Abstract: New Insights for Botulinum Neuromodulator Targets for Correction of the Nasolabial Fold and Midface Rhytids: An Anatomic Study and Introduction of the Malar Levator Muscle

Methods: Fat is harvested using disposable Caraway harvest cannula; processed with a bi-laminar filtration system and injected with disposable 18 gauge cannula. Intravenous clindamycin is given 1 hour before surgery and the intraoral mucosa at the site of injection is re-prepped with betadine. The upper lip is retracted and approximately 1–1.5 cm above and medial to the Stensen’s duct, the injection cannula is threaded carefully through the mucosa and guided by palpation/ultrasound into the buccal fat pad. The cannula is then moved radially and clockwise from 12:00 to 6:00 and counterclockwise from 12:00 to 6:00 filling the buccal space with 2–5 ml of fat, depending on physical findings.