[Nasolabial suspension of the malar fat pad: a new, minimally invasive and reversible technique for facial symmetrization in permanent facial paralysis].

Abstract

Introduction: For the treatment of asymmetry of the midface due to permanent peripheral facial nerve palsy of different etiologies - which means a great psychical burden for the patients - several surgical solutions have been described. Aim: Our goal was to elaborate a minimally invasive surgical technique, that, on one hand, restores an adequate nasolabial fold, which is the most determinative keystone of facial symmetry. On the other hand, our technique can give an appropriate lift for the malar fat pad with shorter operative time and burden, with much lower complication rate and shorter recovery period compared to the classic static sling suspension techniques. Method: Out method is based on the formation of a neo-nasolabial fold, which is then suspended to the temporal fascia by permanent threads thus restoring facial symmetry and giving a lifting effect on the midfacial soft tissues as well. Results: Between 2014 and 2017, six patients had been operated with this nasolabial lifting technique of the malar fat pad without any major complications under local anesthesia on an outpatient basis at our Department. Conclusions: As our surgical exploration is minimal, the postoperative period is shorter, no visible scars remain on the face and the complication rate is negligible. If necessary, suspension could easily be adjusted, and as the technique is reversible, no other possible facial reconstruction methods are excluded. Our method can symmetrize the face in resting position completely on the long term, which is the most important issue for our patients according to their feedback. Orv Hetil. 2019; 160(22): 869-872.