arTicLE | The sOfT lifT |
Figure 6 76-year-old patient complaining about sagging skin around the mandibular line 15 years
after face-lifting. Treatment with 2.5 ml Perlane per side with 25 Pix’L cannula.
References
1. Verpaele A, Strand A. Restylane SubQ, a non-animal stabilized hyaluronic acid gel for soft tissue augmentation of the mid- and lower face. Aesthet Surg J 2006; 26(1S): S10–7
2. Fedok FG. Advances in minimally invasive facial rejuvenation. Curr Opin Otolaryngol Head Neck Surg 2008; 16(4): 359–68
3. Dreissigacker K. Individual Face Balance. Face 2009; 3: 42–5
4. Berros P. Periorbital contour abnormalities: hollow eye ring management with hyalurostructure. Orbit 2010; 29(2): 119–25
5. Monheit GD, Prather CL. Hyaluronic acid fillers for the male patient. Dermatol Ther 2007; 20(6): 394–406
6. Maas CS, Bapna S. Pins and needles: minimally invasive office techniques for facial rejuvenation. Facial Plast Surg 2009; 25(4): 260–9
7. Carucci JA, Zweibel SM. Botulinum A exotoxin for rejuvenation of the upper third of the face. Facial Plast Surg 2001; 17(1): 11–20
8. Wang F, Garza LA, Kang S et al. In vivo stimulation of de novo collagen production caused by cross-linked hyaluronic acid dermal filler injections in photodamaged human skin. Arch Dermatol 2007; 143(2): 155–63
9. Jaspers GW, Pijpe J, Jansma J. The use of botulinum toxin type A in cosmetic facial procedures. Int J Oral Maxillofac Surg 2010; 40(2): 127–33
10. Malhotra PS, Danahey DG,
Hilger P. BOTOX (R) Injections to Improve Facial Aesthetics. eMedicine 2010. http://tinyurl. com/3g3vy9c (accessed 7 September 2011)
11. Jacono A, Meyers AD. Rhytidectomy, SMAS Facelift. eMedicine 2010. http://tinyurl. com/3lfmxsz (accessed 7 September 2011)
12. Gibson JJ, Angeles AP, Hunt
TK. Increased oxygen tension potentiates angiogenesis. Surg Forum 1997; 48: 696–9
13. Busso M. Soft tissue augmentation: nonsurgical approaches to treatment of the mid and lower facial regions. Dermatol Nurs 20(3): 211–4, 217–9
20 ❚ aggressive surgical procedures, which often increase
the risk of changes to the temporal hairline, and visible scars. There are women who absolutely want to avoid any invasive procedures, but still want a rejuvenating and lifting effect. By regularly injecting NAshA products in the right place, with the right amount of material, the desired effect of regaining angles and curves without a scalpel can be achieved. The deep wish of the new generation of women to retain
their own identity and facial character is also very much affecting the future of aesthetic medicine. These patients ask for a good facial balance with a gentle technique and subtle change; and with products they can count on that have a short downtime. if, however, the patient seeks a rhytidectomy, it is important for the facial plastic surgeon to determine the characteristics that are contributing to the patient’s ageing appearance. A comprehensive approach to the ageing face may include many different procedures, such as endoscopic brow and/or mid-face lifting, blepharoplasty, chin and malar implantation, and chemical/ laser exfoliation in addition to rhytidectomy11
. in these
cases, the soft lift is the perfect tool to combine both before and after facial surgery. Before the procedure it can be used to rehydrate the skin, and postoperatively to correct the nasolabial fold, the periorbital area, and after the healing process to lift the cheekbone area. The soft lift can also be used after duplication of the
superficial musculoaponeurotic system (sMAs) face-lift without any risks, by applying the gel with the blunt
October 2011 |
prime-journal.com
cannula above the operated structures. The use of the Pix’l cannula can, however, be slightly more demanding after the invasive facial procedure owing to dermal/subdermal postoperative scars. Additionally, there is the hope that the incidence of secondary facial surgery — mostly carried out at the ages of 65–75 years — can be dramatically reduced. Treating older patients with NAshA gels before the age of the Pix’l cannula was not particularly successful; loss of skin elasticity, excess of skin, and a sagging mid-face made the procedure meaningless. By having the possibility to inject the gel smoothly and regularly under the cutis, it is possible to avoid unevenness and disharmony. it is amazing to see that with this technique even women older than 75 years (Figure 6), women with sun damaged skin, and acne patients can achieve lovely results. The Pix´l micro-cannulae offer the possibility to reduce
the risk of tissue damage, and in that way haematoma can be avoided. This makes the soft lift concept, together with the use of the cannula, even more attractive. The design of the cannula regulates the flow-rate, provides a homogenous filling effect, and is less painful than the conventional use of sharp needles, providing better results and fewer side-effects. The individual facial balance allows for the transition from single-site injections to a minimally-invasive face-lift in age-appropriate patients4
(Figure 5). The
downtime after a soft lift treatment with more than 6 ml can be positively influenced by the avoidance of non-steroidal anti-inflammatory drugs (NsAiDs) for the
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