The nasolabial folds, sometimes called the nasolabial crease, is a highly misunderstood region of the face that gets a lot of attention in facial cosmetic surgery.  Since the increased popularity of soft tissue fillers exploded with the aesthetic enhancement of the lips, many practitioners have taken to injecting the areas of the nasolabial folds in an attempt to make them disappear.

While injection of soft tissue filler into the nasolabial folds can helps soften their depth, it demonstrates a misunderstanding of how the fold develops and what its causes are.  When we “fillâ€� an area with an injectable such as Juviderm or Restylane, we usually do so in an attempt to add volume to an area that is deficient or has shrunk.  In the nasolabial area, however, there is never a loss of volume causing the crease.  In fact, you can see that even babies and children have nasolabial folds…

The nasolabial crease itself is not a sign of aging.  For the same reason, a puffed out, over-filled nasolabial fold that has been treated with excessive injectable does not produce a youthful, or even natural appearance.  Why is this?

In fact, the nasolabial folds appear worse as we age because the cheek above and lateral to the fold falls downward as we get older.  Like the skin and tissue in the area of the jowl and neck sags progressively over time, the cheek tissue falls over the nasolabial region, causing a worsening shadow in the crease.  The fix for this problem is not to fill the area below the fallen tissue, but instead to lift the cheek back to its youthful position.  Just as a Santa Barbara face lift repositions the facial tissue to eliminate excess in the jowl and neck, the cheek lift recreates the natural youthful appearance by returning the cheek tissue to its rightful place.  The cheek lift enhances the soft tissue over the cheek bone, where this tissue was found in youth, and removes the fullness from the lower cheek.  The result is a youthful appearing mid-face with less wrinkling and less shadows in the upper and lower cheek region.  This is why this procedure is often referred to as a mid-face lift.  I will be very pleased to discuss the Santa Barbara cheek lift with any prospective patient- the minimal incisions that are required and the excellent results that are seen make this operation one of my most popular enhancements in facial plastic surgery.

The advantage of the SMAS lift is that as the SMAS is lifted vertically, there is excess that can be manipulated in several ways.  In the full face, this excess is removed so as not to add volume to an already round face.  In the thin or hollowed face, this tissue can be folded on itself to increase volume.  In my Santa Barbara plastic surgery practice, I feel the key to facial plastic surgery, particularly face lifts and rhinoplasty, is to individualize the operation to the patient.  The SMAS lift allow me to do just that.