Can You Use Fat To Inject Into The Nasolabial Folds?

Q: Have you ever used a patient’s own fat to fill in the nasolabial folds?  I had it done in the past and it seems to last longer than other injectable fillers. Besides, I find it more appealling as it is completely natural.

A: The nasolabial folds have been injected with every conceivable form of injectable filler, including fat.  To date, there does not appear to be an ideal filler for this, or  any other, facial area. Off-the-shelf injectable fillers offer convenience but last less than one year at best. The use of fat injections is less convenient, as it must be done in the oeprating room in most cases, but does offer a natural material. Unfortunately, it has not proven to be permanent in most cases and has not been shown to last longer than commercial injectable fillers.

I do use fat as an injection material when one happens to be in the operating room anyway doing other procedures. This is a good time to take advantage of the natural or autogenous injection opportunity. This is particularly convenient when one is having some liposuction performed. In this case, some of the discard can be used for injection into the nasolabial folds.

Another fat option, not thought of very often, is that of the dermal-fat graft. Using a strip of skin with fat attached (and the top layer of epithelium removed), these grafts can be threaded into the nasolabial folds through small incisions above and below the folds. This type of fat graft provides very consistent survival. It does require a donor site, however, and that is a disadvantage if an excisional procedure (such as tummy tuck or breast reduction) is not being simultaneously performed. 

Dr. Barry Eppley

Indianapolis, Indiana