Better Results in Facial Rejuvenation with Fillers

Abstract

Facial rejuvenation is a rapidly advancing field in aesthetic medicine. Minimally invasive techniques represent a powerful tool for rejuvenation, and fillers are a popular modality with which to restore and optimize facial proportions. Currently, our filler armamentarium is characterized by products with an increasing variety of biochemical compositions warranting tailored injection approaches. An intimate knowledge of anatomy, product characteristics, and appropriate injection techniques is essential to achieve optimal results while maintaining patient safety. Here, we review facial anatomy, structural changes secondary to aging, appropriate filler selection, safe injection techniques, and complications.

Fig. 1.

Age-related transformation of the face with volume loss and tissue deflation, increased skin laxity, and bony resorption. Over time, the changes may accelerate.

Fig. 2.

Schematic representation of the facial vessels with their location and relative depths in target areas for filler placement.

Fig. 3.

Schematic display of commonly used injection techniques in the application of various fillers, including include fanning, linear threading, cross-hatching, layering, and depot injection.

Fig. 4.

Images of a young, female patient displaying a prominent tear trough before injection and at the 7-day follow-up visit.

Fig. 5.

Vectra images of a young, female patient before and after augmentation of a nasal dorsal hump, slight left septal deviation, and drooping of her nasal tip with 1 cm³ of Restylane L. The patient also had 1 cm³ Restylane Lyft to the chin for chin augmentation.

Fig. 6.

Vectra images of a young, female patient before and after augmentation of the both the upper and lower lips with 1 cm³ of Restylane L to the vermillion and 1 cm³ of Restylane Refyne to the mucosal lips. The patient had good relative heights of the lower to upper lip, but additional volume was required to match the proportions of the rest of her face.

Fig. 7.

Vectra images of a young, male patient before and after augmentation of the lateral jawline and chin with 2 cm³ of Juvederm Voluma to mandibular angles and lateral jaw and 1 cm³ Restylane Lyft to chin. The bolus technique was used to improve the facial width.