Cosmetic options have undergone a paradigm shift in the treatment of facial aging with a new emphasis being placed on prevention and less invasive approaches. The latest advancement in anti-ageing aesthetic procedures is all about gently lifting, smoothing and re-contouring facial features without surgery.
Today, the emphasis has moved from the correction of individual lines and folds to a whole face approach aimed at the replacement of volume lost through ageing, and the restoration of the youthful facial curves. This shift is from a two dimensional to a three dimensional approach using both a combination of muscle relaxation, recontouring and revolumisation with dermal fillers.
The midface region is one of the first areas of the face that ages. It is also one of the most important areas in conveying an overall look of youth and freshness to the face and facial attractiveness is largely founded on the synergy of the cheek bones, nose, eyes and lips.
These can be divided into three areas:
Upper face – The signs of aging are related to muscle contraction, the weakening of ligaments and the loss of subcutaneous fat pads. These areas include the forehead, brow, and upper eyelid areas. The results can be seen as supraorbital rims becoming more prominent, an increase in the appearance of the brow muscles and hollowing of the temporal area.
Midface – The signs of aging are related to bone loss, decrease in subcutaneous volume and the movement downwards of the fat pads. The results can be seen as buccal hollowing, decreased curvature of the cheek bone, the inferior portion of the eye muscles becoming more evident, worsening of the inferior eye fat pads leading to protrusion and the development of tear troughs, and the formation of nasojugal grooves from below the eye, down and laterally. These changes are not necessarily symmetrical.
Lower face – Due to the loss of volume and weakening of ligaments, we see excess skin and soft tissue accumulation near the jaw and chin leading to the formation of jowls. This is accentuated by the downward pull of the superficial neck muscles which also leads to laxity of the skin of the neck. In the perioral area, nasolabial folds develop and marionette lines form. The lips are especially vulnerable and may loose volume, shape and definition. There may be the formation of lines and wrinkles around the mouth along with the loss of support leading to drooping of the mouth corners.
When we look at the aesthetics of a face, we need to look at it as a whole unit. It is appropriate to address issues such as pigmentation and fine lines, however, without addressing volume loss, in the midface particularly, the patient may still look old. These days, we look at the three areas mentioned above and address any volume loss in that particular zone. An effective and natural looking way of rejuvenating the facial appearance is to replace the lost volume and restore the youthful contours of the face. The midface is one of the most important areas in facial rejuvenation and the one that makes the noticeable change in a person’s appearance or perceived age. When looking at this area, we start with restoration of the malar contour (cheek), resulting in an overall lifting effect which impacts on other areas such as the nasolabial folds, lifting of the lower face and smoothing of the tear troughs.
Following this, the remainder of the face is re-evaluated and other areas of concern are corrected. Correct placement of the filler is of utmost importance to achieve the desired result. The aging face is the result of the loss of multiple layers of soft tissue, so treatment needs to be aimed at revolumising multiple layers.
The combination of dermal fillers with anti-wrinkle injections can enhance the benefits by 50%.
Dermal fillers are now the choice for non-surgical revolumisation of the face. There is a range of fillers available with differing thickness and longevity of effect. This means that various fillers can be used in different areas of the face, depending on the type of correction needed and the volume that needs restoring.
During a consultation with Dr Joseph Beaini, he will assess your particular requirements, advise you on which fillers and which areas are best to treat. He will outline for you the amount of fillers required, the price, the side effects and the after-care required.
Treatment usually involves the use of an anaesthetic, either topical, injected or a dental nerve block to the area to be treated.
Treatment times vary depending on the amount of fillers required and the areas treated, but generally take from 30 to 60 minutes.
After treatment, it is possible to apply make-up if applicable, and to go about your normal activities. We usually ask you to refrain from heavy exercise however, as this may increase the chance of any bruising.
It is important to bear in mind that the overall treatment may take more than one session to get the best results. The first treatment lays the foundation for the subsequent treatments, and future treatments allow for any adjustments to be made. It is also important to understand that the first treatment session is the most detailed and requires most product to be used. Due to the longevity of some fillers, we aim to maintain these results with one or two visits a year for top up of product. In other words, a maintenance regime.
To minimise bruising, it is best to avoid anti-inflammatories such as Aspirin (unless for medical reasons) and Nurofen, green tea, garlic, ginkgo and other herbal products that may thin blood, a week or so prior to the procedure. Alcohol is also not a good idea on the day and should be kept to a minimum the day before. We also encourage our clients to commence arnica tablets a few days before treatment. Note: If you have a history of cold sores and the treatment area is around the mouth, then you should notify your treating doctor as filler treatment can cause cold sore flare ups. If this is the case, you may be required to take anti-viral medications prior to treatment to help prevent these flare ups.
The cost of dermal fillers and anti-wrinkle injections depends on the amount injected and the number of syringes injected per session. Each client is and individual and requires individual amounts and types of filler and muscle relaxants. This is assessed on consultation with the treating doctor. A treatment is mapped out for each client and the cost can be assessed at this time. This is based on a clients unique requirements and the result that is desired. Please note that the total unit price of treatment is discounted when multiple syringes of filler are used at a treatment session and the number of units used for anti-wrinkle injections.