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CC BY-NC 4.0 · Arch Plast Surg 2020; 47(03): 256-262
DOI: 10.5999/aps.2019.01830
Original Article

Multi-modal treatment strategy for achieving an aesthetic lower face

Tae Kwang Jeong 
HB Plastic Surgery Clinic, Seoul, Korea
,
Chang Ho Chung 
Department of Plastic and Reconstructive Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
,
Kyung Hee Min 
Department of Plastic and Reconstructive Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
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Background Most women consider an oval-shaped face to be youthful and beautiful. In recent years, demand has grown for surgical procedures with a shorter downtime and fewer complications. These minimally invasive procedures include botulinum toxin type A (BoNTA) injection, filler injection, suction-assisted liposuction (SAL), laser-assisted lipolysis (LAL), thread lifting, and fat grafting. This study aims to introduce an effective method for creating an aesthetically pleasing lower face using a combination of minimally invasive procedures.

Methods From March 2017 to March 2019, 94 patients simultaneously underwent LAL, SAL, and thread lifting. Ancillary procedures such as BoNTA injections, hyaluronic acid filler injections, and removal of the buccal fat pad (BFP) were selectively performed according to the patient’s condition.

Results Patients rated their postoperative satisfaction as very satisfied, satisfied, dissatisfied, or very dissatisfied. Approximately 83% of all respondents were satisfied with the results, whereas the remaining respondents had complaints regarding the outcomes. The most common reasons for dissatisfaction were a longer-than-expected recovery time and undercorrection, and the most severe complaint was skin depression as a result of overcorrection.

Conclusions Our method of simultaneously performing LAL, SAL, and thread lifting, while adding BoNTA, filler injections, and BFP removal as needed, was capable of producing consistent and reliable aesthetic outcomes for the lower face.

Keywords

Esthetics - Face - Minimally invasive surgical procedures

This article was presented at PRS Korea on November 8–10, 2019, in Seoul, Korea.




Publication History

Received: 03 December 2019

Accepted: 10 April 2020

Article published online:
22 March 2022

© 2020. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • REFERENCES

  • 1 Floyd EM, Sukato DC, Perkins SW. Advances in face-lift techniques, 2013-2018: a systematic review. JAMA Facial Plast Surg 2019; 21: 252-9
    CrossrefPubMedGoogle Scholar
  • 2 Swift A, Remington K. BeautiPHIcation(TM): a global approach to facial beauty. Clin Plast Surg 2011; 38: 347-77
    CrossrefPubMedGoogle Scholar
  • 3 Fattahi TT. An overview of facial aesthetic units. J Oral Maxillofac Surg 2003; 61: 1207-11
    CrossrefPubMedGoogle Scholar
  • 4 Hashem AM, Couto RA, Duraes EFR. et al. Facelift part I: history, anatomy, and clinical assessment. Aesthet Surg J 2020; 40: 1-18
    PubMedGoogle Scholar
  • 5 Cosmetic Surgery National Data Bank Statistics Aesthet Surg J. 2017. 37. suppl_2 1-29
    Google Scholar
  • 6 Bocchialini G, Castellani A, Negrini S. et al. New management in bilateral masseter muscle hypertrophy. Craniomaxillofac Trauma Reconstr 2017; 10: 325-8
    CrossrefPubMedGoogle Scholar
  • 7 Liew S, Dart A. Nonsurgical reshaping of the lower face. Aesthet Surg J 2008; 28: 251-7
    CrossrefPubMedGoogle Scholar
  • 8 de Maio M, Wu WTL, Goodman GJ. et al. Facial assessment and injection guide for botulinum toxin and injectable hyaluronic acid fillers: focus on the lower face. Plast Reconstr Surg 2017; 140: 393e-404e
    CrossrefPubMedGoogle Scholar
  • 9 Khoury JG, Saluja R, Keel D. et al. Histologic evaluation of interstitial lipolysis comparing a 1064, 1320 and 2100 nm laser in an ex vivo model. Lasers Surg Med 2008; 40: 402-6
    CrossrefPubMedGoogle Scholar
  • 10 Tark KC, Jung JE, Song SY. Superior lipolytic effect of the 1,444 nm Nd:YAG laser: comparison with the 1,064 nm Nd:YAG laser. Lasers Surg Med 2009; 41: 721-7
    CrossrefPubMedGoogle Scholar
  • 11 Jung SK, Jang HW, Kim HJ. et al. A prospective, long-term follow-up study of 1,444 nm Nd:YAG laser: a new modality for treating axillary bromhidrosis. Ann Dermatol 2014; 26: 184-8
    CrossrefPubMedGoogle Scholar
  • 12 Tagliolatto S, Medeiros VB, Leite OG. Laserlipolysis: update and literature review. Surg Cosmet Dermatol 2012; 4: 164-74
    Google Scholar
  • 13 Lim SD, Youn JI, Kim WS. et al. Comprehensive histologic analysis of interstitial lipolysis with the 1444 nm wavelength during a 3-month follow-up. Histol Histopathol 2011; 26: 1375-82
    PubMedGoogle Scholar
  • 14 Sun Y, Wu SF, Yan S. et al. Laser lipolysis used to treat localized adiposis: a preliminary report on experience with Asian patients. Aesthetic Plast Surg 2009; 33: 701-5
    CrossrefPubMedGoogle Scholar
  • 15 Rawlani R, Qureshi H, Rawlani V. et al. Volumetric changes of the mid and lower face with animation and the standardization of three-dimensional facial imaging. Plast Reconstr Surg 2019; 143: 76-85
    CrossrefPubMedGoogle Scholar
  • 16 Gulbitti HA, Colebunders B, Pirayesh A. et al. Thread-lift sutures: still in the lift? A systematic review of the literature. Plast Reconstr Surg 2018; 141: 341e-347e
    CrossrefPubMedGoogle Scholar
  • 17 Villa MT, White LE, Alam M. et al. Barbed sutures: a review of the literature. Plast Reconstr Surg 2008; 121: 102e-108e
    CrossrefPubMedGoogle Scholar
  • 18 Fukaya M. Two mechanisms of rejuvenation using thread lifting. Plast Reconstr Surg Glob Open 2018; 6: e2068
    CrossrefPubMedGoogle Scholar
  • 19 Yousuf S, Tubbs RS, Wartmann CT. et al. A review of the gross anatomy, functions, pathology, and clinical uses of the buccal fat pad. Surg Radiol Anat 2010; 32: 427-36
    CrossrefPubMedGoogle Scholar
  • 20 Kim JT, Sasidaran R. Buccal fat pad: an effective option for facial reconstruction and aesthetic augmentation. Aesthetic Plast Surg 2017; 41: 1362-74
    CrossrefPubMedGoogle Scholar
  • 21 Frisenda JL, Nassif PS. Correction of the lower face and neck. Facial Plast Surg 2018; 34: 480-7
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Wong CH, Mendelson B. Newer understanding of specific anatomic targets in the aging face as applied to injectables: aging changes in the craniofacial skeleton and facial ligaments.. Plast Reconstr Surg 2015; Nov 136 (Suppl. 05) 44S-48S
    CrossrefPubMedGoogle Scholar
  • 23 Doerr TD. Lipoplasty of the face and neck. Curr Opin Otolaryngol Head Neck Surg 2007; 15: 228-32
    CrossrefPubMedGoogle Scholar
  • 24 Wilson AJ, Taglienti AJ, Chang CS. et al. Current applications of facial volumization with fillers. Plast Reconstr Surg 2016; 137: 872e-889e
    CrossrefPubMedGoogle Scholar
  • 25 Chang CS, Kang GC. Achieving ideal lower face aesthetic contours: combination of tridimensional fat grafting to the chin with masseter botulinum toxin injection. Aesthet Surg J 2016; 36: 1093-100
    CrossrefPubMedGoogle Scholar