Improving the acute nasolabial angle and medial nasolabial fold by levator alae muscle resection

An acute nasolabial angle and a prominent nasolabial fold are two features that are often associated in the aging face. A new technique is presented that simultaneously addresses both of these features. Levator alae (levator labii superioris alaeque nasi) muscle resection, performed through a subciliary incision, improves the acute nasolabial angle without concomitant rhinoplasty. At the same time, levator alae muscle resection softens the medial nasolabial fold. Partial levator labii superioris muscle resection has occasionally been added to further weaken the middle nasolabial fold. Fresh cadaver dissections were performed to define the anatomy and to plan the surgical approach. This report describes a series of 10 patients who underwent this procedure, with improvement of the acute nasolabial angle and softening of the medial nasolabial fold.