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Clinical case of a patient with an oval face shape treated with the AB face technique to structure the face into a more angular shape. Hydryalix ultradeep hyaluronic acid with high elasticity was used in the following areas: malar lateral (0.8 mL), malar prominence (0.8 mL), zygoma medial (0.8 mL), zygoma lateral (0.6 mL), mental (0.8 mL), prejowl (1.2 mL) (total: 5 mL; four syringes). Harmonyca, two syringes of 1.25 mL was used in the jawline (1.25 mL) and ramus (1.25 mL). The refinement technique was performed with Hydryalix deep, with medium elasticity, 1.25 mL in the nasolabial and labiomental folds. Total volume used: 8.75 mL.
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Introduction The facial beauty is not easy to define, yet it is paramount to assess the needs of each patient to propose an appropriate treatment plan that will provide beautification or rejuvenation in a natural-looking fashion.
One of the beauty aspects easily recognized is the face shape, which can give a perception of age, gender, and attractiv...
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Objectives: The amount of dermal filler procedures is increasing. Some patients opt to undergo dermal fillers instead of orthognathic surgery to treat unesthetic complaints from dentofacial deformities. The aim of this work is to carry out a literature review with regard to a comparison of role and limitations between aesthetic indications of ortho...
Citations
... However, prior to surgical treatment, a comprehensive clinical evaluation must be performed, which includes the determination of facial type. Evaluation of facial type is essential because it entails the formulation of a treatment plan 10 . ...
Any deviation from normal facial proportions and dental relationships is referred to as a dentofacial deformity. This deformity frequently manifests a complex disorder known as dysgnathia, which necessitates a combination of orthodontics and surgery known as orthognathic surgery to correct. After surgery, alterations in the position of the underlying skeletal bones can affect the facial soft tissues. These alterations have an effect on the facial profile of the patient, making the prediction of the patient's facial profile a crucial step in planning orthognathic surgical treatment. The purpose of this study is to obtain direction on standard profile angle measurements in the Chinese and Deutro-Malayid populations in Surabaya in order to perform surgery in the maxillofacial region that can result in changes in profile angle measurements. Data was collected from 100 Surabaya residents who meet the research criteria. Statistical calculations using the Hotelling's Trace test on ANOVA test results between the Chinese and Deutro-Malayid populations in Surabaya obtained p=0.363 (p>0.05). There was only a significant difference in the submental-neck angle among other variables, with p=0.041 (p<0.05). No significant differences in profile angles were found between the Chinese and Deutro-Malayid populations in Surabaya.
... 14,16 Prior clinical experience exhibited favorable outcomes regarding the use of this novel injectable filler for mid and lower-face rejuvenation. 17,18 Although theoretically neocollagenesis is expected at treated areas following its injection, to our knowledge, patient satisfaction and changes in dermal thickness after a single session of HArmonyCa have not been previously published. Therefore, these are the major goals of this study. ...
Unlabelled:
Hyaluronic acid filler injections are regarded as the gold standard procedure for facial rejuvenation. Standing as the second most injected cosmetic filler, calcium hydroxyapatite-based fillers are also widely used worldwide. However, to our knowledge, prospective studies assessing patient satisfaction and sonographic changes in dermal thickness after a single session of a hybrid filler combining hyaluronic acid and calcium hydroxyapatite have not been previously published.
Methods:
This was a single-center, prospective, quasi-experimental study comprising 15 participants between 32 and 63 years of age. Each participant received a single-session treatment based on facial subcutaneous injections of HArmonyCa, a hybrid combination filler comprising hyaluronic acid and calcium hydroxyapatite. This study involved an intrapatient control design and a 120-day follow-up with clinical and sonographic assessment. For this purpose, standardized photographic images, high-frequency ultrasound evaluations, and physician- and patient-oriented overall aesthetic improvement scores were recorded at 0, 30, 90, and 120 following the procedure.
Results:
According to our findings, 20% of the subjects had an exceptional improvement; 20%, "very improved"; and 60%, "improved." Intrapatient sonographic comparison showed a significant increase in dermal thickness, at 90 and 120 days, only on the side treated (P < 0.001).
Conclusion:
In our clinical study, a single-session treatment with a hybrid product combining hyaluronic acid and calcium hydroxyapatite resulted in positive cosmetic satisfaction and increased dermal thickness.
... Bravo et al, Braz and Eduardo, and Wong used HA dermal fillers in periorbital rejuvenation in their study. [16][17][18] There are few studies about HA-AA mixture application. Therefore, we evaluated the effectiveness of both HA and AA in the periorbital area. ...
Purpose
We performed an assessment of the rejuvenation effect of an amino acid and hyaluronic acid mixture in the periorbital area.
Methods
A total of 23 of the 35 participants completed all application sessions and measurements. These 23 women were aged 30–55 years. A hyaluronic acid and amino acid mixture was injected into the participants’ periorbital area. Three sessions of application with 15-day intervals were undertaken. Subjects’ age, height, weight, smoking status, and sport participation were recorded. A photonumeric dark circle scale and Fitzpatrick’s periorbital wrinkling classification were used for evaluation of dark circles and wrinkles in the periorbital area. Anatomical measurements (height of upper and lower eyelids) were done using ImageJ and a skin-analysis system (Observ 520).
Results
The 23 women had a mean age of 42.46±9.33 years, mean height 164.46±4.96 cm, and mean weight 63.94±8.26 kg. Before the sessions, the mean heights of the upper eyelids were 1.24±013 cm (right) and 1.21±013 cm (left), while those of the lower eyelids were 0.98±014 cm (right) and 0.97±0.17 cm (left). One month after the third session, mean upper-eyelid heights were 1.30±0.09 cm (right) and 1.28±0.11 cm (left) and lower-eyelid ones 1.02±0.11 cm (right) and 1.02±0.13 cm (left). Dark-circle and wrinkle-scale scores showed significantly positive results between before the sessions and 1 month after the third session.
Conclusion
A hyaluronic acid and amino acid mixture can be used to rejuvenation of the periorbital area in women aged 30–55 years.
... O uso de toxina botulínica e preenchedores faciais para tratamentos estéticos tem crescido nos últimos anos. Atualmente, procedimentos como correção de sorriso gengival (POLO, 2008;MAZZUCO e HEXSEL, 2010;CHAGAS et al., 2018;CENGIZ et al., 2020), redução de hipertrofia de músculos da mastigação para evitar recidivas em tratamentos ortodôntico/cirúrgico (SEOK et al., 2013;PARK et al, 2015;MUCKE et al., 2016;SHIN et al., 2018), correção de assimetrias e contornos faciais em pacientes padrão II ou III (BRAZ et al., 2020a;MASTROLUCA et al., 2021;DALL'MAGRO et al., 2021) entre outros, tem sido incorporados nas indicações de tratamento com esses materiais. Entretanto, essas indicações são bem específicas e devem ser analisadas com critério para um planejamento individualizado (MASTROLUCA et al., 2021). ...
Este e-book apresenta uma coletânea de estudos que visam aprofundar os conhecimentos na área de Odontologia nas suas mais diversas especialidades: Cirurgia Oral, Dentística, Odontopediatria, Ortodontia, Periodontia e Saúde Coletiva. Os conteúdos abordados focam em uma Odontologia baseada em evidências científicas e que proporcionam uma reflexão da teoria e da prática clínica atual.
... [16][17][18][19] Dermal fillers are used for facial contouring and enhancement. [20][21][22] Newer injectables including deoxycholic acid (ie, Kybella; Allergan, Irvine, CA) can aid in lower face and neck contouring. [23][24][25] Sculptra (Sanofi, Paris, France) is another injectable product which uses poly-l-lactic acid to stimulate collagen to treat deep facial wrinkles and folds, similar to, but distinct from, facial fillers. ...
Background
Over the last two decades, both invasive and minimally-invasive aesthetic procedures have proliferated. Aesthetic surgeons often recommend injectable treatments after cosmetic facial surgery for multiple reasons. Yet, literature is lacking on how cosmetic surgery affects post-operative facial injectable use.
Objectives
The authors aim to identify predictors of facial injectable use after cosmetic facial surgery.
Methods
All adult patients operated on by a single surgeon between 2013 and 2021 were retrospectively reviewed. Patients who had any of the following cosmetic facial surgeries were included: rhytidectomy, blepharoplasty, rhinoplasty, or genioplasty. Patient demographics, clinical history, intraoperative factors, and use of cosmetic facial injectables (neurotoxin, facial fillers, deoxycholic acid, poly-L-lactic acid) were recorded.
Results
A total of 227 patients who underwent facial cosmetic surgery were reviewed, of which 158 were included. 89 patients had rhytidectomy (56.3%), 112 had blepharoplasty (70.9%), 28 had rhinoplasty (17.7%), and 7 had genioplasty (4.4%). 44.3% patients received injectables after their surgery (n=73), compared to only 17.7% before surgery (n=28) (p<0.001). The most common post-operative injectables were neurotoxins (48.5%) and facial fillers (46.0%), followed by deoxycholic acid (2.7%) and poly-L-lactic acid (2.7%). Multivariate regression revealed factors positively correlated with future injectable use were index blepharoplasty or rhinoplasty, and history of pre-operative neurotoxin injection (p<0.05).
Conclusions
Cosmetic facial injectables are an important consideration in achieving and maintaining optimal facial aesthetics. Their use, especially neurotoxins and facial fillers, increases among patients post-operatively. These results highlight the contribution of injectable procedures in the context of multidimensional care for augmenting facial aesthetics.
... It comprises of two steps, the AB structure based on the facial shape which improves the contours and AB refinement aimed to blend and smooth the injected areas. [18] The Sebban Technique One-point (STOP) Facial Aging Method TM is a protocol for facial rejuvenation using HA fillers, a single entry point and a dual plane of injection combining the deep one-point (DOP) and superficial onepoint (SOP) techniques targeting the deep and superficial planes, respectively [ Figure 1]. [19] Mauricio de Maio published the medical codes (MD) TM recently, which provide a uniform symbolic language and reduce the variability in the approach for facial filler injections. ...
Dermal fillers are a cornerstone of the aesthetic treatments of the face. They have evolved over many aspects since their initial use. Facial fillers are not just used for anti-aging to restore volume, but are now also used for contouring, enhancing facial features, and changing the emotional attributes of the face. Newer techniques and approaches have been proposed for greater predictability of results and minimum complications. Newer composite filler materials and a resurgence of older materials have taken place with better understanding of the science behind them. With more use of facial fillers comes the reporting of newer complications with recommendations and guidelines to avoid them. A new perspective is seen in guidelines for their use in the COVID-19 pandemic. This article is a review of the insight into the latest perspectives of facial fillers for aesthetic indications.
Esta revisão narrativa objetivou atualizar a comunidade acadêmica sobre o uso da toxina botulínica e do ácido hialurônico na harmonização orofacial. Teve como questão norteadora “O que há de atual sobre a aplicabilidade do ácido hialurônico e da toxina botulínica na Harmonização Orofacial?”. As estratégias de busca foram estruturadas a partir de DeCS/MeSHterms e para a seleção dos artigos foram usadas as palavras-chave: “orofacial harmonization”, “botulinum toxins”, “hyaluronic acid” nas bases de dados MEDLINE/PubMed, SciElo e Google Academic. A mesma estratégia de busca foi aplicada na busca manual. E, após avaliação dos artigos recuperados, na luz dos critérios de elegibilidade resultou em 29, onde pode-se concluir que ambos os produtos apresentam biocompatibilidade versatilidade e excelência nos resultados, características que ratificam a indicação na harmonização facial, e o reestabelecer da autoestima e jovialidade ao paciente.
Background:
Several elements, including age, influence judgments of beauty and attractiveness. Aging is affected by intrinsic factors (e.g., genetics, race/ethnicity, anatomical variations) and extrinsic factors (e.g., lifestyle, environment).
Aims:
To provide a general overview of minimally invasive injectable procedures for facial beautification and rejuvenation to meet the aesthetic goals of patients across their lifespan, organized by decade.
Methods:
This case study review describes aesthetic considerations of females in their third to sixth decade of life (i.e., 20-60 years of age or beyond). Each case study reports the treatments, specifically botulinum toxin type A and soft tissue fillers, used to address aesthetic concerns.
Results:
Signs of aging, as well as aesthetic goals and motivations, vary by age groups, cultures, and races/ethnicities. However, there are overarching themes that are associated with each decade of life, such as changes in overall facial shape and specific facial regions, which can be used as a starting point for aesthetic treatment planning. Appropriate patient selection, thorough aesthetic evaluation, product knowledge, and injection technique, as well as good physician-patient communication, are essential for optimal treatment outcomes.
Conclusions:
Nonsurgical facial injectable treatments can successfully enhance and rejuvenate facial features across different age ranges. A comprehensive understanding of facial aging and the aesthetic considerations of patients by the decade contributes to optimal treatment planning and maintenance.
Objective:
Facial aging is a complex process that involves genetic, biological, and environmental factors. This paper aimed to present the first aesthetic and safety outcomes of a hybrid filler that combines hyaluronic acid (HA) (20 mg/mL) and calcium hydroxyapatite (HA/CaHa).
Methods:
Prospective and non-randomized interventional study conducted on consecutive healthy patients who attended the clinic for an aesthetic facial rejuvenation procedure. HA/CaHa was injected with 23G cannula (retrograde threads, 1.25 mL per side) in the preauricular region. Ultrasound examinations, elastography images, and 2D and 3D photographs were performed before and after treatment. The primary endpoint were the volumetric changes at Day 180.
Results:
Fifteen patients were included in the study. At Day 180 after treatment, median (interquartile-range) volume increased by 2.1 (1.9-2.3) cc and 2.1 (1.8-2.2) cc in the right- and left-side, respectively, p < 0.0001 each. As compared to pretreatment values, facial-tension vectors significantly increased by 2.2 (1.6-2.2) mm and 2.0 (1.7-2.2) mm in the right and left side, respectively, p < 0.0001 each. Elastography images demonstrated an increase in collagen fibers at post-treatment Day 60, which was confirmed on Day 90, and reached the peak effect between Days 90 and 180. Regarding safety, there were no either unexpected or serious treatment-related adverse events. Most patients experienced a mild redness and inflammation that resolved within the first 48 h without treatment.
Conclusions:
The HA/CaHa hybrid filler (HArmonyCa™), besides its volumizing and lifting properties, was associated with an increase in the viscoelasticity, both at the level of the reticular dermis and the subcutaneous cellular tissue, which might be indicative of the formation of new collagen fibers.
Purpose
To validate an already published facial anteroposterior reference: Upper Incisor (UI) to Soft Tissue Plane or so-called Barcelona line (BL) to trace the most aesthetic sagittal position of the maxilla.
Material and Methods
A cross-sectional multicentre evaluation of Caucasian patients from Spain and Brazil with different anteroposterior maxillary positions was designed. Sagittal images in Natural Head Orientation of grouped patients according to the horizontal distance from the UI to BL were ranked by healthcares and non-professional Caucasian raters according to the aesthetic perception of each profile, using a digital survey.
Results
Seventy-four raters (50 laypeople, 12 orthodontists and 12 maxillofacial surgeons) rated 40 profiles. The best-rated profile corresponded to group 3 (0-4 mm UI-BL) with 61.8% of positive evaluations, followed by group 4 (≥ 4 mm UI-BL): with 61.1%. On the other hand, group 1 (≤ -4 mm UI-BL) was the worst-ranked profile with 71.8% of negative evaluations, followed by group 2 (-4-0 mm UI-BL): with 59.6% of negative evaluations. The correlation between the mean assessment score and UI-BL showed a moderately-strong association (r=0.68, p<0.001). The inter-rater reliability of assessment (74 evaluators) was moderate (k=0.49, 95% CI: 0.39-0.59).
Conclusion
The results suggest that protrusive middle-third facial profiles are preferable. The BL is proposed as a simple, individualized, and reproducible tool to trace an aesthetic sagittal position of the maxilla in orthognathic surgery.
