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Updated: Jun 12, 2026

In Vitro Investigation of the Effects of the Hyaluronan-Rich Extracellular Matrix on Neural Crest Cell Migration
Published on: February 10, 2023
Localization and histological characterization of injected hyaluronic acid in excised nasolabial fold tissue
Timothy M Greco1, Rosalie Elenitsas
1Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. timg@drgrecoface.com
Objective:
To describe a technique for surgical correction of a prominent nasolabial fold (NLF) and use of the excised fold to assess the histology and localization of injected hyaluronic acid (HA) fillers.
Methods:
Surgical correction was achieved by direct excision of the NLF, followed by advancement of the nasolabial fat compartment into the nasolabial crease. Excised tissue samples were injected with HA fillers (Restylane, Perlane, or layered Restylane/ Perlane), sectioned, and treated with histological stains.
Results:
Surgical correction of NLF resulted in highly satisfactory results. HA localized primarily in the lower reticular dermis and subcutis of the excised NLF. Localization appeared similar regardless of the HA product employed.
Conclusion:
Direct excision of the NLF with advancement of the nasolabial fat compartment is a successful treatment for patients with deep NLF. HA injected into the excised tissue localized near the site of injection, emphasizing the importance of proper placement of HA fillers during soft tissue augmentation.
