Ideal anatomy and proportions:
The nasolabial folds are the furrows extending from the nose to the corner of the mouth. If they are deep, they can weigh down your face and make you look older than you are, or even make you look sad. If these folds are moderate, they can be corrected with filler (hyaluronic acid) or lipofilling (fat transfer) injections. If the depth of the fold is important, an injection of the cheekbones bringing a lifting effect or a cheek lift can be associated.
Warning:
Only doctors with a license and liability insurance can inject hyaluronic acid in Switzerland. Laboratories selling hyaluronic acid are only authorized to sell it to doctors with a license. There are many counterfeits that can endanger your body, some of which cannot be corrected by Hyaluronidase. In addition, an intravascular injection (into a vessel) can have dramatic consequences: necrosis, blindness.
Technique:
Filler: entry point (<1 mm at the hairline), then filling: in general, it takes to 2 ml per side.
Lipofilling: fat removal (often inner knee or abdomen) under local anesthesia (no pain with an appropriate anesthesia), decantation and specific preparation of the fat (thus recovering part of the purified fat, rich in stem cells) and then reinjection by the same technique as hyaluronic acid.
Results:
Time frame for final results:
Hyaluronic acid: immediate
Lipofilling: 1 week for the filling, but 3 months for the rejuvenation effect on the skin of the stem cells contained in the fat
Longevity of results :
Hyaluronic acid: 6-12 months
Lipofilling: 5-10 years
Before injection:
Stop smoking 1 month before lipofilling
Do not take Aspirin 10 days before surgery, inform Dr. Lucas of any anticoagulant medication (Sintrom, Coumadin, Eliquis, etc.) to arrange for its discontinuation or replacement.
Take Arnica capsules 5 times a day for 5 days before surgery to prevent hematoma.
Contraindications hyaluronic acid: autoimmune diseases, pregnancy, breastfeeding
Procedure :
Pain: the pain during the intervention will be almost non-existent, with an adapted anesthesia
Duration of the procedure: 30 minutes for hyaluronic acid, 60 minutes for lipofilling
Anesthesia: local
Location: office for hyaluronic acid, operating room for lipofilling
Ambulatory (without hospitalization)
After injection:
Post-operative pain: 1/10 often responding to Dafalgan
Social eviction:
Hyaluronic acid: no (discrete swelling for 24-48h)
Lipofilling: swelling and hematoma for 4-7 days
Sutures removal: no sutures
Return to work: immediate for hyaluronic acid, 2-3 days for lipofilling
Return to sport: 24 hours for hyaluronic acid, 2-3 days for lipofilling
Instructions:
Bed rest without major effort and ice mask for 2-3 days, as often as possible, to reduce swelling.
Do not compress the fat injection area if lipofilling during 3 weeks (risk of fat loss)
Take Arnica capsules 5 times a day for 5 days after surgery to prevent hematoma
Stop smoking permanently to prevent fat and hyaluronic acid resorption
Hyaluronic acid:
Control Dr Lucas 2 weeks
Lipofilling :
Control Dr Lucas 2 weeks, 3 months
Complications:
– Infection, hematoma, asymmetry, under or overcorrection
– Intravascular emboli: it is important to have this procedure performed by a qualified physician who is used to injecting this area, which is richly vascularized with a very variable vessel anatomy. A vascular embolism if it moves into the circulation of the retina can lead to blindness or necrosis.
Alternatives and operations that can be combined:
If the depth of the fold is important, a cheekbone injection providing a lifting effect or a malar (cheek) lift with threads or surgery can be associated.
