By Doctor Fabien Giausseran
Restoring volumes while conserving the face’s emotional language is one of the challenges faced by cosmetic surgeons. A new type of hyaluronic acid, Belotero VOLUME, associated with a very precise injection technique based on the patient’s anatomy, allows for mouldable and optimum integration which enables us to avoid artificial-looking results.
A product that is perfectly integrated into the face
After treatment, the face looks natural and youthful when at rest. In movement, however, the gel can collect around the cheekbones, which makes the surgery visible and makes the patient’s features and traits look unnatural. This artificial appearance can occur when a lot of work has been done to firm up and fill the face. Now this effect can be avoided thanks to Belotero Volume, a volumising gel with a unique rheology, which is easily integrated into the areas that need volumising, filling and firming. This new hyaluronic acid with lidocaine is seamlessly assimilated into large and small intercellular areas for optimum integration. A technique called the “3 triangle technique” has been designed by a plastic surgeon and is taught during medical training sessions organised by the Merz Academy.
Respecting the face’s dynamics
First of all, I listen to the patient and carefully examine their skin, then I ask them to pull some different faces in order to analyse their face in movement. Every woman is different and so every face is injected differently. After locating the face’s anatomical points using my fingers, I draw three triangles which mark out the tear trough, cheekbone and temporal fossa. The product is injected in a bolus deep into the skin, right to the bone, which ensures a very natural-looking result. I immediately massage the gel in order to shape it, so that it perfectly matches the face’s anatomical shape in rest and in movement.
It really is a “sculpting tool” that is malleable and easy to mould, even more so given that we can inject it using 30G needles, which improves comfort both for the doctor and the patient and minimises bruising. The gel is not hydrophilic, which means that it does not make areas such as the oval of the face too heavy, and does not cause the cheekbones or tear trough to be projected in an unnatural way. It is ideal for restructuring and filling a weak chin and firming up the oval.
The loss of fat in the face has been a central concern in my profession for several years now. We need to address tissue ptosis by treating the cause before, not after, it has happened. We no longer inject in order to “fill” wrinkles: we inject specific areas of the face in order to create solid moorings that will stop the tissue from drooping. These anchors are mainly located in the middle third of the face. Belotero Volume enables us to create these anchors, deep within the skin, without creating false volumes. On the contrary: I can sculpt the patient’s face in a subtle and precise way so that the face captures the light. We can thus boost the face’s radiance at these strategic points, which are defined by the three aforementioned triangles. These highly natural results are much sought-after by patients, and the effects last up to 18 months.
Often patients are reticent about injecting into the temple area, but I explain that the temple is the continuation of the cheekbone. The temple area thus reflects light and gives the appearance of a rested face with well-defined contours. Our work has never been more accurate and subtle, and it is a real treat to share our expertise with our patients.
By Doctor Fabien Giausseran 
Doctor Fabien Giausseran, Morphological and Anti-aging Practitioner. Director of the Centre Laser Liberté, Lille. Member of the French national syndicate SNMMAA, member of the SOFMMAA, the WOSIAM, and the scientific committees of the DEFEE group and F.A.C.E2f@ce. Expert in advanced techniques for injectables, collagen-inducers and placing threads. Speaker at international aesthetics conferences. Medical tutor in France and South America for aesthetic pharmaceutical laboratories. Cosmetology consultant.
