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| FACIAL AESTHETICS | ARTICLE Approximately every 6 months,


the mimetic wrinkles of the upper third of the face were treated with


BoNT A using Incobotulinumtoxin A, reconstituted in 1.25 cc, sterile, 0.9% unpreserved saline.


severe wrinkles) at maximum contraction Infraorbital hollowness was MS 4 (very severe hollows),


with upper and lower dermatochalasis and protrusion of lower eyelid fat pad. The nasiolabial folds were marked at MS 4 (very severe fold), the upper mid-face at MS 3 (severely sunken upper cheek), lower mid-face at MS 4 (very severely sunken lower cheek), oral commissures at MS 4 (very severe downturn), upper-lip rhytides at MS 2 (moderate wrinkles), upper and lower lip volume at MS 3 (thick), and the jawline at MS 3 (severe sagging). There was also prominent volume loss to the mid-face


(MS 3–4) and a loss of contour to the jawline (MS 3), as well as static wrinkles (MS 2–4) and severe mimetic wrinkles (MS 2–4). The patient also had signs of actinic elastosis.


Therapy In this article the author showcases the aesthetic treatments that this patient received over the past 7 years, from 2005 to date.


Figure 4 Treatment to the nasolabial folds with dermal filler, (A) before treatment and (B) directly after treatment. This demonstrates the direct filling technique; linear threading with a short, sharp 27G needle, injecting Radiesse®, 0.5 cc per side, premixed with Lidocaine 1%


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