Filling the Midface: Injectables

Abstract

Volumizing the face has become commonplace on the facial aesthetic scene, with a rapid explosion of popularity in the field of nonsurgical rejuvenation. Three-dimensional enhancement of the midface with fillers provides the surgeon with a minimal downtime opportunity to treat early aging or reverse nonsurgical volume loss. With new products come advancements in techniques and the understanding of reversal of the effects of aging. While providing minimal downtime and risk, complications can occur and the physician must be able to recognize and treat these issues. It is crucial for the injector to understand and process these factors to ensure patient satisfaction and safety.

Keywords

injectables - midface volume - tear trough hollow - hyaluronic acid

• References

• 1 Shaw Jr RB, Katzel EB, Koltz PF, Kahn DM, Puzas EJ, Langstein HN. Facial bone density: effects of aging and impact on facial rejuvenation. Aesthet Surg J 2012; 32 (8) 937-942
• 2 Kahn DM, Shaw RB. Overview of current thoughts on facial volume and aging. Facial Plast Surg 2010; 26 (5) 350-355
• 3 Biskupiak J, Sclafani AP. Economic analysis of “liquid” versus surgical face-lift: are large-volume facial soft tissue filler injection treatments a viable alternative to rhytidectomy?. Facial Plast Surg 2010; 26 (4) 296-302
• 4 American Society of Aesthetic Plastic Surg. Cosmetic Surgery National Data Bank Statistics. 2009 . Available at: http://asaps.org/sites/default/files/2009stats.pdf
• 5 American Society of Aesthetic Plastic Surg. Cosmetic Surgery National Data Bank Statistics. 2015 . Available at: http://asaps.org/sites/default/files/2015stats.pdf
• 6 Sherman RN. Global volumetric assessment and three-dimensional enhancement of the face with injectable poly-L-lactic acid. J Clin Aesthet Dermatol 2010; 3 (8) 27-33
• 7 Levy RM, Redbord KP, Hanke CW. Treatment of HIV lipoatrophy and lipoatrophy of aging with poly-L-lactic acid: a prospective 3-year follow-up study. J Am Acad Dermatol 2008; 59 (6) 923-933
• 8 American Society of Aesthetic Plastic Surg. Cosmetic Surgery National Data Bank Statistics. 2010 . Available at: http://asaps.org/sites/default/files/2010stats.pdf
• 9 Latha MS, Vijayammal PL, Kurup PA. Changes in the glycosaminoglycans and glycoproteins in the tissues in rats exposed to cigarette smoke. Atherosclerosis 1991; 86 (1) 49-54
• 10 Kurdykowski S, Mine S, Bardey V , et al. Ultraviolet-B irradiation induces differential regulations of hyaluronidase expression and activity in normal human keratinocytes. Photochem Photobiol 2011; 87 (5) 1105-1112
• 11 Few J, Cox SE, Paradkar-Mitragotri D, Murphy DK. A multicenter, single-blind randomized, controlled study of a volumizing hyaluronic acid filler for midface volume deficit: patient-reported outcomes at 2 years. Aesthet Surg J 2015; 35 (5) 589-599
• 12 Stelnicki EJ, Ousterhout DK. Hydroxyapatite paste (BoneSource) used as an onlay implant for supraorbital and malar augmentation. J Craniofac Surg 1997; 8 (5) 367-372
• 13 Gatherwright JR, Brown MS, Katira KM, Rowe DJ. Three-dimensional changes in the midface following malar calcium hydroxyapatite injection in a cadaver. Aesthet Surg J 2015; 35 (6) NP169-NP175
• 14 Moers-Carpi M, Storck R, Howell DJ, Ogilvie P, Ogilvie A. Physician and patient satisfaction after use of calcium hydroxylapatite for cheek augmentation. Dermatol Surg 2012; 38 (7 Pt 2): 1217-1222
• 15 Tan M, Kontis TC. Midface volumization with injectable fillers. Facial Plast Surg Clin North Am 2015; 23 (2) 233-242
• 16 Palm MD. Filler frontier: what's new and heading West to the US market. Semin Cutan Med Surg 2014; 33 (4) 157-163
• 17 Hexsel D, Soirefmann M, Porto MD, Siega C, Schilling-Souza J, Brum C. Double-blind, randomized, controlled clinical trial to compare safety and efficacy of a metallic cannula with that of a standard needle for soft tissue augmentation of the nasolabial folds. Dermatol Surg 2012; 38 (2) 207-214
• 18 Beer KR. Safety and effectiveness of injection of calcium hydroxylapatite via blunt cannula compared to injection by needle for correction of nasolabial folds. J Cosmet Dermatol 2014; 13 (4) 288-296
• 19 DeJoseph LM. Cannulas for facial filler placement. Facial Plast Surg Clin North Am 2012; 20 (2) 215-220 , vi–vii
• 20 Jones D, Murphy DK. Volumizing hyaluronic acid filler for midface volume deficit: 2-year results from a pivotal single-blind randomized controlled study. Dermatol Surg 2013; 39 (11) 1602-1612
• 21 Beleznay K, Carruthers JD, Humphrey S, Jones D. Avoiding and treating blindness from fillers: a review of the world literature. Dermatol Surg 2015; 41 (10) 1097-1117
• 22 DeLorenzi C. Transarterial degradation of hyaluronic acid filler by hyaluronidase. Dermatol Surg 2014; 40 (8) 832-841
• 23 Sperling B, Bachmann F, Hartmann V, Erdmann R, Wiest L, Rzany B. The current state of treatment of adverse reactions to injectable fillers. Dermatol Surg 2010; 36 (Suppl. 03) 1895-1904
• 24 Meier JD, Glasgold RA, Glasgold MJ. Autologous fat grafting: long-term evidence of its efficacy in midfacial rejuvenation. Arch Facial Plast Surg 2009; 11 (1) 24-28
• 25 Jacono AA, Malone MH, Talei B. Three-dimensional analysis of long-term midface volume change after vertical vector deep-plane rhytidectomy. Aesthet Surg J 2015; 35 (5) 491-503
• 26 Gerth DJ, King B, Rabach L, Glasgold RA, Glasgold MJ. Long-term volumetric retention of autologous fat grafting processed with closed-membrane filtration. Aesthet Surg J 2014; 34 (7) 985-994