DIRECT FIXATION OF THE MALAR PAD

In most patients, the upper portion of the subcutaneous fatty mass-the malar pad-is modest in size and only moderately displaced inferiorly. Mobilization of the malar pad together with the ovelying skin flap ac hieves a pleasing result in these cases. Occasionally a patient will p resent with very prominent and ptotic malar fat pads and deep nasolabi al folds that cannot be adequately addressed by existing methods. This article describes a technique of malar pad suspension by direct sutur ing that preserves the blood supply to the pad while placing it in a h igher, more aesthetic position.