Objectives: Volumetric rejuvenation
Aging changes
Facial fat compartments
Patient assessment
Depth of injection
Needles versus cannulas
Injection Techniques
Point lifts
Deep lateral malar restoration
Deep malar medial zone
Safety concerns while injecting

Introduction: The aetiology of age-related facial changes has many layers. Multiple theories have been presented over the past 50–100 years with an evolution of understanding regarding facial changes related to skin, soft tissue, muscle, and bone.
Original theories behind facial aging have focused on soft-tissue laxity, ptosis, and descent of the envelope over time on account of gravity. Gonzalez-Ulloa and Flores presented their theory on facial aging and “senility of the face” almost 50 years ago. They first described facial aging in relation to changes of the skin, descent of the soft tissues, etc

Materials / method: Pessa and Rohrich have spent 3 decades in evaluating and studying the anatomical facial changes that occur in the facial skeleton and overlying soft tissues over time.
Original theories behind facial aging have focused on soft-tissue laxity, ptosis, and descent of the envelope over time on account of gravity. The gravitational theory of midfacial aging proposes that vertical descent of facial soft tissue secondary to ligamentous attenuation contributes to the deep creases of the aging face.
In 1989, Furnas first described ligaments within the cheek which anchor the dermis

Results: In 2007, Lambros popularized the volumetric theory among plastic surgeons. In his analysis of 130 subjects, each photographed at 2 separate points in time ranging 10–56 years apart, Lambros noted that the lid-cheek junction remained stable within subjects. Furthermore, skin landmarks such as moles and wrinkles in the orbital and upper midface areas did not descend with time.

Conclusion: These landmark studies opened new doors in understanding the complexities of facial aging and the pivotal role of facial bony resorption and remodelling.
Accordingly, failure to address changes in the skeletal foundation of the face may limit the potential benefit of any rejuvenation procedure. Correction of the skeletal framework is increasingly viewed as the new frontier in facial rejuvenation. Aging leads to an inferior migration of the midfacial fat compartments and an inferior volume shift within the compartments.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: The lecture will focus on the following
*Volumetric rejuvenation
*Aging changes
*Facial fat compartments
*Patient assessment
*Depth of injection
*Needles versus cannulas
*Injection Techniques
*Point lifts
*Deep lateral malar restoration
*Deep malar medial zone
*Safety concerns while injecting

Introduction: The aetiology of age-related facial changes has many layers. Multiple theories have been presented over the past 50–100 years with an evolution of understanding regarding facial changes related to skin, soft tissue, muscle, and bone. Original theories behind facial aging have focused on soft-tissue laxity, ptosis, and descent of the envelope over time on account of gravity. Gonzalez-Ulloa and Flores presented their theory on facial aging and “senility of the face” almost 50 years ago. They first described facial aging in relation to changes of the skin, descent of the soft tissues, attrition

Materials / method: Pessa and Rohrich have spent 3 decades in evaluating and studying the anatomical facial changes that occur in the facial skeleton and overlying soft tissues over time.
Original theories behind facial aging have focused on soft-tissue laxity, ptosis, and descent of the envelope over time on account of gravity. Depletion in fat compartments, resorption of bone, and loss of skin elasticity as well as thickness define age-related changes, which along with the loss of muscle tone leads to sagging

Results: Two main schools of thought characterize the soft-tissue changes observed in midfacial aging. The gravitational theory is cantered on changes in the ligamentous system of the cheek. The volumetric theory is based on the fat compartments of the face. The gravitational theory of midfacial aging proposes that vertical descent of facial soft tissue secondary to ligamentous attenuation contributes to the deep creases of the aging face.

Conclusion: In 2007, Lambros popularized the volumetric theory among plastic surgeons. In his analysis of 130 subjects, each photographed at 2 separate points in time ranging 10–56 years apart, Lambros noted that the lid-cheek junction remained stable within subjects. Furthermore, skin landmarks such as moles and wrinkles in the orbital and upper midface areas did not descend with time. Lambros reiterated Donofrio’s proposition that the changing morphology of the midface may not be completely due to gravitational soft tissue descent, but also due to the relative deflation of certain fat pads.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
Yes
Please specify entities (individual, company, society): Suiselle for Aprilline fillers

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work is presented thanks to the support of: Suiselle