PROMOTION
A NEW APPROACH TO 3D FACIAL REJUVENATION
Paola Rosalba Russo explains why Silhouette Soft Sutures are essential for full-face rejuvenation
This study will claim that in order to achieve a successful rejuvenation treatment of the entire face it is necessary to combine the use of the botulinum toxin with hyaluronic acid and Silhouette Soft Sutures. In fact, even though microcannulae and/or needle techniques have yielded interesting results in treating the lower third of the face, Silhouette Soft sutures are indisputably the best possible solution.
T
PAOLA ROSALBA RUSSO, MD, is General Surgeon and Vice President, SIES
contact:
xsanaclinique@gmail.com
126 ❚
HE AGEING OF THE face is a 3D process that affects bones, muscles, adipose tissue and skin. This 3D ageing process is
caused by a range of factors, which include laxity, reduction of volume, effects of gravity, redistribution of adipose tissue, and bone resorption. It is therefore of paramount importance to restore volume loss and reshape the ageing face. In order to achieve such an objective, it is necessary to use a 3D approach. This study will claim that a successful rejuvenation treatment of the full face must be based on the combined use of botulinum toxin, hyaluronic acid, with customised formulations and techniques, and Silhouette Soft Sutures.
The erosion of beauty With age, the bony structures of the face become visible, facial texture is altered and convexities become concave, giving rise to skeletonisation. In general, less new bone is formed than resorbed, and this results in bone volume depression. The face does not escape this phenomenon, even though the physiologic changes that occur in the mandible may be said to differ from those observed elsewhere in the body. The features of a youthful skull include a malar eminence, infraorbital rim, and piriform aperture that are positioned anteriorly and vertically in the sagittal plane. The orbital aperture is small with a horizontally positioned inferior orbital rim. Older patients
March 2013 |
prime-journal.com
have a retroclined malar eminence, infraorbital rim, and piriform aperture compared with that of young patients.
Ageing face syndrome As the face ages, the changes which occur include wrinkles, variation of skin pigmentation, brightness and elasticity, lipotrophy of soft tissues and muscles, accentuation of grooves, tissue and muscle ptosis.
When talking about skin ageing we should distinguish between intrinsic or chronological ageing, which affects all parts of the body; extrinsic photoageing, worsened by external factors such as UV rays, smoking, diet, alcohol, and is visible only in the exposed parts of the body; and dermal photoageing, which results in a decrease in collagen fibres, degeneration of elastic fibres, decrease of hyaluronic acid, loss of tone and elasticity, and wrinkle formation. More superficial volume loss can also be explained as aged skin retains less water than younger skin. Furthermore, the reduction in collagen I synthesis, which occurs in old age, contributes to flattening of the facial contours. In addition, collagen and elastic fibres are
reorganised, presumably in a more tortuous manner, thus becoming distorted and less elastic over time. On the grounds of the crucial role played by collagen and elastin in providing cutaneous tensile strength and resiliency, their decline with age contributes to sagging and laxity.
Restoring the natural balance The ageing process alters the natural balance which normally exists between the upper, middle and lower third of the face. In fact, it provokes the lengthening of the upper third of the face as a consequence of the bone and cartilage ipotrophy and soft tissue ipotrophy and ptosis. It causes the reduction of the middle third of the face, following the soft tissues and bone and cartilage ipotrophy. The lower third of the face becomes
shorter owing to the loss of height in bone structures of the maxilla and mandible, and the thinning of the skin and subcutaneous tissues. The malar fat pads descend, resulting in a loss in the cheek prominence, and causing the deformity of the tear trough, and the appearance of prominent nasolabial folds. It is therefore
Zygomatic arch
The jawline
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 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122 |
Page 123 |
Page 124 |
Page 125 |
Page 126 |
Page 127 |
Page 128 |
Page 129 |
Page 130 |
Page 131 |
Page 132 |
Page 133 |
Page 134 |
Page 135 |
Page 136 |
Page 137 |
Page 138 |
Page 139 |
Page 140