ARTICLE | FACIAL AESTHETICS |
FACIAL AESTHETICS: A LONG-TERM FOLLOW-UP
RECONTOUR IN RELAX AND Sabine Zenker presents a patient case study
investigating the use of dermal fillers and botulinum toxin type A for a full-facial rejuvenation
ABSTRACT
Loss of volume and sagging facial contours, as well as persistent hyperkinetic lines and rhytides, are typical indications for non-invasive facial rejuvenation treatments such as dermal filler and botulinum toxin type A (BoNT A) injections. Facial ageing is a complex, three-dimensional process, which affects all anatomic structures from the skin
SABINE ZENKER, MD, is Dermatologist, Dermatology Surgery Clinic, Munich, Germany
email:
Kontakt@dr-zenker.de T
KEYWORDS 3D vectoring lift, cannulae, low-dose botulinum toxin A, customised treatment
18 ❚
to the subdermal fat pads and the facial retaining ligaments. The typical and first sign of ageing that patients complain about is the appearance of the glabellar fold, followed by persistent forehead lines and crow’s feet. Loss of volume is typically detected in the nasolabial folds, reflecting the consequences of a loss of volume in the cheeks and upper
O RELAX FACIAL MUSCLES AND smooth out facial wrinkles, treatments with botulinum toxin type A (BoNT A) mark the gold standard in aesthetic medicine. The most recent and ÔyoungestÕ BoNT A on the market is
Incobotulinumtoxin A: Xeomin , approved for medical indications in Europe (2005) and the US (2008), and Bocouture for aesthetic indications (Europe 2008/US 2011). This formulation of BoNT A is free from complexing proteins, and therefore presents a low immunogenic potential3, 4
;
Incobotulinumtoxin A does not require a cold chain5
. When it comes to
biodegradable dermal filler material, all those that are FDA- approved and/or CE-marked offer good efficacy and safety.
September 2012 |
prime-journal.com mandible areas1 . As a result, non-invasive
therapies such as dermal filler and BoNT A injections are moving away from single- fold-fixing, to a global restoration and three-dimensional reshaping of the facial structures2
. The target here is to maintain
and optimise the facial features — always aiming to achieve a natural look.
However ® to focus on just some properties of fillers ® there are significant differences between hyaluronic acid (HA)-based fillers with regard to composition, biointegration, and their physical and chemical properties. When smoothing out superficial wrinkles, it has been shown that monophasic polydensified HAs integrate intradermally within the injected tissue without the risk of inflammation or lymphocytic infiltration6
, and with no risk of the Tyndall When it comes to
effect. Dextranomer beads can increase the longevity of HA-based fillers, as they induce collagen stimulation7
biodegradable dermal filler material, all those that are FDA-approved and/or CE-marked offer good efficacy and safety.
. The
biodegradable calcium-based filler, calcium hydroxylapatite (CaHA), has a far higher volumising capacity as its elasticity and viscosity are much higher compared to HA fillers8 CaHA additionally lacks
. As
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84