Q: I hate my deepening nasolabial folds that are developing. I was looking for something more long-lasting to treat them. I have read about the wire release method. At what age can you perform the new wire-release method for nasolabial folds?
A: Deepening nasolabial folds is a result of the cheek tissue above the lip falling down over the more fixed lip tissues. It is actually not a fold that is deepening in terms of indenting into the tissues but a rolling overhang of tissues. Injectable fillers are most commonly used to plump up the fold in an effort to get the top edge of the upper lip more even with the falling cheek tissues.
The concept of doing a release of the dermal attachments of the upper lip so that it ‘springs’ upward to be more even with the lower cheek tissues is not new. The wire release method is just a different way to do this older concept. It is clever but not original. Age is no determinant as to when it can be done. The timing of it is when the nasolabial folds are deep enough to justify more of a surgical approach or when one has tried injectable fillers and found them wanting in terms of a long-term result.
While the wire release method is clever, the nasolabial fold can be released just as easily with more simple pickle-fork instruments and large beveled needles. What we have learned with any method of doing nasolabial fold releases is that they require some interpositional material placed after the release to prevent the fold from re-forming over time. This can be done with with fat injections or allogeneic dermal grafts.
Dr. Barry Eppley