The Teosyal expert day conference, which brought together over 400 of the best dermatologists and plastic surgeons from around the world, has become a highlight in the world of aesthetic medicine. The leading importance at this conference was given to the anatomical and physiological features of the dynamic areas of the face and the features of the use of RHA fillers to achieve the most natural and aesthetically beautiful result.
And the report of Wayna CAREY, Professor of McGill University (Canada), founder of the Canadian Society of Dermatological Surgery, became an invaluable gift for the conference participants. As part of the conference, Elena Stoyanova managed to interview Wayna CAREY for estet-portal.com.
What is written on the forehead: a flat forehead indicates age, a voluminous — for youth
— What is the secret of your successful work with patients?
Wayna CAREY: The main and main rule of — properly and carefully consult. It often happens that the doctor does not pay enough attention when taking an anamnesis, and this — big mistake. Moreover, a person always pays attention only to those wrinkles that he sees when looking in the mirror, in a static position. And this is wrong: the face must be regarded in all projections.
In the course of the consultation, I give great importance to palpation of the face. It is necessary not only to understand the direction of the facial lifting vectors, but also to take into account the proportions, the dynamic mobility of the skin and muscles, the state of fat pads and individual facial expressions.
— Patients who come for a consultation with a cosmetologist want to look younger and more beautiful. Are there any criteria for the youthfulness of the face, which should be paid special attention to?
Wayna CAREY: To answer this question, we need to remember the three main indicators of youth.
Youth Index #1. Forehead. If you look at photographs of the same person 20 years apart, you can't see the difference between them right away: the facial features remain the same, but the chiaroscuro changes. These inconspicuous details give away a person's age.
In our practice, we have successfully used botulinum toxin, and this gives amazing results. We know how to administer it correctly and safely. But we do not always take into account the consequences of this therapy.
The results of many studies I have conducted have shown that with prolonged use of botulinum toxin, there is a slight atrophy of the muscle fibers and a serious atrophy of the subcutaneous fat layer. That is, the forehead becomes more even, but at the same time — flat.
Flat forehead — sign of aging. If you restore the volume of the forehead with hyaluronic acid, you will thereby significantly improve the aesthetic image of the patient.
Filtrum — small architectural detail of the face
Youth Index #2. Filtrum. Did you know that all mammals have a filtrum, except chimpanzees? In aging people, the filtrum also disappears with age. If we look at photographs of an elderly woman in dynamics, we will see how her filterum changes: in youth it will be pronounced, but with age it smoothes out and completely disappears in old age.
Filtrum — a small architectural detail of the face, which is very important. Many patients do not know this and apply mainly for purse-string wrinkles in the area of the upper lip. This is of course also important, but… A rejuvenating effect will be given by the correction of "Cupid's bow" and reconstruction of the filtrum columns.
I often work with patients, who had serious illnesses, as a result of which the motor activity of the facial muscles partially changed, which led to asymmetry. In such cases, when correcting the lips it is important to correctly analyze the state of the face of such a patient, to designate the boundaries of the "cupid's bow"; and mark the filtrum columns.
- Please note that the filtrum columns will not run parallel to each other. It is necessary to create a filtrum more laterally, going from the tops of the Cupid's bow; to the nasal passages. In this case, the drug must be administered very superficially. In my practice, I use a denser preparation of hyaluronic acid, which helps to keep its shape and not blur.
- If a deep crease appears between the filtrum columns after correction, it can be filled using the fan technique.
Youth indicator No. 3. Tragus. The condition of the skin near the tragus is very important for the youth of the face and is subject to mandatory correction with hyaluronic acid preparations. Looking in the mirror, a person does not see the state of the auricle, and even more so — tragus. And often gets confused when we point it out.
In our practice, we face two types of problems.
The first problem relates to operated patients with altered and flattened tragus. Very often, patients cover the auricle with hair, and we can not immediately see their problem. However, as a surgeon, I want to emphasize this point in particular.
After a facelift, the shape of the tragus may also change, which will give the auricle an unnatural appearance. This can be avoided by shaping the tragus with hyaluronic acid injections.
But the second problem concerns older non-operated patients. Due to the excess of the skin flap , they have multiple wrinkles in the tragus area. This immediately gives the real age of the patient. And, if you want to achieve a rejuvenating & nbsp; effect, they must be aware that such a defect must be eliminated. This can be achieved by the superficial injection of a light formulation of hyaluronic acid.
Interviewed by Elena Stoyanova
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