Br J Dermatol. The most common postinjection side effects are usually limited to 2 weeks and include erythema, ecchymosis, and edema. M. T. Villa, L. E. White, M. Alam, S. S. Yoo, and R. L. Walton, Barbed sutures: a review of the literature, Plastic and Reconstructive Surgery, vol. Aging of the human face is the result of both superficial textural wrinkling of the skin and changes in the 3-dimensional (3-D) topography of the underlying structures. It is the main mineral in human bones and teeth; therefore, it has good biocompatibility with the human body. With advancing age, progressive loss of facial fullness causes the subcutaneous fat deposits and underlying soft tissue and skeletal structures to become more evident (center); involutional exposure of fat deposits in the jowl and chin gives the impression of descent (right). 1, pp. 19, 2007. However, facial muscle exercises have limited effects in restoring muscle tension [24]. Before 8 Proven Ways to Prevent Wrinkles What causes wrinkles? 9197, 2007. Rare complications of these injections include palpable vascular occlusion and nodules. Der Hautarzt; Zeitschrift fr Dermatologie, Venerologie, und verwandte Gebiete. The incidence of nerve damage is lower than that of conventional debridement (0.7%2.5%) [128]. 140, no. The main collagen injectable products include bovine, human, and pig collagen products of different concentrations. eCollection 2023. S. Xiong, C. Yi, and L. L. Q. Pu, An overview of principles and new techniques for facial fat grafting, Clinics in Plastic Surgery, vol. This evidence-based paper aims to provide a comprehensive overview of the latest research on the etiology and progression of facial aging by explaining the aging process from the "inside. [58] Additionally, it is now more commonly used to stimulate collagen production within the facial skin to improve the quality of the skin [59]. Its safety is similar to that of hyaluronic acid or calcium hydroxyapatite [115]. R. J. Rohrich and J. E. Pessa, The fat compartments of the face: anatomy and clinical implications for cosmetic surgery, Plastic and Reconstructive Surgery, vol. 3, pp. Research shows that regular facial massages widen blood vessels and blood flow response. PLLA microparticles are large enough to avoid phagocytosis and immediately result in subclinical foreign body inflammation, which leads to encapsulation of the microparticles, fibrous tissue hyperplasia, and type I collagen deposition in the extracellular matrix to achieve the esthetic effect of filling. Compared with traditional facial cosmetic surgery, nonsurgical modalities results in more natural, nonstiff, and smoother results with very small trauma and significantly shorter recovery, therefore its preference by patients [2]. Dermal and subcutaneous fillers, used either alone or as an adjunct to surgical and nonsurgical facial rejuvenation techniques, are a logical and effective treatment choice for lifting and filling the facial soft tissues. J. L. Cohen, Understanding, avoiding, and managing dermal filler complications, Dermatologic Surgery, vol. The applicable parts include the zygomatic and cheek depressions, lower facial relaxation and fold, lower orbital depression, neck lines (venus chain), and hands. The filling layer of PMMA is either the deep dermis or subcutaneous space. Facial Plast Surg Clin North Am. 2010 Oct;32(5):330-9. doi: 10.1111/j.1468-2494.2010.00574.x. 1, pp. Collagen is an excellent coagulant with hemostatic effects, does not easily diffuse distally, and does not easily embolize (does not mean that it will not embolize). Autologous fat has many properties of an ideal filler and can be removed when necessary [107]. After 1-2 weeks of injection, collagen begins to mix with the hosts collagen and is gradually absorbed and degraded by the skin tissue, making the skin feel increasingly natural. Finally, we appreciate the authors valuable overview of the aging process. Sydney Coleman receives royalties from Byron Medical and is an unpaid consultant for Medicis; he has no financial interest in Q-Med. Additionally, injections should be avoided at sites of inflammation [12]. As this fullness between the muscles and the skin disappears with age, the intrinsic tone of the glabellar, procerus, and frontalis muscles gives rise to fixed wrinkles or folds. The face is a cosmetically sensitive region where the process of ageing is most clearly manifested. Aesthetic Plast Surg. Early collagen was derived from bovine or human cadavers, which are species-specific and tissue-specific. 189e196e, 2019. 2, pp. A. Rivkin, A prospective study of non-surgical primary rhinoplasty using a polymethylmethacrylate injectable implant, Dermatologic Surgery, vol. PLLA particles are metabolized by the same metabolic pathway as that of lactic acid; they reduce by 6%, 32%, and 58% at 1, 3, and 6 months, respectively, and degrade completely by approximately 9 months [66]. [126]. N. Semchyshyn and R. D. Sengelmann, Botulinum toxin A treatment of perioral rhytides, Dermatologic Surgery, vol. S. R. Coleman and E. B. Katzel, Fat grafting for facial filling and regeneration, Clinics in Plastic Surgery, vol. Michael B Silberberg Published 16 December 2020 Medicine Aesthetic Surgery Journal Abstract The normal course of aging alters the harmonious, symmetrical, and balanced facial features found in youth, not only impacting physical attractiveness but also influencing self-esteem and causing miscommunication of affect based on facial miscues. A. Woodward, Analysis of the anatomic changes of the aging facial skeleton using computer-assisted tomography, Ophthalmic Plastic and Reconstructive Surgery, vol. Common complications are generally mild and mostly resolve spontaneously. 6. Miyamoto K, Inoue Y, Yan X, Yagi S, Suda S, Furue M. J Clin Med. Fine lines and wrinkles. The .gov means its official. A total of 65 papers met inclusion criteria for analysis. The site is secure. The shallow fat tissue of the forehead and the orbital and perioral fat also undergo atrophy [15]. official website and that any information you provide is encrypted Such hyaluronic acid may contain very small amounts of bacterial proteins, which may also trigger an allergic reaction [84, 85]. Would you like email updates of new search results? Conclusion: The ageing process is unique to the individual and depends on the interplay between an individual's genetics and external environmental factors. H. Pereira, D. A. Sousa, A. Cunha et al., Hyaluronic acid, Osteochondral Tissue Engineering, vol. 813820, 2020. Makrantonaki E, Zouboulis C. Molecular etiology of skin aging. Reproduced with permission from Coleman, 2004.6. 5, pp. Nasal reconstruction with the expanded forehead flap: Long-term follow-up of esthetic outcome and 12-year experience. RSULTATS: Un total de 65 articles rpondait aux critres d'inclusion pour l'analyse. In youth, the subcutaneous fullness of the forehead conceals the muscles of facial expression in this region. 2, pp. [103] examined 1000 patients who were injected with calcium hydroxyapatite and noted only minor side effects of bruising, redness, and itching. The commonest complication of autologous fat injections is fat necrosis that may be accompanied with hematoma and infection. Rocha Mota L, Motta LJ, Duarte IDS, Horliana ACRT, Silva DFTD, Pavani C. BMJ Open. 22, no. Marisa Sobotka. Rarely, advanced granuloma and tissue necrosis may also occur; the former occurs due to an allergic reaction to bovine collagen and PMMA, and the latter is mainly due to intravascular fillers or excessive compression of the surrounding blood vessels [116]. It should be noted that volume loss from deep fat compartments, or increasing severity of nasolabial folds, is also associated with midface volume loss. Lipotransfer is a very safe facial filler, and several trials have demonstrated that this method results in a good prognosis with few complications [114]. The cones are arranged in the opposite direction, and the tip of the cone points to the end of the suture. Epub 2023 Apr 11. da Cunha ALG, Vasconcelos R, Di Sessa D, Sampaio G, Ramalhoto P, Zampieri BF, Deus BS, Vasconcelos S, Bellote T, Carvalho J, Petrone G, Figueredo V, Limongi Moreira G. Clin Cosmet Investig Dermatol. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. However, by understanding the process from the perspective of different specialties, each physician may better treat the spectrum of facial aging. The most common complications are the same as those with most logical surgical procedures, such as pain, swelling, and bruising. 45, no. Int J Cosmet Sci. 599614, 2014. 1059, pp. Most of the changes that occur with aging in the nose take place in the glabella, nasion, and medial eyelid. It differs from other glycosaminoglycans as it lacks sulfated groups and covalently linked peptides [75]. There are several signs of aging on the face. 40, no. Federal government websites often end in .gov or .mil. For example, the most important complications in the glabellar complex and forehead area are drooping of the upper eyelid and eyebrows. However, the data available on its use as an intradermal filler are scarce, and none are available in dermatological practice from the US. All authors critically revised the manuscript for important intellectual content. Different sides of the face can age differently, and such a phenomenon happens frequently. 26, no. 7, pp. eCollection 2023. Porcine collagen is biodegradable and lasts for approximately 1 year in soft tissues. Moreover, the authors attributed aging to volume loss in different areas of the face. 12, pp. Facial fat is divided into superficial fat and deep fat by the superficial fascia system (Figure 1) [11]. Porcine collagen is biodegradable and lasts for approximately 1 year in soft tissues. With the increase of age, the change of fat interval position leads to the change of adipose tissue contour [13]. 13781382, 2018. Each of temporal, midface, and submalar areas received two vials of Sculptra [, (a) Nasolabial fold fine lines and glabellar lines before collagen injection. 144, no. The reduction of fat in this area can also be a cause of thinning of the temples, which results in an emaciated look [40]. As a Facial Plastic & Reconstructive Surgeon, Dr. Nassif understands the layers of the skin and the skin aging process from the inside out. M. A. Sulamanidze, P. F. Fournier, T. G. Paikidze, and G. M. Sulamanidze, Removal of facial soft tissue ptosis with special threads, Dermatologic Surgery, vol. Le visage est une zone du corps esthtiquement importante o le processus de vieillissement se manifeste particulirement clairement. 7, pp. With aging, the skin envelope, Superficial temporal compartment: volume and, Superficial temporal compartment: volume and size by age group. PMC E. Rostan, Collagen fillers, Facial Plastic Surgery Clinics of North America, vol. 2129, 2001. What you can do. This previously unpublished, new illustration was created by Allergan Aesthetics, an AbbVie Company (Irvine, CA) who granted permission to publish it. Autologous collagen has a low risk of hypersensitivity and is relatively safe [67]. If hyaluronic acid is carelessly injected into a blood vessel, it may lead to necrosis, delayed reticular erythema, and pain in distant skin [98]. Meanwhile, the round, smooth PMMA microspheres are wrapped in the connective tissues of the host and are not degraded or excreted, thus becoming stable, permanent, and irreversible [115]. J. F. Scheuer 3rd, D. A. Sieber, R. A. Pezeshk, C. F. Campbell, A. 27, no. doi: 10.1093/asjof/ojad016. 50e58e, 2017. 27, no. 2, pp. Dr. Coleman is Assistant Professor of Plastic Surgery in the Department of Surgery at New York University School of Medicine, New York, NY. Multiple microinjections which are no more than 1mL are preferable over a single injection [107]. 253257, 2019. Generally, a combination of such treatments can produce better results. Although hydroxyapatite calcium has become the second most popular filling agent after hyaluronic acid due to its short marketing time and good biocompatibility with the human body, its use is limited to the lacrimal groove area of the lip and the lower orbital margin. Aging of the female face, as represented by models representing an individual at 20 years of age (left), 50 years (center), and 75 years (right). 31 Citations Citation Type More Filters Essential Surgical Anatomy for Facelift S. Uppal Medicine Facial Plastic Surgery 2022 TLDR The various layers of the face and neck affected by ageing are described, including the fat compartments, superficial musculoaponeurotic system (SMAS), potential facial spaces, facial ligaments, and facial nerve. 75, no. J. Sykes, V. Tapias, and L. Pu, Autologous fat grafting viability: lower third of the face, Facial Plastic Surgery, vol. Sydney Coleman, MD, 44 Hudson Street, New York, NY 10013. 2, pp. Unable to load your collection due to an error, Unable to load your delegates due to an error. 30s or earlier. 23, no. , Liew S, Weinkle S, Garcia JK, Silberberg MB. There are two main sources of hyaluronic acid used in facial injections: animal-derived and non-animal-derived sources. [123] described the procedure as making a small incision in the temporary temple and drawing out several sutures under the skin. With aging, the skin envelope deteriorates faster than the muscle strength, leading to the orbicularis oris overwhelming the perioral skin. Hyaluronic acid is injected into the forehead where it fuses with the pre-existing hyaluronic acid, thus producing a skin swelling and forehead augmentation effect [89]. The next generation, Plastic Surgical Nursing, vol. Certain people may develop allergic reactions; therefore, skin tests must be performed before its use. 19, no. In addition, the changes in facial muscles may also be a result of adaptation in response to the changes in facial ligaments and bones [13]. A general overview of the changes occurring within each of the main layers of the facial anatomy is presented, including facial skeleton remodeling, fat pad atrophy or repositioning, changes in muscle tone and thickness, and weakening and thinning of the skin. In profile, the primary arc of the cheek is broken, the mandibular arc is replaced by a jowl line, and the forehead and brow lose their anterior projection. R. J. Rohrich, A. Ghavami, and M. A. Crosby, The role of hyaluronic acid fillers (Restylane) in facial cosmetic surgery: review and technical considerations, Plastic and Reconstructive Surgery, vol. Les altrations combines des voies intrinsque et extrinsque entranent des rides, une laxit plus importante, un relchement et un amincissement de la peau. Lambros2 investigated the validation of 3-dimensional (3D) visual models of facial aging and how to apply these 3D models to the relationships between facial parameters. 2, pp. With progressively increasing skin laxity, depletion of malar and perioral fat deposits, and resorption of alveolar bone, a relative excess of skin occurs in the aging lower face, leading to loss of definition of the jawline.