In the twenty-first century, technology rules the world, and aesthetic medicine is no exception. The constant development of technology for the production of fillers based on hyaluronic acid and the study of aging processes have given a new understanding and approach to correcting the age and shape of the face. Every year our client becomes more and more demanding on his appearance, constantly raising the quality bar for a doctor. Therefore, BEAUTY customization has become a key method in working on the client's face. More about the method, its stages and the preparations used – for readers of estet-portal.com Andrey Vaganov-Dashkov, anti-age therapy doctor, dermatovenereologist, certified specialist in injection techniques, scientific director of the Laskos training center.
The first stage of BEAUTY customization: choosing the perfect filler
The term "customization" came from digital technologies and means personalization of the approach (customization — adaptation of a mass product to the needs of a particular consumer). In our understanding of BEAUTY customization – this is the choice of the drug, as well as the method and place of injection of the filler, which makes it possible to preserve the client's charisma to the maximum (the concept of "charisma" originates from ancient Greek mythology — means «to attract attention»).
To create the perfect correction, we need the right high-tech filler to make the correction as comfortable as possible for the client.
This is especially important for lip correction, where the procedure is most painful. Therefore, when choosing a drug, you need to focus on fillers, which include lidocaine, which allows you to minimize the pain of the client.
The second factor in choosing the optimal filler is the technology for converting hyaluronic acid into a gel. Such a technology could be HMD™ technology (Highly Micronized density™) Monophasic HA. The technology is based not only on highly stabilized hyaluronic acid BDDE, but also on a high degree of purification of the preparation from BDDE, followed by micronization of molecules into separate globules and re-binding of BDDE, which led to a high degree of stabilization of the preparation from 15 to 30%, depending on the concentration of hyaluronic acid in preparation.
The third important aspect is the ability to choose the concentration of hyaluronic acid, which makes it possible to inject the filler into various layers of the soft tissues of the face. For example, Ialugen® Esteem.
Second stage of BEAUTY customization: evaluation of the correction zones of the patient's face
The second stage of BEAUTY customization is the correct understanding of the areas of correction of the client's face, which will lead not only to rejuvenation, but also to an aesthetic improvement in the perception of the face. Therefore, the first step to understanding the correctness of correction zones is to analyze the face. The analysis according to Besins T is considered the most correct scheme. This scheme allows you to evaluate the face in dynamics, identifying the most correct injection points.
Using the S1 zone as an example, let's consider the choice of drug, administration technique and correction goals.
In the S1 zone, we analyze the harmony of the client's profile, age-related changes, correction and modeling of the shape of the lips. The analysis starts from the bottom up, as it is driven by the laws of aging of the facial part of the skull, discussed in detail by the plastic surgeon Bryan Mendelson and Chin-Ho-Wong in the article "Changes in the Facial Skeleton with Age: Implications and Clinical Developments in Facial Rejuvenation".
First step: consider chin correction, what will we correct here:
• harmonization of altitude parameters of the middle and lower thirds;
• b-correction of the second class of occlusion (distal occlusion);
• c-gender harmonization;
• d- correction of age-related changes.
To correct this area, we choose the most dense filler 24mg / ml, the technique of setting the needle – periosteal bolus. For example, such a filler may be IALUGEN®; ESTEEM VOLUME by "Laskos".
Second stage – This is a lip test. It should be noted here: fashion has a great influence on the tasks of correction, dictating the shape and size of the lips. It is precisely these parameters that are key when choosing a drug, since the degree of volumizing effect will be a key factor. Today, two main trends are observed - an imperceptible correction of age-related changes and the creation of fashionable forms - hyper-volume lips, "Flower lips". We also take into account that when correcting the lips, we do not violate the aesthetic line of Ricketts.
For the correction of purse-string wrinkles, a preparation with a concentration of hyaluronic acid 12mg/ml-IALUGEN® is ideal; ESTEEM SOFT. To restore lip volumes lost with age, we will choose the drug 16mg/ml IALUGEN®; ESTEEM GLOBAL (read about fashion trends in the next article). The injection technique can be linear-retrograde, you can use the blanching method, microbolus, bolus techniques.
Third Stage – This is a nose job. One of the most interesting corrections, as it allows you to adjust the profile of the face as discreetly as possible, while such a correction requires a minimum amount of preparation. The nose consists of three corners:
• root of nose corresponds to 150*,
• bridge of nose 180*,
• nose root 110* – in women and 90* – in men.
It is also worth noting that women have slightly more snub noses and more open nostrils than men. Therefore, the correction of the columela of the nose leads to a pronounced aesthetic harmony.
This area is the most dangerous for needle correction, as it is saturated with multiple vessels, and an error can lead to ischemia and soft tissue necrosis. In this area, it will be appropriate to inject the drug with a cannula. For this zone, it is good to use preparations of moderate density such as IALUGEN®; ESTEEM INTENSE with a density of 20mg/ml.
The final stage of correction – forehead roundness. The gender feature of European women is a rounded profile. With age, the frontal tubercles move forward, which leads to the lowering of the soft tissues of the upper third of the face and the formation of a sullen look.
As with nose correction, you need to be extremely careful due to the many vessels located in this area. It is necessary to inject the drug under the frontal muscle of the forehead, since the zone is very mobile. If the drug is placed superficially, this can lead to its migration to other areas and unaesthetic correction. Therefore, this area should be treated with neurotoxin type A before the filler is injected into this area. The choice of drugs should be made in favor of a medium density, such as IALUGEN®; ESTEEM GLOBAL 16mg/ml.
We also analyze and correct the S2 and S3 zones, taking into account their anatomical and physiological features and aging features of each zone, as well as the aesthetic laws of plastic and anthropometric anatomy.
The next thing to look out for is the – wrinkles and folds. Age markers are formed due to the unique structure of facial muscles. Unlike skeletal, they have only one point of attachment to the bone, and the other in the skin of the face. Thus, we can express various emotions on the face, but the same feature leads to the formation of wrinkles and folds.
A study in 2015 showed that the deformation of the skin flap occurs with our every slightest movement, which gives a new look at age correction and new age limits.
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