Facelift for laugh lines, or medically referred to as nasolabial folds, requires going deeper than the skin to achieve natural results that can last for many years. It is important to note that relying on skin alone will lead to a short-lived outcome due to the relative weakness of this layer.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says that a youthful face has its malar fat pad attached to the cheekbone high, giving it a relatively plump look.
The high cheekbone appearance gives younger faces an inverted triangle shape, which aging gradually reverses, he adds.
Aging causes the facial skin and supportive structures to lose their strength, which in turn also causes the malar fat pad to descent. Dr. Smiley says this contributes to the nasolabial folds, which run from the corner of the nostril down to the mouth.
Facial volume loss can further aggravate the appearance of nasolabial folds, making the patient appear perennially tired or even angry. On top of that, repeated smiling (and other facial expressions) deepens this fold throughout life, he adds.
Facelift for laugh lines warrants elevating the SMAS, a layer overlying the muscle. With this facelift technique, the celebrity plastic surgeon says the skin, malar fat pad, and tissue are raised all at the same time, leading to more natural, longer-lasting results.
Moreover, the SMAS facelift technique allows the surgeon to eliminate most of the tension on the skin, further contributing to favorable scars and better wound healing.
The sagging cheek fat pad that contributes to the laugh lines is pulled upward so it will lie over the cheekbone. To further smooth out these “folds,” Dr. Smiley says that some patients require a simultaneous fat injection in which the goal is to replace lost facial volume.
Fat injection for the correction of laugh lines can serve as a stand-alone procedure in patients whose mid face has not yet sagged to a significant degree. Another option is dermal fillers (e.g., Perlane, Radiesse, Restylane, and Juvederm) whose effects last an average of 4-6 months and so they require regular touch-ups.
The results of fat injection, meanwhile, can last 12-15 years, says Dr. Smiley.
While the upfront cost of fat injection is higher than most dermal fillers, in the long run it is less expensive because it does not require touch-ups.