| FACIAL REJUVENATION | ARTICLE
Javier Moreno-Moraga, Josefina Royo de la Torre, and Gema P• rez Sevilla present the results of a study examining this technique for treatment in the lower face
LASER-ASSISTED FACIAL CONTOURING
ABSTRACT Objective Facial ageing correlates with a gradual redistribution of soft tissue and an inversion of the ‘triangle of youth’. The shift in subcutaneous fat exacerbates the signs of bone ageing, with ptosis of the nasolabial fold. The labiomental fold and jowl appear on the lower third as a consequence of sagging fat. Laser-assisted facial contouring can be applied to directly treat sagging fat. This technique can be performed with local anaesthetic on an outpatient basis and with a short downtime.
Patients and methods The authors used a dual-emission diode laser (924 and 975 nm) for facial rejuvenation in 124 women
T
who completed a 3-month follow-up. Improvement was assessed double-blind using the Wrinkle Severity Rating Scale and the Global Aesthetic Improvement Scale. Data were analysed using SAS 9.2.
Results Patients improved 1–2 degrees on both scales, with no difference as a result of the double-blind approach. Patient satisfaction was 7.3 out of a maximum of 10 points. The most significant side-effects were prolonged induration and burns, which can be avoided by perfecting the technique. All side-effects had resolved after 3 months of follow-up.
Discussion Laser-assisted facial contouring was
RADITIONAL TECHNIQUES FOR structural rejuvenation of the lower and middle thirds of the face are based on manipulation of loose, displaced tissue (surgical lifting), and replacement of tissue
volume (e.g. implants, fillers). According to Holcomb et al1
and Coleman et al2 ,
ageing of the lower and middle thirds of the face involves bone abnormalities such as atrophy of the anterior aspect of the maxilla and increased pyriform aperture with attenuation and retraction of the supporting soft tissue (mandibular septum). These processes also affect soft tissue in such a way that the redistribution and displacement of subcutaneous fat exacerbates bone ageing ® the cheekbones lose projection and position, leading to ptosis of the nasolabial fold. The labiomental fold and the jowl of the cheek are also
moderately to markedly effective, with high patient satisfaction. It improved skin tightening and reduced the incidence of injury. The flexible tip allows for ease of use. The technique provided better results than traditional liposuction approaches, was less invasive, and also prevented the facial disproportion that is sometimes caused by facial fillers used to correct the defects examined in the present study.
Conclusions The outcome of laser-assisted facial contouring for the rejuvenation of the lower third of the face is satisfactory. However, it does not remove the need for rhytidectomy, dermal fillers, or autologous fat transfer.
consequences of sagging fat. Collectively, these changes affect the balance of the facial triangle, which shifts from being defined by both cheekbones and the chin, to focusing on both jowls with the apex on the nose. Although a number of variations of
rhytidectomy have been developed to improve the jowls, nasolabial folds, and marionette lines, conventional procedures do not completely correct these ageing-associated changes. Many surgeons have reported satisfactory outcomes with techniques in which liposuction is extended to the nasolabial fold and jowl, though generally requiring at least moderate sedation and a relatively invasive procedure. In 1989, McKinney and Cook3
reported the successful
use of liposuction to the nasolabial folds as an adjunct to rhytidectomy. In 2000, Langdon4 achieved satisfactory results with direct
Although a number of variations of rhytidectomy have been
developed to improve the jowls, nasolabial folds, and marionette lines, conventional procedures do not completely correct these ageing-associated changes.
KEYWORDS laser-assisted facial contouring, facial ageing, displaced fat pad, nasolabial fold, labiomental fold, jowl
prime-journal.com | April/May 2012 ❚ 21
JAVIER MORENO-MORAGA is Plastic Surgeon, Instituto M• dico Láser, Madrid; JOSEFINA ROYO DE LA TORRE is Plastic Surgeon, Instituto Médico Láser, Madrid; and GEMA PÉREZ SEVILLA is Maxillofacial Surgeon, Instituto Médico Láser, Madrid, Spain
email:
consulta@iml.es
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