"Double duck" nasolabial lifting

BACKGROUND: During aging, the vermilion border of the upper lip wrinkles, stretches, and inverts because of the sphincteric action of the orbicularis oris muscle. Furthermore, a decrease of the nasolabial angle can be observed because of maxillary retropositioning. Most techniques for lip shortening do not affect this angle. In this study, a treatment approach is proposed that addresses all of these signs of aging. METHODS: During a 1-year period, a procedure was performed on 10 patients using the following techniques: 1. transverse incision of the skin of the nasal floor and bilateral alar margin; 2. cutaneous detachment of the entire upper lip up to the mucocutaneous transition; 3. stabilization of the nostrils with a transcolumellar nylon stitch; 4. elevation of the released skin by elliptical skin resection at the alar margin and a trapezoid segment resection at the nasal floor; 5. use of nylon and absorbable sutures to approach the dermis and close the skin, respectively. RESULTS: Adequate results were observed in 9 of the 10 patients, characterized by shortening and projection of the upper lip, vermilion eversion, reduced incidence of rhagades, and improvements of the nasolabial angle. In 1 patient with unilateral paralysis of the lip, no significant correction of the asymmetry was achieved. CONCLUSIONS: The proposed "double duck" technique proved to be simple and effective, with successful resolution of nasolabial defects and effective concealment of scars