The aging of the lower third of the face is accompanied by the appearance of such imperfections as a change in the oval of the face, the appearance of nasolabial and labiomental folds, wrinkles in the perioral region, blurring of the lower jaw line and other aesthetic defects. Of course, for a harmonious result, it is often important to work at the level of all three parts of the face, combining different techniques.
This is especially true when it comes to older patients. In this article estet-portal.com Dr. Heather Muir demonstrates a case of successful correction of the line of the lower jaw and china with filler injections in an age patient.
Consultation before injections of fillers in the lower third of the face
A 62-year-old female patient underwent multiple procedures at the author's clinic over the course of eight years: the patient was injected with hyaluronic acid, botulinum toxin, and skin tightening. Although satisfied with the general appearance of the face, the patient complained of blurring of the lower jaw line and the appearance of an orange peel effect on the chin.
The solution of aesthetic problems in the lower third was part of the plan for the correction of the entire face.
The patient has been informed in advance of the risks of bruising, swelling, asymmetry, nodules, and more serious complications. Surgical and thread lifting options have been proposed as an alternative to contouring. However, the patient, due to the less invasiveness and the minimum rehabilitation period, decided to carry out the correction with fillers. Before the procedure, the patient's skin was cleansed of make-up residues with Clinisept Plus.
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Choice of preparations for correction of the line of the lower jaw and chin
For the lower third of the face, in this case, the author used the Restylane Lyft filler, which, due to its high elasticity, provides advantages when working in the back of the lower jaw. This means that a small amount of the drug, administered in a bolus technique, is enough to quickly tighten the tissues and provide their structural support.
To work with the lower third of the face, the author used the Restylane Lyft filler, in the area of the premaxillary sulcus – Restylane Defyne.
The author used Restylane Defyne in the region of the premaxillary sulcus. Based on his own experience, the doctor notes that this drug integrates well into tissues. And this ability is very important in the correction of moving zones. Rather high elasticity and cross-linking of HA make the filler elastic, but more uniform.
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Technique for injecting fillers into the lower third of the face
The first stage of correction – deep injection of boluses (on the bone structure) of 0.5 ml of filler with a needle.
Second stage – injection of the drug with a 25-gauge cannula at two points on the border of the lower jaw. The entry point is located at least 1 cm anterior to the anterior edge of the masseter muscle. During the introduction, the author paid special attention to the facial artery, which passes in front of the masseter muscle. This point was marked to avoid intravascular administration of the drug. The markings were applied when the patient was in a sitting upright position.
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From this, the doctor moved the cannula in the opposite direction along the lower jaw, and then – up to the anterior point of the chin area.
During the introduction, the author paid particular attention to the facial artery, which runs in front of the masseter muscle. This point was marked to avoid intravascular administration of the drug. The markings were applied when the patient was in a sitting upright position.
The author used a cannula to work along the border of the lower jaw, injecting 0.5 ml of the drug in a fan technique towards the premaxillary sulcus on both sides of the face (Restylane Defyne preparation).
The author started the correction with a deep injection of the filler, then injected the drug in a linear technique using a cannula, and then – in the fan technique in the region of the premaxillary sulcus.
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Also, the doctor eliminated the effect of the orange peel on the patient's chin by fan injection of the filler; the drug provided additional support to the structures between the skin and the mentalis muscle. Thus, during muscle activity, when the depressions are most noticeable, the drug smoothes the relief and makes the effect less pronounced.
Results
After the procedure, the patient developed a small hematoma in the region of the premaxillary sulcus, which disappeared spontaneously after a couple of days.
Two weeks after the procedure, the patient was completely satisfied with the results.
Adapted from Aesthetics
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