Dr Natalia Bronitsyna
To make a beautiful face does not only consist in restoring its youth but resides in the capacity to give it perfect proportions. These proportions must be respected for the overall balance of each face. In this article, Dr. Bronitsyna talks about a comprehensive and tailor-made approach to facial rejuvenation based on harmony and balance of contours.
Age-related changes in facial tissues.
Aging is a complex process, accompanied by destructive changes in all layers of the soft tissues, the ligaments and the bone structures, caused by the effect of endogenous and exogenous factors, reflecting the outcome of the natural biological aging of the entire body. The action of gravitational forces adds to all of these processes, causing soft tissue ptosis.
One of the effective injection methods to restore harmony to the face is the “STYLAGE® Facial Transformation”. The goal is to work with several anatomical layers, and precisely the ones in which the involutional changes are the most pronounced, using a combination of STYLAGE® dermal fillers with different viscoelastic parameters in one procedure.
Patient choice.
- Middle-aged patients with subcutaneous fat deficiency.
- Patients with gravitational ptosis, expressed by changes in the shape and volume of the face (photo 1 and 2).
Product choice.
To perform the “STYLAGE® Facial Transformation” method, we used STYLAGE® L (24 mg/g) and STYLAGE® XL (26 mg/g) dermal fillers based on hyaluronic acid crossed-linked using the VIVACY’s patented IPN-Like Technology to restore the soft tissue volumes.
STYLAGE® dermal fillers are fully compliant with the European pharmacological standards and manufactured under strict quality control.
Treatment protocol.
First of all, the physician performs a facial analysis and takes full face, three-quarter and profile pictures of the patient; it is mandatory to fill in a patient consent form explaining the procedure. Afterwards, make-up removal and skin treatment with a disinfectant solution are performed, followed by the application of a local anaesthetic, if necessary.
The procedure itself is performed in two steps:
Step 1. Restoration of the lost volumes in the zygomatic area and the lower third of the face (chin area and the lower jaw angle) according to the injection scheme (photo 3).
During this step, we have used STYLAGE® XL, which has a high viscosity. The insertion point is located on the line between the corner of the mouth and the earlobe, the medial line is drawn from the inner corner of the eye to the front line of the chewing muscle (the line restricts the anatomically dangerous zones located more medially: the facial artery line and the infraorbital neurovascular bundle). A supraperiosteal bolus injection of STYLAGE® XL with a 22G70 mm cannula is performed, which makes the procedure less traumatic and allows working near the anatomically dangerous zones in a more secure way. The volume restoration in these points allows to achieve an immediate lifting effect of the tissues. The injected volume is 1ml per side. It is also possible, if necessary, to correct the periorbital region from the same insertion point, by injecting STYLAGE® S or STYLAGE® M using the bolus technique.
Step 2. Additional volume restoration in the superficial fat compartments, which ensures good restoration of the facial tension vectors and allows improvement of the gravitational ptosis. The correction is performed with STYLAGE® L according to the injection scheme by using a 22G70 mm cannula (a 100 mm cannula can be used if it is necessary to restore volumes in the lateral parts of the face) in the hypodermis, a linear retrograde fashion, using the fanning technique. The total volume of the product injected was 2ml.
For this patient, it is recommended to carry out correction starting from the zygomatic point to replenish the temporal and anterior region. Some of the adverse events after the procedure may include hematoma, which can be observed at the site of the injection, and painful sensation.
Complications are extremely rare if the injection technique is performed correctly. The clinical effect of STYLAGE® dermal fillers lasts up to 12 months or more depending on the area injected. The injection facial contouring is one of the effective methods to improve the patient’s appearance.
However, despite the apparent simplicity of the procedure, the method has many nuances and requires from the physician a good knowledge of the tissue layers anatomy, the preparations for facial contouring, their characteristics and the particularities of the injection techniques.
Dr Natalia Bronitsyna: MD. Certified trainer of Laboratoires VIVACY.
@dr._bronitsina_natalia
