Face aesthetics are about a mix of skin, bone and soft tissue which make a concept of harmony and proportion. The midface and the triangle of beauty which is defined by 3D eminences (cheekbones and chin), the midface (malar area) and includes the aesthetic attraction keys (eyes, nose and lips).

Sagging occurs in the aging face not only for gravity but also because of the changes in the fat compartments that accompanies aging. The current concepts on soft tissue facial aging are defines as the loss of fatty pads in the upper and mid face and around the mouth, tightening of the central ligaments and loosening of the lateral ligaments and the result is the “arc of aging” of the older faces.

Cutaneous Aging

  • Loss and displacement of Sub-cutaneous fat
  • Resorption of bone and cartilage
  • Gravity induced dissent of soft tissue
  • Loss of collagen and elastic fibres
  • Hyperdynamic musculature induced creasing
  • The face can be divided into fifths using the width of the eye from corner to corner as a point of measurement. Starting from the very outside edge of one ear to the other — the face ideally would be 5 eye widths apart. Of course, since we are human and not designed by computers, it is perfectly fine if you are not exactly 5 eye widths a part. The width of the base of the nose, at the nostrils (or ala), should be 1/5 of the face, or one eye width.
  • Facial analysis of aging changes- compartment wise
  • Upper face-has following features which show age related changes
  • Brow muscles and blood vessels become more prominent
  • Impression of brow poises created by loss of support to lateral brow plus loss of fullness to upper eyelid
  • Appearance of worry and glabellar lines
  • Mid face- shows Infraorbital tear-drop depression due to volume redistribution
  • Periorbital lines (crow’s feet) due to decreased tone of around the eye muscles
  • Darker (‘tired eyes’) appearance due to loss of volume between muscle around the eye and overlying skin of the lower eyelid
  • Cheek fat redistribution downwards (creating nasolabial folds)
  • Nasolabial crease is a giveaway sign of aging and results from either cheek ptosis, loss of volume or muscle hyperactivity.
  • Nasolabial fold in an individual may reflect a single or more than one of the above contributing factors.
  • The cheekbones and ogee curve have to be considered – zygomatic bones and overlying fat and soft tissues.
    Cheekbones are the key point of the midface. High cheekbones are a sign of youthfulness
  • Lower face-may show
  • Loss of definition at the vermilion border and loss of lip volume
  • Downturn of the angles of mouth .Redistribution of subcutaneous fat and loss of skin support around the chin pad
  • Loss of jawline definition and the appearance of a horizontal chin crease

Replacement Fillers

Restore soft tissue volume lost in deep dermis or subcutaneous space

  • Collagen
  • Hyaluronic acids (HAs)

Stimulatory Fillers

Restore volume by stimulating fibroblast activity, collagen synthesis and soft tissue growth

  • Poly-L-lactic acid (PLLA)
  • Polymethylmethacrylate (PMMA) – Permanent

Calcium hydroxylapatite (CaHA) Common ingredient in skin care products HA injections temporarily smooth wrinkles by adding volume under the skin

Using dermal fillers is a treatment of choice for wrinkle

  • Hyaluronic acid (HA) fillers
  • Most widely used biopolymer is composed of d-glucoronic acid and n-acetyl-d-glucosamine
  • Naturally occurring substance, which exhibits no species or tissue specificity.
  • Essential and one of the predominant component of the extracellular matrix
  • is cross-linked for stability in tissues.

Are superior to collagen fillers with minimal allergy and immunogenicity reports

  • non-animal stabilized HA (NASHA) produced by the fermentation of equine streptococci.
  • And cross-linked with 1, 4-butanediol diacrylate (BDDA), with 1% degree of cross linking.

WHERE CAN FILLER ARE USED FOR AGING FACE?

Volume

  • Cheek
  • Tear trough
  • Earlobes
  • Volume and layering
    • Glabella
    • NL fold
    • Marionette line
    • Prejowl sulcus
  • Contouring
    • Tear trough(lateral)
    • Eyebrow
    • Nose
  • Lips- Enhancement and Augmentation
  • those that have good shape and definition but who desire
    augmentation of certain features of their lips
  • – those that have atrophic lips requiring augmentation
  • Those that have loss of lip definition and/ or perioral rhytids.

What does the treatment Involve?

The filler is an injectable and procedure is conducted over 15 to 30 mines. The injection technique involves deposition of filler material into various skin planes to restore and refill lost volume. There is minimal pain and person walks out of procedure with minimal injection marks. The key futures are instantaneous correction, long term results, safe and sans any down time.

From simple correction of nasolabial folds, mid cheek and lip augmentation, face, neck and hand rejuvenation, under eye volume restoration the fillers are now the safest and most popularly conducted procedure for wrinkle correction with results staying for long time.

After Treatment Care

  • Apply ice packs for the first 48 hours
  • Limit during the first 48 hours
  • Limit smiling and laughing for the first week
  • Avoid strenuous activities for 1-3 days
  • Keep the lips clean to avoid infection (antibiotics may also be dispensed)
  • Risks & Complications: Rare
  • For details post us a query

Fillers Face

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