Li Qin, Cui Haiyan, Tseng Fang-Wen, Liu Qingyang, Xue Zhiqiang, van Loghem Jani, Hung Kai-Chih, Zhou Lijun, Xie Wen, Zhao Jingjing
From the AIST Medical Aesthetic Group, Chengdu, Sichuan, China.
Tongji Hospital, Tongji University, Shanghai, China.
Plast Reconstr Surg Glob Open. 2025 May 27;13(5):e6792. doi: 10.1097/GOX.0000000000006792. eCollection 2025 May.
Causes contributing to nasolabial fold (NLF) appearance can be multifactorial, hence requiring distinct dermal filler strategies. We devised 4 assessment, strategy, and treatment (AST) injection protocols, incorporating NLF etiology and severity, patient expectations, and the selection of Belotero Balance Lidocaine (BBL) and Belotero Volume Lidocaine (BVL) hyaluronic acid fillers.
The underlying etiology and photonumeric assessments of NLF severity guided protocol selection. In protocol 1, the NLF was injected directly with BBL into the mid-to-deep dermis and/or immediate subdermal plane. In protocol 2, BVL was injected using dual-plane sandwich technique into the canine fossa and subcutaneous layers. Protocol 3 combined indirect injections of BVL into the deep medial cheek fat compartment and preauricular hollows to lift ptotic soft tissue, followed by direct NLF injections with protocols 1 and 2. In protocol 4, BVL was injected into the temple and/or jawline, in combination with midface augmentation (AST protocol 3) and direct NLF injections (AST protocols 1 and 2) to fully address all underlying etiologies contributing to NLF appearance.
AST protocols facilitate treatment customization to each patient's NLF etiology and severity through direct and indirect approaches. At 30 days, NLF severity improved visibly and satisfactorily. Improvements varied from effacement of superficial nasolabial wrinkles to shallower NLF depth, improvement in cheek projection and nasojugal groove appearance, and smoother submalar contours.
The AST protocols provide a strategic reference for combining BBL and BVL in a personalized patient-centric approach for effective, holistic, and balanced NLF corrections and pan-facial aesthetic improvements.
导致鼻唇沟（NLF）出现的原因可能是多因素的，因此需要不同的真皮填充策略。我们设计了4种评估、策略和治疗（AST）注射方案，综合考虑了NLF的病因和严重程度、患者期望以及贝洛特罗平衡利多卡因（BBL）和贝洛特罗容积利多卡因（BVL）透明质酸填充剂的选择。
NLF严重程度的潜在病因和数字化评估指导方案选择。在方案1中，将BBL直接注射到鼻唇沟的中深层真皮和/或紧邻的皮下平面。在方案2中，采用双平面三明治技术将BVL注射到犬齿窝和皮下层。方案3先将BVL间接注射到内侧脸颊深部脂肪隔和耳前凹陷以提升下垂的软组织，然后按照方案1和2直接注射到鼻唇沟。在方案4中，将BVL注射到颞部和/或下颌缘，结合中面部填充（AST方案3）和鼻唇沟直接注射（AST方案1和2），以全面解决导致鼻唇沟出现的所有潜在病因。
AST方案通过直接和间接方法促进针对每位患者的鼻唇沟病因和严重程度进行治疗定制。在30天时，鼻唇沟严重程度有明显且令人满意的改善。改善情况包括表浅鼻唇皱纹消失、鼻唇沟深度变浅、脸颊突出度和鼻颧沟外观改善以及颧下轮廓更平滑。
AST方案为以患者为中心的个性化方法中联合使用BBL和BVL提供了战略参考，以实现有效、全面和平衡的鼻唇沟矫正及全脸美学改善。
