Whole face rejuvenation – a difficult task, associated with high expectations of the patient, to solve which it is necessary to work with superficial and deep fat packages, as well as provide lifting of the upper, volumization of the middle and lifting of the lower third of the face. At the same time, the goal for the doctor is – get visible results while maintaining the natural proportions of the face.
There are many full face rejuvenation techniques that aim to restore volume or stimulate collagen with standard dermal fillers, including those based on HA, calcium hydroxyapatite, and poly-L-lactic acid. In this article, Dr. Ayad Harb presents a protocol for a three-point facelift with polycaprolactone fillers.
Main objectives of the 3-point facelift procedure
Three-point lifting – is a full face rejuvenation protocol with polycaprolactone fillers. This technique is a simple, systematic approach to targeting the deep and superficial fat pads of the face through three access points.
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The need to replenish collagen lost with age in the dermis and epidermis cannot be overestimated. It is another important goal of the three-point lifting is the effective biostimulation of collagen production in the subcutaneous layer and superficial fat compartments of the face.
Filler choice for injectable full face rejuvenation
Polycaprolactone microspheres in Ellansé – extremely powerful stimulators of collagen type 1 production in the skin. In addition, Ellansé provide effective volumization.
Other dermal fillers can be used for the 3-point lifting technique, however, polycaprolactone microspheres stimulate the production of type I collagen, while most traditional fillers stimulate the synthesis of collagen types I and III.
Read also: What role do collagen types play in skin aging
Three-point facelift: procedure protocol
The procedure is performed with a 25 gauge microcannula through three insertion points located on each side of the face. These points allow access for deep injections and are the centers of rotation of the cannula when working with superficial structures (Fig. 1).
Deep structures: boluses (0.1-0.2 ml each) of the drug are injected into the deep fat compartments (Fig. 2). The total amount of filler depends on the degree of loss of cheek volumes and varies between 0.5 & ndash; 3 ml.
Working with superficial structures: microboluses (0.02-0.05 ml each) of the filler are injected into the subdermal plane (Fig. 3) using a linear technique. The central point is the insertion point, which allows the cannula to be rotated 360 degrees.
1. First point
Located in the middle third of the face, in the center of the zygomatic bulge. Provides access for deep bolus injection of fillers on the periosteum into the deep fat pads of the middle third of the face, temporal and prezygomatic regions, as well as perform surface injections throughout the middle third of the face. The treated area may also cover the nasolabial border for superficial biostimulation of the upper lip.
2. Second point
Designed to work with the lower third of the face and the perioral area. This access point is located in the premaxillary sulcus and allows you to enter the drug on the periosteum in the lower part of the facial oval. Through the same access point, superficial biostimulation of the entire perioral zone is performed.
3. Third point
Located in the angle of the mandible and provides the possibility of introducing the filler on the periosteum along the posterior border of the mandible and creating a well-defined mandibular angle. Superficial insertion sites include the area in front of the parotid gland, the upper part of the neck, and the area along the jaw line.
Results of non-surgical full face rejuvenation with fillers
Final result – volumization of deep facial fat compartments and strengthening of bony prominences, as well as massive infiltration of polycaprolactone microspheres in superficial fat pads and subdermal layer throughout the face.
Immediately after the injection of the polycaprolactone filler, pronounced volumization, moderate swelling and redness of the skin are observed. The appearance of hematomas due to the use of this technique is not typical.
Because the procedure is performed through only three access points, which are treated with antibacterial ointment after the end of the procedure, the patient can apply makeup immediately after the procedure.
The effect lasts from 1 to 5 years, depending on the subtype of the product used.
In the Ellansé 30% polycaprolactone microspheres are suspended in carboxymethyl cellulose gel, which makes up 70% of the preparation volume. The intensity of the initial result decreases during the first 4-6 weeks, but after about 6 weeks there is an increase in volume, the skin becomes softer and more toned.
Three-point facelift with hyaluronic acid - technique
This process takes about 3-6 months. The final results are very good and are maintained for a long time mainly due to the synthesis of new collagen. The effect lasts from 1 to 5 years, depending on the subtype of product used.
The best results after a three-point facelift are seen in patients aged 30-50 years with mild to moderate volume loss and skin laxity.
The best results after a three-point facelift are seen in patients aged 30-50 years with mild to moderate volume loss and skin laxity.
Fig. 4: female patient, 42 years old, before, immediately after correction and one year after facial rejuvenation using the three-point lifting technique
The author notes that the described protocol can be used to prevent aging (at the age when the skin begins to lose collagen), as well as to prepare the skin for procedures such as threadlifting and even surgery.
It is important to explain to patients the mechanism of action of polycaprolactone fillers and warn them about the gradual improvement in results.
When working with biostimulants, it is extremely important to avoid overcorrection, which can lead to palpable or visible bumps on the face, as well as cause unnatural results.
Adapted from Aesthetics
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