Abstract:
The preferred methods for facial rejuvenation have been changing over the past decade, with operative procedures on the decline and minimally invasive, office-based procedures on the rise. As a result, it is critical for plastic surgery practitioners to understand the intricacies of the use of neuromodulators and soft tissue fillers in this milieu. While these procedures are usually performed in an office, without general anesthesia, the risk of significant complications still exists. The knowledge of facial anatomy, techniques, and pitfalls is essential for achieving high quality, predictable, and reproducible results. Likewise, when a complication arises, prompt recognition and appropriate treatment is paramount. In this chapter, the history, purpose, technical guidelines, and complications of adjunctive techniques for facial rejuvenation are reviewed in detail. This review contains 2 tables, and 52 references. Keywords: facial rejuvenation, neuromodulator, soft tissue filler, botulinum toxin, dermal filler, aging face, facial rhytids, filler complications, glabellar lines, nasolabial foldKeywords:
Rejuvenation
Facial Rejuvenation
Filler (materials)
Nasolabial fold
Cosmetic Techniques
Facial muscles
Minimally invasive procedures
Cite
The preferred methods for facial rejuvenation have been changing over the past decade, with operative procedures on the decline and minimally invasive, office-based procedures on the rise. As a result, it is critical for plastic surgery practitioners to understand the intricacies of the use of neuromodulators and soft tissue fillers in this milieu. While these procedures are usually performed in an office, without general anesthesia, the risk of significant complications still exists. The knowledge of facial anatomy, techniques, and pitfalls is essential for achieving high quality, predictable, and reproducible results. Likewise, when a complication arises, prompt recognition and appropriate treatment is paramount. In this chapter, the history, purpose, technical guidelines, and complications of adjunctive techniques for facial rejuvenation are reviewed in detail. This review contains 2 tables, and 52 references. Keywords: facial rejuvenation, neuromodulator, soft tissue filler, botulinum toxin, dermal filler, aging face, facial rhytids, filler complications, glabellar lines, nasolabial fold
Rejuvenation
Facial Rejuvenation
Filler (materials)
Nasolabial fold
Cosmetic Techniques
Facial muscles
Minimally invasive procedures
Cite
Citations (0)
Filler (materials)
Facial Rejuvenation
Rejuvenation
Cosmetic Techniques
Cheek
Liposuction
Nasolabial fold
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Citations (2)
This is a comprehensive review of facial fillers including landmark studies and expert commentary spanning the years from 2003 (when the first hyaluronic acid [HA] dermal filler underwent Food and Drug Administration approval in United States) to present.
Rejuvenation
Facial Rejuvenation
Cosmetic Techniques
Filler (materials)
Nasolabial fold
Landmark
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Citations (0)
Filler injections are widely used for facial rejuvenation. The technique is safe as long as some precautions are respected. In this review we will focus on vascular anatomy in the upper, middle and lower face. We performed a PUBMED research on "facial danger zones" and "filler injections" and "hyaluronic acid" and "vascular compromise" with a focus on the last decade. This is of particular importance since vascular compromise is one of the most severe adverse events possibly leading to tissue necrosis and in rare cases to loss of vision. We describe the danger zones in these esthetic units and provide recommendations how to avoid severe adverse events. We report on temporal region, glabella and nose, infraorbital region, nasolabial folds and nasal triangle, lips, and chin. Although we focus on hyaluronic acid fillers, our recommendations will also scope other filler types and autologous adipose tissue transfer. We also take a closer look on innovations to improve the safety of facial filler injections. Facial rejuvenation with hyaluronic acid fillers is a popular method. It is safe if the facial danger zones are recognized and proper injection techniques and fillers are used.
Glabella
Facial Rejuvenation
Filler (materials)
Nasolabial fold
Cosmetic Techniques
Cite
Citations (50)
Filler (materials)
Facial Rejuvenation
Acne scars
Cosmetic Techniques
Polymethyl methacrylate
Nasolabial fold
Biocompatible material
Rejuvenation
Insert (composites)
Cite
Citations (37)
Treatment aimed at preventing and reversing the facial aging process has grown in popularity. The aging midface is defined by classic deepening of the nasolabial folds, formation of marionette lines around the mouth, and significant atrophy of deep facial fat. While surgical options have been investigated with satisfactory and long-lasting results, nonsurgical alternatives such as soft tissue fillers are a safe and effective strategy for facial rejuvenation. This review focuses on a variety of injectable fillers available for the treatment of the aging midface, including hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, and polymethyl methacrylate. Mechanism of action, relevant anatomy, indications/contraindications, technique, and any evidence of efficacy and safety are described. The benefits of injectable fillers include reduced patient discomfort and shorter recovery times. Understanding the advantages and limitations of injectable fillers for midface augmentation can allow providers to counsel and treat patients seeking care appropriately.
Facial Rejuvenation
Rejuvenation
Cosmetic Techniques
Nasolabial fold
Filler (materials)
Polymethyl methacrylate
Cite
Citations (1)
Nonsurgical procedures have become very popular for the rejuvenation of the aging face. Trends now are for less invasive procedures as well as for more preventative intervention to slow the damage from ultraviolet light and environmental factors, as well as from intrinsic aging. The goal of these procedures is to eliminate or delay the need for corrective surgery. The regular use of sunscreens; retinoids and improved cosmeceuticals; injectable neurotoxins; soft-tissue augmentation products; and minimally invasive laser, light, and radiofrequency treatments are decreasing and delaying need for invasive procedures. Injectable fillers entered mainstream cosmetic medicine with the development of bovine collagen injections in the 1980s. The availability of improved fillers that are less allergenic and longer lasting has resulted in a renaissance in filler techniques. No single filler has proven to be more popular than the category of hyaluronic acids (HA). This article will review the use of the hyaluronic acid fillers that are currently approved for use by the Federal Drug Administration in the United States and describe the significant differences between them to assist the practicing cosmetic physician in choosing and using this category of dermal filler.
Rejuvenation
Facial Rejuvenation
Filler (materials)
Cosmetic Techniques
Nasolabial fold
Cosmeceuticals
Minimally invasive procedures
Skin Aging
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Citations (168)
Purpose of review Current cosmetic surgical practice for facial rejuvenation has undergone a significant change due to the introduction of technologies to improve the age-associated changes of the face. The most widely adopted methods of minimally invasive facial rejuvenation include the use of neuromuscular blocking agents and injectable fillers. The topic of minimally invasive procedures might include a variety of subjects including nutritional and hormonal modulation, light-based and laser-based therapies, minimal incision surgical procedures, as well as the use of botulinum toxin and fillers. The focus of this study will be on the minimally invasive facial rejuvenation efforts achieved by injection techniques. Recent findings Botulinum A neurotoxin has been shown to be effective in the reduction of hyperfunctional lines in the upper and lower face. Anatomic areas that have been found to benefit include the glabella, the forehead, the periorbital area, lips, and the platysma muscle. The more recently introduced hyaluronic acid and other injectable fillers are receiving increasing usage. These temporary fillers have been found to improve creases and wrinkles, augment deep nasolabial folds, augment thin lips, and improve hollowing in the periorbital and other depressions and deformities. Summary There has been a significant paradigm shift in the field of rejuvenation surgery. Injectable minimally invasive methods have been offered to remedy age-related and other acquired deformities of the head and neck region. These methods have provided temporary correction of undesirable characteristic that were traditionally approached with more invasive surgically oriented modalities.
Glabella
Facial Rejuvenation
Rejuvenation
Minimally invasive procedures
Nasolabial fold
Invasive surgery
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Citations (34)
There are multiple surgical and non-surgical ways to treat the nasolabial fold. Traditionally, the non-surgical way of treating nasolabial folds was through careful placement of hyaluronic acid fillers directly to the fold. Our understanding of the facial ageing process and facial anatomy has enabled us to evolve our technique so that nasolabial fold treatments are safer for patients and deliver better clinical outcomes. By treating nasolabial folds indirectly, by addressing the changes that occur through aging, the aesthetic practitioner can achieve more natural and effective reduction in the fold. Indirect treatment of the nasolabial fold requires addressing the bony resorption, deep fat and superficial fat volume loss. Through better understanding of the facial aging process, we are entering an era where more practitioners are treating the cause of a particular line than treating it directly. This has the benefit of creating a more balanced and natural result with longer lasting rejuvenation.
Nasolabial fold
Facial Rejuvenation
Cosmetic Techniques
Rejuvenation
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Citations (0)
Rejuvenation
Nasolabial fold
Facial Rejuvenation
Cosmetic Techniques
Cite
Citations (14)