Rules for safe facial correction in the middle third

The middle third of the face is the main area of ​​aesthetic correction, since working with age-related changes in this area allows you to achieve the most pronounced results. However, do not forget about the safety rules that allow you to avoid unwanted complications.

To do this, the doctor should pay special attention to the anatomical features of this zone. The secrets of safe and effective correction of the middle third of the face, as well as the main technical nuances of working in this area with the readers of estet-portal.com were shared by a specialist in the field of plastic, aesthetic and reconstructive surgery, Dr. Patrick Trevidik.

Facial correction: anatomical features of the middle third

The middle third of the face is bounded above by the commissure of the eyes and below by the commissure of the mouth. In this area passes the facial artery - the largest vessel of the face.

In 30% of cases, the facial artery passes in the medial buccal sulcus, in 70% - in the nasolabial sulcus.

In the middle third of the face are fat compartments:

•    deep fat pack;

•    nasolabial fat compartment located between the buccal fold and nasolabial sulcus;

•    medial fat pad;

•    mid buccal compartment;

•    infraorbital fat pack — it is its omission that gives the age-related appearance of the periorbital zone.

The orbicular muscle of the eye is the boundary between the superficial and deep fat packages, which include the medial and lateral suborbicular compartment and the deep cheek compartment.

Read also: Protocol for correction of the temporal region using the Gun shot technique

Mechanisms of age-related changes in the middle third of the face

With age, some fat packages atrophy, while others hypertrophy: the nasolabial increases, while all the others decrease in volume and shift down. This causes the characteristic "age" kind of face.

Over the years, resorption of the bones of the orbit in the medial and lateral direction occurs, and the skin also becomes thinner.

Thus, during the aesthetic correction of the middle third of the face in young patients, emphasis should be placed on deep fat packages, while in older patients, more attention should be paid to superficial ones.

Perfect facial outline: how to properly correct cheekbones

Technical features of face correction in the middle third

I.    Markup

Markup – this is the most important part of the correction of the middle third of the face. It allows you to determine the location of the fat compartments, as well as select the injection point.

•    first line — this is the vertical line of the face — border between the medal and lateral superficial fat pads that connects the edge of the eyebrow and the edge of the eye;

•    second line — this is the mid-buccal sulcus;

•    the third zygomatic line connects the commissure of the lip with the lowest protrusion of the zygomatic bone.

The injection point should be located on the zygomatic bone, lateral to the lateral fat pad.

II.    Choice of drug

In the middle third of the face, I work deeply with Teosyal Ultra Deep or Teosyal RHA 4, which are presented by "Academy of Scientific Beauty", because these fillers allow you to achieve a more lasting result.

III.    Correction Method

I fill three fat packs with a 25G cannula. With my fingers, I lift the tissues up, then insert the needle, bring it to the bone and medial fat pad. Then I slowly inject 0.2 ml of Teosyal Ultra Deep, provided by "Academy of Scientific Beauty", after which I move the needle and inject 0.2 ml of the filler already into the lateral fat compartment, and deep buccal fat pad.

The advantage of this – one entry point, which allows you to reduce pain. For younger patients it is better to use Teosyal RHA 4 as this dermal filler is better distributed. However, even when I use it, I end up with a very intense massage.

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