Surgical Procedures of the Correction of Severe Static Glabellar Lines by Utilizing Resection with Free Dermal Fat Grafting (FDFG).

[BACKGROUND] Botulinum toxin alone is unable to sufficiently reduce the muscle in cases of severe static glabellar lines due to the folded skin and dermal breakdown that frequently accompany these conditions. Augmentation of the soft tissue and removal of folded skin at the same time is the final solution. To simultaneously resolve interbrow skin laxity and replenish tissue volume, we present for the first time the method of glabellar lines excision combined with FDFG.

[METHODS] This retrospective study involved 23 patients with moderate-to-severe static glabellar lines underwent resection and/or free dermal fat grafting (FDFG) from June 2022 to June 2023. Fifteen of them underwent glabellar lines excision combined with FDFG, and seven were filled only. These patients were followed up at least 6 months to evaluate the effect. We utilized FACE-Q and WSRS for assessment in order to investigate the clinical results.

[RESULTS] There is no complication such as discoloration, hematoma, infection and palpability in all cases. After 6-15 months of follow-up, all the patients' dynamic and static lines were improved to a certain degree, and the patients were satisfied with the results with the WSRS score decreased from 3.5 ± 0.47 to 1.8 ± 0.62, and FACE-Q assessments in "Line between the eyebrows" decreased from 87 ± 7.39 to 43 ± 10.3.

[CONCLUSIONS] Resection in conjunction with FDFG is a brief, innovative and effective technique to correct static and dynamic severe glabellar wrinkles and maintain an acceptable outcome over an extended period of time which worthy clinical promotion.

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