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Objectives: The T- frame is a new systematic approach to facial sculpting combining fillers and suspension threads.

Introduction: This cannot be understood without some anatomical and functional concepts.
The fatty deflation theory explains the descent of skin, and some of the facial fat compartments with aging due to loss of volume. The line of ligaments is an imaginary line that connects the 4 major facial ligaments separating the face into a medial and lateral face. Volumizing treatments of the lateral face primarily result in lifting effects.
While medial treatments to this line will have a local volumizing effect.

Materials / method: The transverse facial septum is the dynamic equivalent to the line of ligaments. Whilst smiling, the tension of the septum leads to a cranial and medial shift in the position of the medial midface. And it is the leading cause of “apple-cheeks”. The T-Frame lift has 3 phases. Each of which is comprised of several steps.

Results: The first phase , the pillars, consists of restoring the loss of volume lateral to the line of ligaments seeking a lifting effect. The second phase, the definition of thirds, consists of filling the areas medial or close to the line of ligaments seeking a local volumizing effect. The third phase or anchorage consists of fixing the lifted tissues by the placement of suspension threads.

Conclusion: - Fill from top to bottom and from lateral to medial. We are looking for more lifting effect than just adding volume.
- Ask the patient to smile while medial mid face is being treated to avoid the overfilled syndrome
- First fill with hyaluronic acid and then fix with threads.
- Rather more threads pulling less than fewer threads pulling more.
If we take these concepts into account, we can obtain predictable and reproducible results.

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