Clinical Study
Evaluation of Subcision for the Correction of
the Prominent Nasolabial Folds
R. M. Robati,
1
F. Abdollahimajd,
1
and A. M. Robati
2
1
Skin Research Center, Shahid Beheshti University of Medical Sciences, Shohada-e Tajrish Hospital, Shahrdari Sreet,
Tehran 1989934148, Iran
2
Department of Surgery, Bam University of Medical Sciences, Bam, Iran
Correspondence should be addressed to R. M. Robati; rezarobati@sbmu.ac.ir
Received 28 July 2015; Revised 1 December 2015; Accepted 3 December 2015
Academic Editor: Iris Zalaudek
Copyright © 2015 R. M. Robati et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background. A prominent nasolabial fold (NLF) is a cosmetic problem. Currently, numerous therapeutic modalities are available
for pronounced NLFs with variable efcacy. Objective. To determine the efcacy and safety of subcision using a hypodermic needle
for the correction of the prominent NLFs and its efect on skin elasticity. Methods. Sixteen patients with prominent NLFs underwent
subcision. Te investigators’ assessment of improvement and the patients’ satisfaction were both recorded 1 and 6 months afer the
procedure. Also, we evaluate the skin elasticity of NLFs before and afer the treatment using a sensitive biometrologic device with the
measurement of cutaneous resonance running time (CRRT). Results. Tirteen (81.25%) patients showed a moderate improvement
at 1st month and 13 (81.25%) patients had at least a mild improvement at 6th month. Tere was no persistent side efect lasting more
than a few days. Mean CRRT at 1 and 6 months afer the treatment was signifcantly higher compared to the baseline. Conclusion.
Subcision may be considered efective for the correction of pronounced NLFs. However, further controlled studies with larger
sample size are necessary to assess the efcacy of this technique in particular with use of more objective assessment of skin biometric
characteristics. Tis trial is registered with IRCT201108097270N1 (registered on January 27, 2012).
1. Introduction
Te nasolabial fold (NLF) is a unique boundary between
the cheek, mouth, and chin [1, 2]. Its shape can be concave,
convex, or straight. It is generally imperceptible in children,
in part, due to their skin elasticity [1]. Te NLF ofen becomes
apparent around the age of 25 years and then becomes
more obvious with aging as a combination of thinning
and relaxation of the skin [3, 4]; also other factors can be
efective on this process such as ultraviolet radiation [1]. A
prominent nasolabial crease is a cosmetic problem. Currently,
numerous therapeutic options such as synthetic dermal fllers
[1], fat grafs [4], Nd:YAG laser [5], radiofrequency device [6],
direct excision or rhytidectomy [7, 8], and intense focused
ultrasound [9] are available for improvement of a pronounced
NLF with variable outcomes.
Subcision or subcutaneous incisionless surgery was frst
described by D. S. Orentreich and N. Orentreich in 1995. It is
a surgical modality for the treatment of wrinkles and
depressed scars with a tribeveled hypodermic needle inserted
under the depressed area [10]. Te releasing action of this pro-
cedure separates the fbrotic attachment. Moreover, the con-
nective tissue forms during the wound-healing process, so the
depression is raised [11]. Subsequently, several reports intro-
duced that subcision with various types of needles or blades is
efective for wrinkles, depressed scars, and prominent NLFs,
as well as for acne scars [12–16]. Te NLF is ofen a function of
dermal atrophy. Terefore, subcision may be a useful option
for the treatment of NLF not only due to its releasing action
but also due to its induction of connective tissue formation.
In general, few studies have assessed the efcacy and
safety of subcision in the treatment of prominent NLFs. In
this study, we assess the efcacy and safety of subcision for
the correction of pronounced NLFs. Also, we quantitatively
evaluate the efcacy of this technique on skin elasticity using
a sensitive biometrologic device (Reviscometer RVM 600)
Hindawi Publishing Corporation
Dermatology Research and Practice
Volume 2015, Article ID 976153, 7 pages
http://dx.doi.org/10.1155/2015/976153