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ArtiCle | fACiAlAeSTHeTiCS |


usiNg ATrAumATic cANNulAe


New TechNiques of 3D VecToriNg


recently developed 3D vectoring techniques add a new dimension to the treatment of the ageing face.


Kate Goldie provides a practical, evidence-based guide to using this approach


ABSTRACT


The signs of the ageing face arise from the interaction of anatomical and physiological changes that develop over time. Absolute skin laxity, underlying volume loss, and the force of gravity over the passing years result in the softening and sagging of facial structures. 3D vectoring is a set of techniques that strategise the placement of filler to create positive vectors to lift and resculpt the face. Significantly improved results follow the consideration of the relatively fixed stable zones in the face in relation to mobile compartments1


DR KATE GOLDIE MBChB is Clinical Director, Medics Direct (Europe) Ltd; and Clinical Director, Advanced Rejuvenation Clinic, Glasgow


email: kate@medicsdirect.com


bone mass is depleted and facial fat is lost or redistributed, results in surplus skin or an increase in relative skin laxity, which will be present, with or without the absolute increase in skin laxity2, 3


. As these two effects of ageing combine, the face . Calcium hydroxylapatite (CaHA)


has unique qualities, in particular a high viscosity and elasticity that is suited to vectoring techniques. Using micro-atraumatic cannulae, treatment becomes virtually painless with minimal tissue trauma and bruising. This article provides a practical guide to the 3D vectoring approach using atraumatic cannulae.


A


KEYWORDS cannula, vectoring, calcium hydroxylapatite, ageing face


24 ❚


bsolute skin lAxity, A term which describes laxity that is a result of the qualities of the skin itself, increases over time as there is a decrease in cutaneous collagen and elastin secondary to ageing and


environmental insult. A thinner, weaker dermis develops with a larger surface area. the problem of an increasing absolute skin laxity is compounded by a diminishing structural support to hold up facial features against gravity. the loss of facial volume, as


September 2011 | prime-journal.com


sags into the classic gravitational signs of ageing at the jowls, nasolabial folds, and marionette lines. Simply put, the skin starts to droop, becoming looser and less elastic, while at the same time, the supporting facial structures degrade and become less structurally effective. The 3D vectoring techniques recently developed allow for the structural rejuvenation of facial contours and lift mid- and lower-facial signs of ageing in a natural-looking way. Accurate diagnosis in aesthetic medicine is always


important. When using a 3D vectoring full-face approach, careful diagnosis becomes crucial to ensure the best results. Using calcium hydroxylapatite (CaHA) to volumise key areas of the face can lift, and in some cases completely correct, excess skin in patients with relative skin laxity. CaHA has the ability to increase collagen in the skin4, 5 and to a degree may, therefore, also correct absolute skin laxity, while increasing mean skin thickness6


. However,


beyond a certain degree of absolute skin laxity there may be simply too much cutaneous surplus, and any attempt


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