Fillers: A Full-Face Approach for Facial Recontouring

The aging face presents a variety of intriguing challenges. More and more, these challenges are being met with injectable fillers, and an increasing variety of fillers populate the market.

At the outset, fillers were used primarily to address specific consequences of aging such as the deepening of the nasolabial folds, the prejowl sulcus, marionette lines and oral commissures.

While fillers met their objective of ameliorating deficits in specific areas, they increasingly are coming to be seen as having broader applications, including the noninvasive remodeling of the lower two-thirds of the older face.

As we age, the face becomes characterized by sagging skin and volume loss. Because skin laxity can result both from the intrinsic aging process as well as volume loss, a certain subjectivity is inherent in treatment considerations. Aging mechanisms of each specific patient may vary from one to the next. By analyzing the face as a whole, rather than isolated lines or wrinkles, today’s aesthetic physician can execute comprehensive treatment protocols to help return the aging face to the “triangle of beauty.”

One such comprehensive treatment protocol that has been effective in my practice has been the replacement of volume to reduce skin laxity arisen from weakened support. I employ a full face approach involving the use of Radiesse dermal filler to effect facial contouring that encompasses both skin surplus reduction and structural enhancement.

While we need to take a total face approach to recontouring, we can divide the face zones as a way to better understand how the face works and how skin laxity in different zones impacts each the other.

These are:

• the central zone involving the mouth and nose areas (relatively immobile),
• the paramedial zone involving the nasolabial folds and malar fat compartments (highest mobility),
• the lateral zone involving mainly the preauricular fossa (minimal mobility), and
• the zone of the ear concha (anchoring point).

Each zone is treated individual to achieve the best overall results for the whole face.