The New Paradigm in Facial Rejuvenation: Soft Tissue Fillers 2015









Corey S. Maas, MD, FACS, Editor
The history of cosmetic injections has seen dramatic swings in acceptance, application, and use. From the reports of fat injection by Peer in the 1950s, to nearly 20 years of exclusivity of bovine and subsequently human collagen, to our current market including a palette of molecules and materials for injection, providers in esthetics are now challenged to provide the correct product for each indication in each individual. That, remarkably, is a new paradigm. These are the primary categories for contemporary use of cosmetic injections: volume enhancement or replacement, enhancement of certain beauty features (eg, lips, chin, nose), and the softening of sharp transitions that result from aging. The latter is often thought of as the primary use of cosmetic injectable fillers as reflected in the common FDA approval pathway of nasolabial region softening of the cheek-lip transition zone, although this applies to many areas such as the labiomandibular groove and sulcus, suborbital grooves, and hollows commonly referred to as the tear trough depression and the orbital malar groove, and the genio mandibular sulcus.


It is clear from social observation, however, that the use of these products in many cases has “gone too far” with extraordinary posttreatment lip morphology and overly bloated-looking faces that do greater harm than benefit to the patient, the physician and specialty reputation, and ultimately, the products. Industry, professional societies, and responsible thought-leaders have a duty to collaborate and bring clear standards of care to the forefront that focus on beauty and restoration that are natural and complimentary to the diverse population of patients being treated. The directive of each of the authors in this issue was to bring their unique and expert perspective to both the outstanding potential for proper use of cosmetic injectable materials and the sad reality of what appears to be at least a decade of overinflated faces and in many cases facial features that are disproportionate to the point of deformity. Clearly, a balance is needed in treating the face, hands, and other areas of potential indication between restoring volume and managing the skin envelope. The advances in nonsurgical skin tightening have provided some tools for these purposes, and thoughtful practitioners provide or refer for surgical restoration of the skin envelope. Surgical implants, skin repositioning, and feature balancing remain integral to the paradigm with thoughtful use of cosmetic injection as described by our expert authors. I would like to extend a special thanks to each of them and to Steven L. Basta for providing an industry perspective on this rapidly expanding service line. Beauty is our business. Natural beauty should be the goal.

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Feb 8, 2017 | Posted by in General Surgery | Comments Off on The New Paradigm in Facial Rejuvenation: Soft Tissue Fillers 2015

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