How can doctors use fat grafting to fill in nasolabial folds?

Modern grafting uses fat from any convenient location. Most people have plenty to give up. I prefer the abdomen or the hip.

I make a quarter-inch incision inside the belly button or under the bathing suit line. I numb the fat and use tiny tubes to extract it in a manner similar to liposuction. Several teaspoons of fat are all that is needed.

The blood and local anesthetic are then removed by placing the fat on an absorbent Telfa gauze pad. The Jello-like fat is scooped up and placed into small syringes. A blunt-tipped needle on the syringe breaks up the fat in and around the nasolabial fold and marionette lines.

This step is crucial, for it creates a space for the fat to live. The technique not only adds fat to the fold, but also redistributes the adjacent "shoulders" of fat into the fold. The harvested fat is then distributed throughout the tissues under the fold.

Part of the benefit probably comes from scarring underneath the skin, which may shrink the fold. The incisions for fat grafting can be made in the fold, at the corner of the nose, or inside the lips. The cuts are usually only about an eighth of an inch in length and are repaired with one or two stitches.

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