Wrinkle Improvement, Duhan Plastic Surgery - Mouth Lines, Nasolabial Folds

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Fat grafting

is also called fat injection.

Because it is a delicate and precise fat grafting procedure,

it is also referred to as micro fat grafting.

Using a syringe, your own fat is collected,

then injected again into the desired area with a syringe

to correct the facial contours.

The key to micro fat grafting is

the expression of a natural, soft contour and a high survival rate.

By using 3D volumetric fat grafting and 2D planar fat grafting,

the most ideal fat grafting is performed for each area.

Except for bone surgery such as cheekbones and jawbones,

contour correction for other sunken areas

can be improved with fat grafting.

Because the procedure is simple, has no side effects,

and can naturally correct any area as much as desired,

it is one of the best facial contour plastic surgeries.

Director Shin Duhan

Fat grafting for mouth lines and nasolabial folds

Fat grafting for mouth lines and nasolabial folds is a procedure that corrects wrinkles formed between the side of the nose and the mouth area.

The deeper the wrinkles, the older one appears, and the more protruded the mouth may look. The corrective effect includes softening the wrinkles for a more youthful appearance, along with a visual effect that makes a protruding mouth look somewhat less prominent.

What are the indications for fat grafting for mouth lines and nasolabial folds?

Lip corner wrinkle line
Mouth-area nasolabial fold line
When the front part of the face beside the nose is sunken and appears hollow

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. For wrinkle correction, a large amount of fat is not needed, so collecting from the lower abdomen is preferable. - 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 remove impurities (local anesthetic, serum, red blood cells), etc. The purpose of centrifugation is to remove impurities contained in the fat, increase fat concentration, and improve the fat survival rate. |

| 3. After centrifugation, the fat undergoes a second concentration process to remove water and oil. By removing water and oil, almost 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 transferred again into a thin 1cc syringe and grafted into the desired area. At our clinic, a self-developed micro needle (micro grafting cannula) is used. The micro needle is a special grafting cannula used only at our clinic, enabling ultra-precise grafting. When grafting, a subcutaneous tunneling procedure must be done in advance so that the fat can be grafted accurately into the wrinkle area and correct the wrinkles effectively. |

Examples of wrinkle correction with fat grafting

Mouth lines and nasolabial folds

For fine wrinkles around the mouth, correction is possible with fillers (Restylane, Juvederm, Artecoll), but fillers are almost not effective for deeply sunken wrinkles.

Also, these fillers are meant to be injected in small amounts for fine wrinkles, but if too much is grafted into deep wrinkles, not only will the procedure be ineffective, but side effects may also occur.

With fat grafting, even severely sunken wrinkles can be corrected sufficiently.

Correcting deeply sunken mouth lines and nasolabial folds is one of the best uses of fat grafting.

Sometimes, using fat grafting and fillers together can be more effective.

What are the advantages of wrinkle correction with fat grafting?

1. The procedure is simple.

2. Because no foreign material is used like fillers (Restylane, Radiesse, Artecoll), there is no concern about side effects.

3. Because the procedure does not involve cutting the skin, there is no concern 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 survives, the effect can be maintained for a long time.

What should be kept in mind when correcting wrinkles with fat grafting?

1. After the procedure, if you laugh excessively or make a grimacing expression, the grafted fat may be compressed and absorbed more, so caution is needed.

2. Do not press on the fat grafting area or massage it strongly.

3. Running exercise should be avoided for about one month.

How many fat grafting sessions are needed for mouth lines and nasolabial folds?

In the case of mouth lines and nasolabial folds, there are several variables that affect the procedure's results.

If you laugh or grimace heavily after the procedure, the fat cells may be compressed and the effect reduced by half.

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

Therefore, in the case of wrinkle fat grafting, facial expression management should be done well for about one month.

For glabellar lines or nasolabial folds, one session, or at most two sessions, is usually enough to achieve a satisfactory result.

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

What is the lasting effect of fat grafting for mouth lines and nasolabial folds?

Some people say that fat grafting has no effect because much of it is absorbed, but this applies to cases where the procedure was performed at a place with insufficient experience in fat grafting,

or when the fat grafting was done poorly.

If performed correctly, fat grafting can produce a satisfactory result, and once the grafted fat survives, it will no longer be absorbed and will remain your own fat tissue for life, making it one of the safest and most effective methods.

On average, after one to as many as two fat grafting sessions, you can achieve a semi-permanent, satisfying wrinkle improvement effect.

However, no procedure lasts forever.

Wrinkles are a sign of aging, so there is no way to prevent aging; what matters is prolonging the effect of wrinkle treatment as much as possible.

Once fat grafting has been performed in an area, the tissue beneath the skin is reinforced, so it resists the force that would otherwise create wrinkles, making wrinkles less likely to form 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.

What are the side effects of fat grafting for wrinkle procedures?

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

To graft into the wrinkle line and achieve a smoothing effect, an appropriate amount of fat must be grafted at the proper depth after tunneling.

If fat grafting is done poorly, areas other than the wrinkle line may bulge more, and there may be side effects such as protrusion beyond the correction of the wrinkle line. Conversely, there may be cases where almost no effect is seen, or where severe swelling causes discomfort immediately after the procedure.

Also, because fat grafting does not apply to every wrinkle, it should be used only for wrinkles that can benefit from fat grafting. 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-board-certified plastic surgeon.

How can complications from excessive fat grafting be resolved?

If a practitioner lacks experience with fat grafting and performs it in a manner that goes against the principles, or if the amount is misjudged and too much fat is grafted, the grafted area may swell significantly or, even after the swelling subsides, the treated area may remain overly protruded and look unnatural.

This usually occurs when a large amount of poorly purified fat containing many impurities is forcibly injected.

In most cases it settles over time, but if the swelling is too severe, hyaluronidase for reducing swelling may be injected into the treatment area to bring the swelling down more quickly. If too much fat was injected, a cannula may be inserted to suction out the grafted fat and remove it again.

Excessively grafted fat can be removed more easily if suctioned out again within 3 months.

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

However, if fat grafting is done properly, these problems almost never occur.

What other treatment methods are there for wrinkle removal?

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

Mouth lines may also be corrected with fillers or collagen, but the use of fillers is very limited.

For fine, crack-like wrinkles, fillers can be tried.

However, in the case of deeply sunken wrinkles, fillers are almost ineffective, and the injected filler may be pushed outward by the force of smiling, making the nasolabial folds 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 satisfactory results from filler procedures.

■ Implant insertion method (silicone, Gore-Tex)

Implants are often used for rhinoplasty, but they are unsuitable for wrinkle plastic surgery.

Small implants are sometimes inserted through the nose or a mouth incision in what is commonly called an aristocratic surgery, but this is intended to correct a slight depression rather than wrinkles.

However, it is not an appropriate surgery for correcting long wrinkles, and various side effects may occur.

Because it is a foreign material, you may feel discomfort when smiling, or 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 nasolabial folds is not a desirable method.

In principle, implants should not be inserted into movable areas that make facial expressions.

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

A procedure called a magic lift, which pulls the face with threads, is also sometimes performed, but it has almost no effect not only on overall facial wrinkles but also on nasolabial folds.

There is a limit to how much the facial skin can be pulled with thread force, and because wrinkles quickly recur or the procedure can cause facial contour deformities, caution is needed.

■ 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 procedures are difficult.

Also, because liquid AlloDerm is absorbed to a considerable extent, the corrective effect is hard to predict, and dissatisfaction with the procedure is common.

Solid AlloDerm is mainly used for non-bridged rhinoplasty to create a curved nose tip and is not a desirable procedure for correcting nasolabial folds.

■ Insertion of gold threads or gold needles

Some clinics try to entice patients by saying that inserting gold needles into the face will make the skin elastic and firm and smooth out wrinkles.

It is mainly performed by non-specialists. Because it is a very expensive procedure, it is promoted as if the effect is excellent, but consumers should be cautious.

What are the side effects of fat grafting?

Because fat grafting uses autologous fat, unlike commercial filler substances, it has almost no side effects.

Except for some swelling and bruising after the procedure, side effects can be said to be virtually nonexistent.

Therefore, it can be considered safer than any other cosmetic surgery.

However, this is based on cases where fat grafting is performed properly. If the procedure is done against the principles, side effects can sometimes occur, such as an uneven surface, hardening due to fat necrosis, inflammation, or an unnatural appearance caused by excessive injection.

These are issues determined by the practitioner’s experience and skill, not by fat grafting in general.

Therefore, if the procedure follows the proper principles, these side effects almost never occur.

What is the effect of our clinic’s fat grafting for wrinkle removal?

Rather than injecting a large amount into one place using a tunneling technique, we perform 3D micro fat grafting in layers and evenly with 100% concentrated fat.

Using a delicate and careful injection method, customized design is possible.

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

Tunneling means creating a space for the fat just under the skin using a micro needle. Because space is created like making a tunnel and then the fat is injected afterward, it does not sag downward with gravity or become lumpy even after all the fat has been placed.

The tunneling technique includes a dissection process of the wrinkle, so the fat is grafted under the dissected wrinkle, resulting in a clearer improvement in wrinkles compared with fat grafting at other clinics.

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