler # wrinkle Botox # wrinkle fat grafting

facial wrinkle fat grafting # forehead wrinkle Botox # crow’s feet Botox # glabellar wrinkle Botox # bridge-of-nose wrinkle Botox # facial wrinkle Botox # depressed scar filler # filler procedure side effects # filler side effects

filler procedure # Juvederm procedure # Juvederm injection # fine-wrinkle filler procedure # scar filler procedure # wrinkle-correction fat grafting # perioral wrinkle fat grafting # nasolabial fold fat grafting # forehead wrinkle fat grafting

deep wrinkle fat grafting # glabellar wrinkle fat grafting # glabellar vertical wrinkle # under-eye wrinkle fat grafting # under-eye sunken wrinkles # hollow forehead # sunken forehead # glabellar wrinkle Botox # forehead wrinkle Botox

bridge-of-nose wrinkles # crow’s feet Botox # wrinkles at the outer corners of the eyes # outer-corner eye wrinkles # bridge-of-nose wrinkle Botox # wrinkles on the bridge of the nose # fine wrinkles on the bridge of the nose # Botox effects # expression wrinkle Botox # wrinkle between the eyebrows

wrinkles # wrinkle-line improvement # wrinkle improvement # wrinkle eraser # anti-aging # youthful appearance # youthful face # youth surgery # youth plastic surgery # youth treatment # Botox treatment effects # crow’s-feet Botox # glabellar Botox

severe expression wrinkles # severe expression-wrinkle Botox # forehead wrinkle filler # wrinkle filler # filler procedure # filler injection # glabellar wrinkle filler # crow’s-feet wrinkle filler # bridge-of-nose wrinkle filler # nasolabial fold # lip wrinkles

nasolabial fold filler # lip wrinkle filler # fine facial wrinkles # fine facial wrinkle filler # depressed scar # chickenpox scar # acne scar # facial wrinkle filler # facial wrinkle Botox # filler effects # filler advantages

Juvederm # Juvederm procedure # Juvederm injection # expressionless wrinkles # glabellar expressionless wrinkles # crow’s-feet expressionless wrinkles # skin booster injection # aqua lifting # Duhan Aqua Lifting # Duhan # Duhan Plastic Surgery

Dr. Shin Duhan # Duhan wrinkle plastic surgery # removing wrinkles # wrinkle removal procedure # safe filler # facial filler # facial wrinkle filler # micro-wrinkle filler # depressed scar filler # scar improvement # scar filler

fine forehead wrinkles # fine perioral wrinkles # fine nasolabial wrinkles # small depressed scar # chickenpox scar correction # acne scar improvement # acne scar # forehead fine wrinkle filler # perioral fine wrinkle filler # fine wrinkle filler

hyaluronic acid # deep facial expression wrinkles # fat grafting for wrinkles # facial wrinkle fat grafting # facial autologous fat grafting # facial microfat grafting # microfat grafting # autologous fat grafting # fat injection

deep and wide wrinkles # nasolabial fold fat grafting # perioral wrinkle fat grafting # perioral nasolabial fold fat grafting # glabellar wrinkle fat grafting # glabellar fat grafting # perioral fat grafting # under-eye sunken wrinkles # under-eye

under-eye wrinkle fat grafting # under-eye sunken area # under-eye improvement # under-eye surgery # under-eye plastic surgery # wrinkles beside the nose # nasolabial fold beside the nose # deep forehead wrinkles # forehead wrinkle improvement # nasolabial fold improvement # glabellar wrinkle improvement

under-eye wrinkle improvement # clinic with expertise in fat grafting # second fat grafting # third fat grafting # revision fat grafting # wrinkle recurrence # wrinkle-correction fat grafting # facial wrinkle surgery # Duhan autologous fat grafting

forehead depression # hollow forehead # three-dimensional fat grafting # layered fat grafting # tunneling technique # Duhan tunneling technique # Gangnam wrinkle plastic surgery # Apgujeong wrinkle plastic surgery # Sinsa Station fat grafting # wrinkle plastic surgery

Botox treatment for wrinkle correction

Botox is a brand name,

and its ingredient is a type of neurotoxin produced by the anaerobic bacterium Clostridium botulinum,

which is found when canned goods spoil.

When this neurotoxin acts on the human body,

it blocks the release of acetylcholine at nerve endings

and has the effect of paralyzing muscles.

Its use is to suppress facial expression wrinkles.

It can be applied to the glabellar area, eye area, and forehead wrinkles where expression wrinkles are strong.

What is the history of Botox use?

It began being used in ophthalmology for strabismus treatment in the 1970s, and from the late 1980s it was also used for wrinkle correction, including blepharospasm. More recently, it has also been used for localized hyperhidrosis (a condition of excessive sweating) in certain parts of the body.

It has been used for nearly 30 years and has no special side effects from the medication itself.

By applying this muscle-paralyzing effect, it is used to suppress expression wrinkles.

Botulinum toxin type A (brand names: Botox, Dysport, BTX, etc.) is commercialized and used.

Application of Botox for facial wrinkle correction

Among facial wrinkles, the wrinkles that can benefit from Botox are expression wrinkles that occur when making facial expressions.

These include horizontal forehead lines, the vertical glabellar line between the eyebrows, crow’s feet that appear when smiling, and horizontal lines on the bridge of the nose.

Other areas such as under the eyes or around the mouth should not be treated.

Under the eyes, the skin may sag or side effects such as ectropion may occur, and around the mouth the expression may become stiff and unnatural, so in principle Botox should not be used below the under-eye area.

What are the treatment areas for Botox?

Forehead wrinkles	Crow’s feet
Glabellar wrinkles	Bridge-of-nose wrinkles

How is the Botox procedure performed?

The commercialized botulinum toxin is diluted and injected into the area where wrinkle correction is desired. During the procedure, only mild pain is felt.

The effect usually appears after 2 to 3 days and does not interfere with daily life.

The effect lasts about 3 to 6 months, and as the medication wears off, muscle strength gradually returns. By around 6 months, the effect of the medication almost disappears.

At that point, the procedure can be repeated.

What kind of anesthesia is used and how long does the Botox procedure take?

Botox is performed without separate anesthesia.

Sometimes a topical numbing cream (EMLA) is applied, but it can be considered to have almost no effect.

Topical numbing cream only anesthetizes the epidermal layer of the skin, so it has almost no anesthetic effect for Botox procedures, which require deep injections under the skin.

Local injection anesthesia can also be used, but since the needle prick itself causes pain, it does not serve much purpose.

In fact, it can be less painful to skip anesthesia and receive the Botox injection directly.

Because Botox procedures use the thinnest 30-gauge injection needle, there is no pain other than a slight stinging sensation, so there is no need to worry.

The procedure takes about 2 to 3 minutes per area.

What is the process of facial wrinkle Botox treatment?

① The face is disinfected, and the areas for wrinkle correction are marked with a design pen.

② The Botox is drawn into a syringe.

③ Botulinum toxin is injected along the marked areas.

Usually, 0.5 cc is injected into each marked area.

④ Immediately after the procedure, you can put on makeup and go home to resume daily life.

Examples of Botox treatment application for wrinkle correction

What are the differences among the types of Botox currently sold in Korea?

The first product introduced and sold in Korea was American Botox.

Later, the product imported from France was Dysport, and more recently there is BTX, which is manufactured in China through OEM and imported as a domestic product.

All are the same botulinum toxin, so the ingredients are identical, but there are some differences.

The high-priced product is Dysport, followed by Botox, and the inexpensive product is Chinese BTX.

Different clinics use different types of botulinum toxin, so treatment costs vary.

If the price is unusually low or the effect seems weak, you should check whether a Chinese product is being used.

How long does the effect of Botox last and how does recurrence happen?

The duration of Botox varies depending on the area and differs from person to person.

In some cases, the effect may wear off in as little as 3 months, and in others it may last more than 9 months.

On average, the effect wears off between 3 and 6 months, after which facial expressions return to how they were before and expression wrinkles recur.

If you want to suppress expression wrinkles again, the procedure can be repeated.

Is there resistance to Botox?

When Botox enters the body as a foreign substance, resistance can develop, just like with other medications.

In some cases, the body itself produces Botox antibodies, and if antibody production is high, there are cases where Botox has almost no effect.

As the number of procedures increases, the likelihood that the body will produce antibodies against Botox increases, so it should also be kept in mind that repeated injections may reduce the effect due to antibodies.

What wrinkles do not respond to Botox treatment?

Botox works by paralyzing the facial expression muscles so that wrinkles cannot form, so it is effective only for wrinkles that appear when making facial expressions.

However, deep wrinkles that are present even in a relaxed, expressionless state are not significantly improved even with Botox.

To correct these wrinkles in an expressionless state, hyaluronic acid products such as fillers (Juvederm, Restylane) are used.

What are the side effects of Botox?

Botox has no special side effects, but it does have the effect of paralyzing facial expression muscles.

The following side effects may occur.

If injected under the eyes, the muscles relax and the eyelids may appear saggy.
If Botox is injected under the eyes in cases of age-related lower eyelid droop, ectropion may occur.
If injected into wrinkles around the mouth, mouth movement may become unnatural and the expression may become awkward.
If injected into the forehead or glabella, eyebrow drooping or eyelid drooping may occur.
Because there are many blood vessels around the eyes, bruising may occur after injection.

How can Botox side effects be prevented and managed?

You should receive the procedure from an experienced board-certified plastic surgeon.

Even if an undesired result occurs from Botox, it is temporary.

When the medication wears off, it returns to the state before the Botox procedure, so there are no permanent side effects.

It returns to its original appearance after 3 to 6 months.

Filler injections for wrinkle correction - Juvederm

Juvederm is hyaluronic acid that has been cross-linked

into a more advanced form of hyaluronic acid so that its effects last longer.

Its effect usually lasts about one year,

and even if it recurs, it tends to recur only mildly at the original treatment site,

so the more often it is treated, the more the treatment effect accumulates.

It is effective for fine wrinkles around the eyes, fine forehead wrinkles, fine wrinkles around the mouth, and small depressed scar correction.

Let’s look at the types of fillers by ingredient.

1. Hyaluronic acid (Juvederm, Restylane, Teosyal, Perlane)

Hyaluronic acid is an intercellular substance that exists between the dermis and epidermis of the skin. It is a biomaterial that helps cells adhere to one another and acts as a lubricant between cells.

Hyaluronic acid - the ingredient in Juvederm - is non-animal hyaluronic acid.

It is the most widely used filler, and because it is a biomaterial, it is a safe filler with a very low likelihood of side effects or inflammation.

It is divided into three types according to use: low concentration injected just below the epidermis, medium concentration injected into the dermis, and high concentration injected below the dermis.

It must be used according to its purpose, and if a high concentration is used in the epidermal layer, side effects such as skin protrusion may occur, so a filler with an appropriate concentration must be used for the treatment area.

Use: Mainly used for fine wrinkles around the eyes, glabella, and mouth, as well as for correction of depressed acne or chickenpox scars

2. Polymethyl methacrylate (Artecoll)

Artecoll is composed of PMMA (polymethyl methacrylate) particles suspended at a ratio of 1:3 in a 3.5% collagen solution.

PMMA (polymethyl methacrylate), also called methacrylic resin, is a type of thermoplastic.

Inflammatory side effects are not common, but when it is applied superficially in the skin layer, unevenness can occur, causing the skin to become hard or irregular.

It is not a filler that can be used in delicate areas.

In deeper areas, its viscosity is weak, so it is difficult to expect a strong contour-correcting effect for depressed areas.

Use: Correction of small depressed areas; not suitable for fine wrinkles or precise procedures

3. Polyacrylamide (Aquamid, Interfall, Royamid, Bio-Alcamid)

Its ingredients are Polyacrylamide 2.5% mixed with Apyrogen water 97.5%.

It is considered to have excellent durability, but after being imported and used in Korea, many side effect cases such as inflammation have been reported, so caution is needed.

Because side effect cases are frequent, some products have been banned from import by the Ministry of Food and Drug Safety.

Use: Often causes inflammation, so use with caution

4. Collagen (Evolence)

Collagen is one of the components in the human body and is a biomaterial, so it is relatively safe, but side effects such as allergies sometimes occur.

Also, because collagen is absorbed in the body by an enzyme called collagenase, its durability is lower than that of other fillers.

Use: Used for small depressed areas and correction of fine wrinkles

5. Radiesse (calcium formulation)

It consists of particles of calcium hydroxyapatite, a bone component, in a water gel. It is a bone-derived material.

Because the particles are hard, it is not suitable for correcting fine wrinkles in the skin, and it can be applied below the skin for small depressed scars or contour correction of small areas.

Procedures under the mucosa in soft tissues such as the lips should be done with caution because they can cause firm lumps as a side effect.

Use: Small depressed areas, chickenpox or acne scars

What are the characteristics of filler injections (Juvederm)?

It is safe because it is a biomaterial.
The procedure is easy and allows precise treatment.
Because it is a highly biocompatible material, allergy testing before the procedure is not necessary.
Because it is made by cross-linking hyaluronic acid, it maintains its effect for a long time.
The effect can be checked immediately after the procedure.

What is the treatment range for filler injections (Juvederm)?

Forehead wrinkles	Glabellar wrinkles
Crow’s feet	Bridge-of-nose wrinkles
Nasolabial folds	Lip wrinkles
Other fine facial wrinkles	Depressed scars (chickenpox, acne scars)

What is hyaluronic acid (Juvederm)?

Juvederm is injected into the dermis beneath the wrinkle through a thin 27-gauge syringe.

After Juvederm is injected, the increased volume pushes the wrinkle upward.

By physical force, hyaluronic acid supports the wrinkle from below, improving the wrinkle and helping suppress recurrence by remaining in place.

What is the Juvederm filler procedure?

① Apply a topical anesthetic (EMLA) to the area where wrinkle correction is desired.

② Apply it evenly over the entire wrinkle area.

③ Seal it with plastic wrap so the anesthetic does not dry out.

④ After sealing with plastic wrap, wait about 30 to 40 minutes for the anesthetic to absorb.

⑤ After 30 to 40 minutes, wipe off the topical anesthetic (EMLA).

⑥ Inject the hyaluronic acid along the wrinkle line.

For crow’s feet, the procedure takes about 10 minutes, and because anesthesia is used, there is almost no pain.

⑦ After the procedure, you can put on makeup and go home.

⑧ Return after one week to confirm that the wrinkles have definitely disappeared.

Examples of filler injection procedures

What is the treatment range for filler injections (Juvederm)?

As with most fillers, they are not very effective for deep wrinkles.

They are mainly used for correcting fine wrinkles.

The wrinkles that are mainly treated include fine forehead wrinkles, fine glabellar wrinkles, crow’s feet, and nasolabial folds around the mouth.

They are also used effectively for acne scars, chickenpox scars, and other scars.

Fillers should not be used to correct deep expression wrinkles or facial contours.

Their effect is minimal or there may be concern about side effects, so caution is needed.

When is filler injection (Juvederm) not effective?

It is weak or almost ineffective for very thick and deep wrinkles.

For forehead wrinkles, vertical glabellar wrinkles, and deeply sunken nasolabial folds around the mouth, the treatment effect is insufficient.

Filler injections are for fine wrinkles.

What are the duration of effect and number of treatments for filler injections (Juvederm)?

Juvederm is injected into the dermis of the skin to push wrinkles upward.

Juvederm is cross-linked hyaluronic acid developed to maintain its effect for a long time.

The effect usually lasts about one year, and even if it recurs, it tends to recur only mildly at the original treatment site, so the more often it is treated, the more the treatment effect accumulates.

The duration varies depending on the degree of wrinkles, facial expression habits, and the location of the wrinkles.

In some cases, it may last for several years or more.

The number of treatments depends on how the wrinkles appear; repeat treatment can be performed, and it is not done on a fixed schedule.

What are the side effects of filler injections (Juvederm)?

It is made by refining the intercellular substance that exists between the dermis and epidermis of the skin, and because it has excellent biocompatibility, it is safe enough that allergy testing before the procedure is not necessary.

For example, with collagen injections, an allergy test is performed to determine biocompatibility, and only if no allergy is expected is the procedure performed. In the case of Juvederm, such testing is not needed.

Another side effect is that, if the injector lacks experience and injects too much Juvederm into one area, the injection site may rise above the normal skin surface.

If over-injected, it can be removed again or dissolved with the antagonist hyaluronidase.

Correct knowledge you should know about fillers

★ Safe fillers should be used.

Fillers containing polyacrylamide ingredients (Aquamid, Interfall, Royamid, Bio-Alcamid, etc.) have frequently been reported to cause side effects such as inflammation after being imported and used in Korea, so caution is needed.

Some products are currently banned from import by the Ministry of Food and Drug Safety.

They are advertised as highly durable, but because it is difficult to completely remove the injected filler, serious aftereffects can occur once inflammation develops, so this should be kept in mind.

★ They must be used for the proper purpose.

There are various types of fillers, and people often focus on how long they last. However, long durability can be both an advantage and a fatal disadvantage.

When a problem occurs, most fillers are difficult to remove.

Therefore, if the filler spreads between tissues and causes problems, you may suffer serious side effects and aftereffects.

The use of fillers should be limited to correcting fine wrinkles and small depressed scars.

For example, using them to raise the nose, for under-eye plastic surgery, or on the cheeks, forehead, or lips is a procedure that should be strongly discouraged.

This is because, aside from having little effect, the risk of side effects is very high.

Just as even a good medicine can become harmful if used for the wrong purpose, even a good filler will inevitably have a higher rate of side effects if used outside its intended purpose.

★ Side effects of embolism

Even safe fillers can block arteries in the subcutaneous layer when injected, causing embolism.

Due to embolism, the tissue or skin supplied by the artery may become necrotic.

Necrosis caused by embolism can be considered a serious side effect.

Once skin tissue becomes necrotic, it recovers over a long period while leaving severe scars, so it is a serious problem.

Therefore, fillers should be used only for small depressed scars or fine wrinkles in the dermis, and it should be kept in mind that if they are injected into deeper areas below the dermis for deep wrinkles or contouring, there is always a risk of embolism traveling through an artery.

★ Problems with fillers that have high durability

Fillers with high viscosity and strong durability can sometimes cause serious problems.

High durability means the filler hardens firmly, so it can cause issues such as uneven protrusions or contours at the treatment area, or a foreign-body sensation and a firm feel that is not soft like one’s own tissue.

Therefore, fillers with high durability must be used very carefully to avoid side effects.

★ Proper understanding of filler durability

As an example, Juvederm comes in three types.

They are marked with the numbers 18, 24, and 30 and have different viscosities.

The ingredients are the same, but the higher the number, the higher the viscosity, the better the correction effect for depressed areas, and the greater the durability.

Therefore, Juvederm 30, marked as 30, has the best durability.

You might think that only the most durable 30 should be used, but they were released in three types because each has a different purpose.

The least durable 18 is a filler injected just below the epidermal layer and is used for the finest and shallowest wrinkles.

However, if Juvederm 30, which has better durability, is used for shallow wrinkles just below the epidermis, the treated area may protrude, causing unevenness and producing poor results.

If this unevenness lasts for years or does not disappear, it can be quite troublesome.

Therefore, for shallow wrinkles, the low-viscosity 18 product should be used for safety and effectiveness.

Accordingly, the purpose of Juvederm 30 is to be injected just below the dermis and used for deep wrinkles or depressed scars.

In this way, only by using the appropriate filler for wrinkles or depressed areas can the procedure be effective without side effects. If it is judged only by durability and used outside its intended purpose, there is a greater concern about side effects, so this should be kept in mind.

★ Cautions about using fillers for under-eye plastic surgery or aegyo-sal procedures

Fillers should not be carelessly injected under the eyes.

Fillers are not made for contouring.

They are simply for correcting fine wrinkles and small depressed scars.

Nonetheless, they are often misused by being injected for under-eye aegyo-sal procedures or into depressed areas under the eyes, making the eye area look awkward or causing side effects.

Because fillers are transparent, when they are injected under the eyes, the color often becomes pale and looks unnatural.

They may also create a lumpy shape, or the filler may spread and protrude in unintended areas.

Many people complain that their under-eye shape looks unnatural or experience side effects after under-eye filler procedures, so to avoid following in their footsteps, fillers should never be injected under the eyes.

This applies not only under the eyes, but also to the nose, lips, and cheeks.

Fillers should be applied only to fine wrinkles around the eyes, fine forehead wrinkles, fine wrinkles around the mouth, and small depressed scars.

If the filler is not a hyaluronic acid filler, once an incorrect shape or side effect appears after filler treatment, correction is almost impossible.

Many people contact this clinic for correction because of poorly performed filler procedures at other hospitals, but there is no special correction method here either, so receiving filler treatment under the eyes is absolutely not recommended.

★ How to address side effects caused by using fillers for the wrong purpose

If the filler is a hyaluronic acid product, there is an antagonist called hyaluronidase.

It is an enzyme that dissolves hyaluronic acid, and although it has mainly been used to reduce swelling in surgical patients, many clinics also use hyaluronidase to dissolve hyaluronic acid fillers when problems arise from indiscriminate filler procedures.

If you were treated with Restylane, Juvederm, or Perlane, it can be dissolved using hyaluronidase.

However, for fillers made of other ingredients, there is no antagonist that can dissolve them, so if side effects occur, correction is almost impossible.

Many people contact the clinic for correction because of poorly performed filler procedures at other hospitals, but there is no special correction method here either, so receiving filler treatment for contour correction under the eyes, nose, or face is absolutely not recommended.

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Fat grafting for wrinkle correction

This is a treatment that is mainly effective for deep facial expression wrinkles.

Commercial fillers (Restylane, Juvederm, Artecoll, Lofilane) and the like

are mainly used for fine wrinkles,

while deep and wide expression wrinkles (nasolabial folds, glabellar wrinkles, forehead wrinkles, under-eye sunken wrinkles) can achieve satisfactory results with fat grafting.

What wrinkle areas can be treated with fat grafting?

Perioral wrinkles and nasolabial folds beside the nose	Deep forehead wrinkles
Vertical glabellar wrinkles	Under-eye sunken wrinkles

How is fat grafting performed for wrinkle removal?

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

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

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

② The collected fat is placed in a centrifuge to obtain pure concentrated fat.

The purpose of centrifugation is to obtain pure concentrated fat, reduce side effects after grafting, and increase the fat survival rate.

③ After centrifugation, a second concentration process removes water and oil from the fat.

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

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

★ The tunneling technique used for fat grafting at this clinic~

Fat grafting also includes a process called “tunneling,” which allows the grafted fat to make maximum contact with surrounding abundant blood vessels so it can continuously receive nutrients.

Tunneling means creating spaces for the fat just under the skin using micro-needles. Since a space is made like drilling a tunnel and fat is injected afterward, even after all the fat has been placed, it does not sag in the direction of gravity or become uneven.

Rather than injecting a large amount into one place, we perform three-dimensional microfat grafting with 100% concentrated fat distributed evenly across multiple layers.

A delicate and thorough injection method allows for customized design.

http://www.microfat.net

Let’s look at examples of wrinkle correction with fat grafting.

Please refer to the following.

1. Forehead depressions and wrinkles

For the forehead, fat grafting is performed when there are depressed areas or deep forehead wrinkles.

2. Glabellar wrinkles

For glabellar wrinkles, mild wrinkles can be treated with filler substances such as Restylane or Juvederm, but for deeply sunken vertical glabellar wrinkles, fat grafting can produce better results.

3. Under-eye wrinkles

For under-eye wrinkles, satisfactory results can be obtained for depressed wrinkles between the eyes and the nose.

4. Perioral nasolabial folds

If fat grafting is performed for nasolabial folds beside the nose or wrinkles around the mouth, sufficient correction can be achieved even in severely sunken wrinkles.

What are the advantages of wrinkle correction with fat grafting?

The procedure is simple.
Because no foreign material is used like fillers (Restylane, Radiesse, Artecoll), there is no concern about side effects.
Because the skin is not incised, there is no concern about scars.
Because it uses your own tissue, the appearance is natural.
There is almost no swelling or bruising.
You can return to daily life immediately after the procedure.
Because the fat tissue survives, the effect can be maintained for a long time.

What should be kept in mind when undergoing wrinkle surgery with fat grafting?

Because some fat is absorbed, one procedure may be insufficient, and a repeat procedure may be needed after 2 to 3 months.
It is difficult to apply to fine wrinkles such as those around the eyes or under the eyes.

How many times is fat grafting needed for wrinkles?

For most fat grafting procedures, including nasolabial folds, satisfactory results can be achieved with an average of about two sessions.

The interval between procedures is 2 to 3 months, and for repeat treatment, the fat that was collected at the time of the initial fat grafting can be thawed and used.

What is the duration of the effect of fat grafting?

Some people say fat grafting has no effect because much of it is absorbed, but if the procedure is performed properly, satisfactory results can be achieved.

Once the grafted fat survives, it is no longer absorbed and remains your own fat tissue for life, so it is considered one of the safest and most effective methods.

On average, receiving fat grafting twice is thought to provide a semi-permanent and satisfying wrinkle-improvement effect.

Other wrinkle-removal treatment methods

■ Methods using fillers (Juvederm, Artecoll, Teosyal, Evolence)

Perioral wrinkles are sometimes corrected with fillers or collagen, but the use of fillers is very limited.

Fillers can be tried for fine cracks and similar fine wrinkles.

However, for deep depressed wrinkles, fillers are almost ineffective, and the injected filler may be pushed outward by smiling muscles, 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 depressed wrinkles.

Therefore, satisfactory results cannot be expected from filler procedures.

■ Implant insertion method (silicone, Gore-Tex)

Implants are often used in nasal augmentation, but they are not suitable for wrinkle plastic surgery.

Small implants are often inserted through the nose or an incision in the mouth in what is commonly called a “noble surgery,” but this is intended to correct slight depressions rather than wrinkles.

However, it is not an appropriate surgical method for correcting long wrinkles, and various side effects can occur.

Because they are foreign materials, you may feel them when smiling, the contour may protrude, or the implant may shift position due to the force of smiling.

They can sometimes cause problems such as inflammation, so inserting implants into nasolabial folds is not a desirable method.

In principle, implants should not be inserted into moving areas where facial expressions are made.

■ Magic lift (a procedure that pulls the facial skin with threads)

There is also a procedure called Magic Lift that pulls the face with threads, but it has little effect not only on overall facial wrinkles but also on nasolabial folds.

There is a limit to how much facial skin can be pulled with the force of threads, and the procedure should be approached with caution because recurrence is quick and there are many side effects such as facial contour deformity.

■ Insertion or injection of artificial dermis Alloderm (Surederm)

Correction is sometimes performed using artificial dermis such as Alloderm, made by processing human dermal tissue, but precise treatment is difficult.

Also, liquid Alloderm is largely absorbed, so the corrective effect is difficult to predict, and dissatisfaction with the procedure is common.

Solid Alloderm is mainly used for nasal tip surgery to create a slightly upturned nose and is not a desirable procedure for correcting nasolabial folds.

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