Demonstrating Techniques for Pyriform Aperture and Nasolabial Fold Enhancement

Dr. Melanie Palm from Solana Beach, CA, presents techniques for enhancing the pyriform aperture and nasolabial fold in an Asian patient. She addresses mid-facial hypoplasia by utilizing PLLA (polylactic acid) and hyaluronic acid fillers. Starting with the pyriform aperture, she sterilizes the area and employs a 25 gauge needle to deliver PLLA, focusing on the soft tissue beneath the facial artery. This technique aims to support the nasal tip and improves the structural integrity of the nose. Dr. Palm then shifts to the nasolabial fold, where she uses PLLA on the right fold, administering approximately 0.75 CC through a specific entry point. She demonstrates an alternative approach with a hyaluronic acid filler using a 25 gauge cannula, which is designed for patient comfort and involves retrograde injection techniques to create a natural look. The filler is applied more densely at the top of the nasolabial fold and gradually lessens towards the bottom. Dr. Palm also addresses the pre-jowl sulcus to enhance overall facial symmetry. After both techniques, she performs a pinch test to assess the results. Each method reflects her goal of achieving aesthetic harmony while considering patient safety and comfort.