Objective: To describe our clinical experience with, and functional outcomes of the nasolabial flap for reconstruction of orofacial defects. Methods: Design: Retrospective Case Series. Setting: Tertiary National University Hospital. Participants: Records of 11 patients on whom a nasolabial flap was performed for reconstruction of head and neck defects between January 2013 and December 2018 were analyzed. Results: All patients underwent wide excision with or without frozen section, with or without neck dissection, and nasolabial flap closure was performed by a single surgeon. There were no major complications. In two cases, the nasolabial flap was used as an adjunct for Abbé and deltopectoral flap reconstruction. One had poor oral competence due to the bulk of the deltopectoral flap. Acceptable aesthetics and functional outcomes were achieved. Conclusion The nasolabial flap is a viable alternative for reconstruction of orofacial defects following head and neck surgeries. Additional cases can help validate our initial experience
Nasolabial Fold ; Mouth ; Skin ; Surgical Flaps

Pleomorphic adenoma is the most common benign tumor of the salivary gland. Pleomorphic adenoma occurs most commonly in the parotid gland but it may involve other salivary gland such as submandible or lingual. We report an ectopic pleomorphic adenoma in the subcutaneous layer of the face. A woman presented with a mass of the nasolabial fold. After excision of the mass, it was revealed as an pleomorphic adenoma pathologically. An ectopic pleomorphic adenoma which was located in the subcutaneous layer of the face is very rare in medical literature.
Adenoma ; Adenoma, Pleomorphic ; Cheek ; Female ; Humans ; Nasolabial Fold ; Parotid Gland ; Parotid Neoplasms ; Salivary Gland Neoplasms ; Salivary Glands ; Skin ; Subcutaneous Tissue

Recently, there is a growing interest of hyperbaric oxygen therapy in many fields of medicine. We had a 43-year-old female patient presented with severe necrosis of the nose, philtrum, and upper lip due to retrograde arterial occlusion after nasolabial fold hyaluronic acid filler injection. Our patient went through 43 sessions of systemic hyperbaric oxygen therapy from December 2, 2017 to January 18, 2018. We administered 2.8 atmosphere absolute (ATA) for 135 minutes in the first session and the remaining sessions consisted of 2.0 ATA for 110 minutes. In reporting this case, we wish to provide a warning regarding the latent risk of filler injections and share our experience about minimizing soft tissue damage in the early stages with systemic hyperbaric oxygen therapy.
Adult ; Atmosphere ; Female ; Humans ; Hyaluronic Acid ; Hyperbaric Oxygenation ; Lip ; Nasolabial Fold ; Necrosis ; Nose

OBJECTIVE: This study investigated the feasibility and clinical result of radical resection of posterior buccal carcinoma by using the facial nasolabial fold "smile" incision approach. METHODS: From August 2016 to March 2017, 23 patients with posterior buccal carcinoma were included in this study and underwent radical surgery. Upon finishing the cervical lymph node dissection, an arc-shaped incision was made at 1 cm lateral to the ipsilateral angulus oris, extending along the nasolabial fold upward to the inferolateral margin of the nasal alar while downward in direct continuity with the neck dissection incision. RESULTS: Satisfactory exposure and easy resection of the primary tumor with negative surgical margin were achieved in all 23 patients. After 12-22 months of follow-up (16.5 months on average), all patients recovered favorably, and no local recurrence or distant metastasis was observed. Mouth opening was restored to normal in all cases. The scars were hidden in the nasolabial fold, thus named "smile" incision. CONCLUSIONS For posterior buccal cancer patients, the facial "smile" incision approach can satisfy the need of surgical exposure, facilitate operative performance, and preserve the annular integrity of the lips without affecting the radical tumor ablation, thereby maintaining a favorable mouth opening. With these advantages, the "smile" incision approach is considered worthy of being popularized in clinical application.
Humans ; Lip ; Nasolabial Fold ; Neck Dissection ; Neoplasm Recurrence, Local ; Nose

A nasolabial cyst is a rare, non-odontogenic cyst that develops within the area adjacent to the ala of the nose around the uppermost portion of the nasolabial crease. The origin of such a cyst is unclear but may be due to developmental problems. Clinical characteristic of asymptomatic nasolabial swelling and radiological findings are important for diagnosis. Treatment is usually surgical resection via a sublabial approach but can also involve incision and drainage or marsupialization. Unlike the typical clinical features reported in other cases, we experienced a case of a giant nasolabial cyst of 4.4 cm in a 56-year-old male with elevation of the nasal cavity base, gingival swelling, and perilesional bony destruction. In this case, we discussed the growth potential of a nasolabial cyst and proper timing of treatment.
Diagnosis ; Drainage ; Humans ; Male ; Middle Aged ; Nasal Cavity ; Nasolabial Fold ; Nose

BACKGROUND: The nasolabial flap is ideal for reconstruction of the nasal alar subunit due to its proximity, color and contour match, and well-placed donor scar. When raised as a random-pattern flap, there is a risk of vascular compromise to the tip with increased flap length and aggressive flap thinning. Surgical delay can greatly improve the chances of tip survival, allowing the harvest of longer flaps with greater reach. METHODS: We describe our technique of lengthening the nasolabial flap through multiple delay procedures. A bipedicled flap was first raised and then transferred as a unipedicled flap with a 6:1 length-to-width ratio. During the delay process, the flap tip was thinned to the subdermal layer. RESULTS: In our case series of seven patients, defects as far as the medial canthal area and contralateral ala were reconstructed successfully with no incidence of tip necrosis or flap loss. The resultant flaps were thin enough to be folded over for the reconstruction of alar rim defects. CONCLUSIONS: We highlight the success of our surgical technique in creating thin and robust nasolabial flaps for the reconstruction of full-thickness defects around the nose.
Cicatrix ; Graft Survival ; Humans ; Incidence ; Nasolabial Fold ; Necrosis ; Nose ; Reconstructive Surgical Procedures ; Surgical Flaps ; Tissue Donors

BACKGROUND: Mannitol containing monophasic filler with higher crosslinking has not been well studied for moderate and severe nasolabial fold (NLF) correction. OBJECTIVE: To compare the efficacy and safety of a novel mannitol containing hyaluronic acid (HA) filler (HA-G) with biphasic HA filler (HA-P) for moderate and severe NLF correction. METHODS: Thirteen subjects with symmetric moderate to severe NLF received HA-G (in one NLF) and HA-P (in other NLF) and were evaluated for 24 weeks. RESULTS: At both 12 and 24 weeks, the mean improvement in Genzyme 6-point grading scale from baseline was significantly greater in the side of face that was treated with HA-G than HA-P (1.96±0.91 vs. 1.54±0.73 at week 12; p=0.044, 1.88±0.78 vs. 1.3±0.79 at week 24; p=0.027, respectively). At 12 weeks, the mean Global Aesthetic Improvement Scale score was 2.92±0.93 for HA-G and 2.31±0.95 for HA-P (p=0.008). Both fillers were well tolerated. CONCLUSION: The HA filler HA-G provides better efficacy and similar local tolerability compared with HA-P in 6 months following treatment for moderate and severe NLF.
Dermal Fillers* ; Hyaluronic Acid* ; Mannitol* ; Nasolabial Fold*

Despite the fact that benign skin lesions can undergo malignant transformation, the necessity and timing of the surgical resection have yet to be established. In this study, we analyse three cases of benign-appearing skin lesions, which were found to be carcinomatous on histologic examination and review the literature regarding the importance of prophylactic removal of benign-appearing skin lesion. The first and second cases were female patients wishing for cosmetic surgery. The first patient had a benign-appearing lesion on dorsum nasi, and the second patient had an inconspicuous lesion right along the right nasolabial fold. The third patient was a middle-aged male with a pigmented lesion on the left cheek, who presented to the clinic only after having met the operating surgeon through an acquaintance outside the hospital setting. All of the lesions were suspected to be of benign nature and were excised for cosmesis only. However, histologic examination of these lesions showed that the first two tumors were basal cell carcinoma with the last tumor being squamouse cell carcinoma. Thus, it is considered that removal of benign like skin lesion will result in good prognosis of patients scheduled to undergo other surgery.
Carcinoma, Basal Cell ; Cheek ; Female ; Humans ; Male ; Nasolabial Fold ; Nevus ; Prognosis ; Skin Neoplasms ; Skin* ; Surgery, Plastic

BACKGROUND: Previous studies have investigated facial artery perforators, but have reported inconsistent results regarding lateral nasal artery (LNA) perforators. Although several authors have described the use of LNA perforators for ala nasi and nasal sidewall reconstruction, the literature contains little information regarding the cadaveric dissection of LNA perforators, and most previously published studies have focused on facial artery perforators. METHODS: Sixteen hemifaces from eight fresh cadavers were dissected to study the LNA perforators. After the dissection was performed, the total length and diameter of the LNA and its perforators were measured. The quantity and the distribution of the LNA perforators supplying the overlying skin were then assessed. LNA perforator flaps were used for reconstruction in 10 nasal and perinasal defects. RESULTS: The mean total lengths of the LNA and its perforators were 49.37 mm and 16.06 mm, respectively. The mean diameters of the LNA and its perforators were 2.08 mm and 0.91 mm, respectively. Based on our findings, we mapped the face to indicate zones with a higher probability of finding perforators. No infection, hematoma, or complete flap necrosis were observed after the procedures. CONCLUSIONS: Nasal reconstruction is a challenging procedure, and LNA propeller/V-Y perforator flaps are an excellent reconstructive option in certain cases. Based on our cadaveric study, we were able to identify an area in the upper third of the nasolabial groove with a high density of perforators.
Arteries* ; Cadaver ; Hematoma ; Nasolabial Fold ; Necrosis ; Perforator Flap* ; Skin ; Skin Neoplasms

BACKGROUND: As harvesting techniques have improved the viability of transposed adipose tissue, autologous fat transfer is increasingly utilized for facial augmentation. Conventional techniques involve placing harvested fat deep in subcutaneous tissue through skin punctures. Trans-oral fat injections at the buccal and labial sulci and through the mucosa of the oral commissures obviate external scars. We report experience with this technique for augmentation of the cheeks, zygomatic arch, nasolabial folds, upper and lower lips, and chin in 130 patients over a 14-year period. METHODS: We report an observational case series of 147 procedures performed in 130 patients (118 women and 12 men, 19-69 years of age) in which 10 to 60 mL autologous fat supernatant harvested from the hips, buttocks, or abdomen were injected through the oral mucosa for augmentation. Single preoperative doses of antibiotic and methylprednisolone were administered in all cases. Fat frozen and banked during initial treatments was used for additional augmentation 3 to 6 months after initial treatments in 46% of cases. Outcomes were assessed clinically with physical exams and photographs. RESULTS: Mucosal puncture wounds healed uneventfully. Most patients tolerated the procedures well and recovered rapidly compared to historical experience with conventional percutaneous techniques. One patient developed a sterile seroma 3 weeks after facial augmentation that responded to needle aspiration. CONCLUSIONS: Transmucosal, intra-oral autologous fat grafting was associated with minimal visible scarring, swelling, or infection at the recipient site. This technique may be considered an alternative to percutaneous transfer for proximate peri-oral facial augmentation.
Abdomen ; Adipose Tissue ; Buttocks ; Cheek ; Chin ; Cicatrix ; Cosmetic Techniques ; Female ; Hip ; Humans ; Lip ; Male ; Methylprednisolone ; Mouth Mucosa ; Mucous Membrane ; Nasolabial Fold ; Needles ; Punctures ; Reconstructive Surgical Procedures ; Rejuvenation ; Seroma ; Skin ; Subcutaneous Fat ; Subcutaneous Tissue ; Tissue Transplantation ; Transplants ; Wounds and Injuries ; Zygoma