What it means for a patient
- Fillers placed beneath the skin can lift the brow and cheek and fill areas around the mouth and jawline, with an immediate result.
- Biodegradable fillers wear off, so a patient can try a change first or repeat treatment over time.
- Permanent (nonbiodegradable) fillers are an option some people choose for a longer-lasting effect.
- The comparison with the "pulled" look of overcorrected surgery is the authors' view. The abstract reports no measured comparison.
- This is a technique article. It reports no patient data.
Why this paper matters
It described subdermal filler placement at specific facial sites as a nonsurgical method of facial sculpting. It named the subdermal injection plane as the key change in technique.
Overview
Deep facial sculpting was once done only with surgery. Newer dermal and subdermal fillers, and wider recognition that filling a volume-depleted face improves its appearance, have expanded the uses of soft tissue fillers. The authors describe the facial sites where subdermal support restores contour, and the change from intradermal to subdermal injection. The abstract reports no patient numbers.
Findings
- Sites for subdermal support: the lateral two-thirds of the brow, the nasojugal fold, and the malar and buccal fat pads.
- Further sites: the corners of the mouth and the area around the mouth, including the pre-jowl sulcus.
- Support at these sites restores youthful facial contour and harmony.
- Injection in the subdermal plane in place of the intradermal plane is described as an important advance in technique.
- Fillers can give an immediate brow lift, cheek lift, lip expansion and perioral augmentation.
- The authors describe the result as softer and more relaxed than the "pulled" look of some surgical overcorrections.
- Treatment can be combined with botulinum toxin and other procedures.
- Biodegradable but longer-lasting fillers allow a "rehearsal" treatment or ongoing treatment.
- Some people, such as those with HIV-related lipoatrophy or those who want a longer-lasting effect, may choose a nonbiodegradable filler.
Terms
- Dermal filler: a gel or other material injected to add volume.
- Subdermal: beneath the skin.
- Intradermal: within the skin.
- Nasojugal fold: the groove that runs down and out from the inner corner of the eye.
- Buccal fat pad: a pad of fat in the cheek.
- Lip commissures: the corners of the mouth.
- Pre-jowl sulcus: the hollow in front of the jowl along the jawline.
- Lipoatrophy: loss of fat beneath the skin.
- Biodegradable: broken down by the body over time.