Percutaneous elevation of the malar fat pad and its softening effects on the nasolabial groove.
Midface aging, marked by ptosis of the malar fat pad and increasing prominence of the nasolabial fold, has necessarily received and increased amount of solutions other than facelifting. Heretofore, the primary procedure used to efface the folds effectively has been the deep-plane facelift.1,2 A resurgence of interesr in a procedure specially to resuspend the malat fat pad has created more options for surgeons.
Percutaneous-suture suspension of the fallen malar fat pad has undergone modifications since its introduction in 1995 by Su.3 Most recently, Keller1described a modification of a technique first presented by Sasaki and Cohen5that strives to circumvent the temporary pucker at the nasolabial stab-incision site created by the pull of the suspension stitch. Keller´s4 modification of this minimally invasive technique makes use of a suture with a single tetrafluoroethylene polymer (polytef) bolster that is maneuvered away from the stab-incision site and seated within the substance of the malar pad itself. The suture that passes trrough this bolster is then threaded cephalab into a small temporal pocket (different from that proposed by Sasaki and Cohen) and secured to the fascia of the temporalis muscle. The technique provide effacement of the nasolabial fold by resuspending the malar fat pad to its posterior and superior location. The permanent suture and bolster used for resuspension provide lasting results.
