Filler injections are increasingly being used not only to rejuvenate older patients, but also to beautify young patients. To make the cheekbones more expressive, to correct the aesthetic defects of the nose, to perform a slight volumization – these and other tasks contour plastics of the middle third of the face are posed by patients to cosmetologists by modern patients. Particular attention in their decision should be given to the correct choice of the drug. In this estet-portal.com article, Drs. Raul Cetto, Beatriz Molina, Sofie Shotter and Charlotte Woodward share their selection criteria for midface fillers in young patients.
Choice of filler for mid-face contouring
Contouring the middle third usually requires several different fillers, depending on the individual characteristics of the patient's face from the target areas.
Dr. Chetto reminds clinicians that injecting a high G’ deep volumizing product into superficial fat pads will result in a so-called hamster cheek effect as the drug will not integrate into the tissues and follow their movements.
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When working with fillers in the middle third, Dr. Chetto prefers to use a layered approach which allows for more efficient use of the product. The doctor uses a deep volumizer Ultra Deep, and then – Surface volumizer RHA for beautification and contouring. In older patients, more attention should be paid to deep fat pads, which begin to atrophy.
Middle third contouring usually requires several different fillers, depending on the individual characteristics of the patient's face from the target areas.
Dr. Molina also notes that good tissue integration is essential for sculpting and contouring. When the specialist works with young patients with no evidence of deep midface atrophy, she injects the product into the subcutaneous layer using a cannula. This allows you to make the cheeks and cheekbones more expressive. For this purpose, the doctor uses the Aliaxin EV filler (previously the author performed the correction with the Restylane Defyne product), which allows you to create attractive and natural contours.
Filler selection for upper third facial correction in young patients
Before and after correction of the zygomatic area with a filler Aliaxin SV (1 ml on each side)
If the patient needs a little volumization and tissue support, the doctor will inject a high G’ (such as Aliaxin SV) with a needle into a deep plane, and then – product with lower G’ with a cannula into the superficial plane for contouring purposes. Aliaxin SV – a new product that, according to the doctor, does an excellent job of contouring the cheekbones, lines of the lower jaw and chin. This is facilitated by the high lifting ability and softness of the drug.
Woodward uses Perfecta Subskin, Ultra Deep or Ellansé fillers for patients with a flat mid-face. The specialist injects these drugs with a needle deep into the bone in the area of the zygomatic groove and the triangle of the wings of the nose. When performing the procedure with the Ellansé filler, it is important to always slightly undercorrect the area, because, unlike HA preparations, this filler immediately after injection provides only 85% of the result, which will gradually increase over three months.
Effective approaches to volume restoration in the middle third of the face
In addition to deep filler injections, Dr. Woodward also occasionally injects RHA 4 superficially.
Dr. Shotter believes that Juvéderm Voluma can make the zygomatic area more attractive when injected deep. With the help of this drug, you can get the effect of contouring without makeup, which is what many patients need today. For superficial fat patients, Dr. Shotter chooses Juvéderm Volift.
Nose Contouring Filler
When performing nose contouring, as noted by Drs. Shotter and Chetto, it is important to understand that there is no special filler for the correction of this area – they are all entered off-label.
Since the base of the nose is hard tissue, the doctor prefers to use a product with similar characteristics, which is Teosyal Ultra Deep. The filler can be injected in small amounts to create a good lift. If the defect is more pronounced, the specialist prefers to use a short cannula for insertion, however, he corrects small imperfections with a needle.
Gender features of facial contouring: important aspects
Dr. Molina uses a cannula exclusively for nose correction for safety reasons (in order to reduce the risk of vascular damage). Molina chooses the product individually for each patient. If the ultimate goal – increased projection, a product with a high G’ and good lifting ability.
Dr. Molina uses a cannula exclusively for nose correction for safety reasons (in order to reduce the risk of vascular damage).
The doctor uses NASHA technology fillers that do not integrate into tissues and create a projection. In this case, the drug of choice is Restylane Lyft. However, for patients with thin skin, Dr. Molina does not inject such a product, since in this case the filler will be noticeable. If you need to change the shape and integrate the filler into the tissues, the doctor chooses Aliaxin EV. For minor correction – Aliaxin FL and Restylane Refyne.
Adapted from Aesthetics.
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