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ARTICLE | VOLUMISING TECHNIQUES |


VOLUMISATION ENHANCING THE MID-FACE WITH


VECTORS FOR HYALURONIC ACID


Lakhdar Belhaouari, Paul Teisseire and Pierre Quinodoz discuss the anatomy of the mid-face and orbital regions,


and what the physician should consider when treating these areas with hyaluronic acid


ABSTRACT Rejuvenation and enhancement of the mid-face with hyaluronic acid is an important part of the aesthetic physician’s practice. To successfully treat this area, a thorough understanding of facial anatomy, the morphological changes associated with the ageing process, and available products and administration techniques are essential. In this article the authors address these issues, propose an original scale for mid-face volumisation and ageing, and provide an understanding of the vectors involved in the beautification and rejuvenation of the mid-face with hyaluronic acid.


LAKHDAR BELHAOUARI, MD, is Plastic and Aesthetic Surgeon, Toulouse, France; PAUL TEISSEIRE, MD, is Head of Clinical Ophthalmology, Toulouse, France; and PIERRE QUINODOZ, MD, is Plastic and Aesthetic Surgeon, Geneva, Switzerland


email: Belhaouari.l@wanadoo.fr


KEYWORDS hyaluronic acid, mid-face, anatomy, fat, muscle, nerves


28 ❚


requested procedures in the aesthetic clinic. It is a challenge that aesthetic surgeons and physicians relish, but successfully rising to this challenge requires a perfect understanding of anatomy, both structural and functional, and the physiological and morphological changes induced by ageing, as well as excellent knowledge of the techniques and products used.


T January/February 2012 | prime-journal.com


HE MID-FACE IS MORE THAN JUST A detail. Situated between the smile and the eyes, it is the centre of harmony and balance of the face. Beautification and rejuvenation of the mid-face today is one of the most commonly


What is important to understand in anatomy and physiology ? Structural and functional anatomy The middle third of the face, or mid-face, is located between the lower eyelid and nasolabial fold. It includes a bony support (orbitomalar and upper maxillary skeleton) on which the two malar fat compartments lie (deep malar fat pad and superficial malar fat pad). Between these two fat compartments lies the orbicularis oculi muscle. Of course, these structures are covered by the skin envelope.


Orbitomalar and maxillary bone support The orbitomalar and maxillary bone supports form the structural foundation of the face, which support the soft tissue compartments (Figure 1). They are essential components for the shape and volume of the mid-face.


Orbicularis oculi muscle The orbicularis oculi muscle is composed of medial (palpebral) and lateral (orbital) parts1


. Only the lower half


of the orbital part, which is located in the mid-cheek area, is of concern for the purposes of this article (Figure 2).


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