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Facial aging results from a combination of changes that involve the skin (eg, wrinkling, dyspigmentation, and vascular changes) and underlying tissues. A progressive loss of tissue volume due to the atrophy and displacement of subcutaneous fat, as well as a reduction in structural support due to bone atrophy, contribute significantly to facial aging.

Soft tissue fillers can be used to restore a semblance of youth through the replacement of lost tissue volume and the filling and effacement of coarse wrinkles. Examples of age-related features that may be treated with soft tissue fillers include:

Upper face

  • Glabellar lines – Deep vertical lines in the glabellar area form as a result of repetitive contraction of the muscles that mediate brow depression. Soft tissue fillers can be used to soften the appearance of these lines. Because of the important role of muscular activity in the creation and exacerbation of glabellar lines, concomitant treatment with botulinum toxin is often beneficial
  • Horizontal forehead lines – Horizontal forehead lines result from the repetitive elevation of the brow over time. Similar to glabellar lines, placement of a soft tissue filler into deep horizontal forehead lines can diminish their appearance. Horizontal forehead lines may also be improved with botulinum toxin injection.
  • Lateral brow lift and temporal fossa changes – The natural loss of periorbital fat that occurs with aging results in lateral brow ptosis and reduced lateral brow projection. Fillers can be used to elevate the lateral brow and restore its anterior projection
  • Temporal fossa wasting – Volume replacement with soft tissue fillers can minimize the appearance of age-related concavity in the temporal area.
  • Mid-face
  • Nasojugal fold (tear trough depression) – With aging, pronounced depressions may occur between the rim of the orbital bone and the nasal sidewall due to the relaxation of suspensory ligaments of the eye and the descent of the malar fat pad. This can be difficult to correct surgically. The nasojugal fold has been successfully managed with the injection soft tissue fillers
  • Cheeks – Hypoplasia of the zygoma and the descent and atrophy of midfacial fat contribute to loss of the heart-shaped contour that is characteristic of the young female face. Injection of soft tissue fillers into the malar area increases anterior projection of the cheek and diminishes the appearance of nasolabial folds, leading to a more youthful appearance

Lower face

  • Nasolabial folds – Nasolabial folds are the most common sites treated with soft tissue fillers
  • Oral/perioral – Vertical perioral wrinkles and mouth frown can be corrected with soft tissue fillers; lip augmentation also can be performed with these agents
  • Chin – Melomental folds (marionette lines) and horizontal creases in the chin are amenable to treatment. Fillers have also been used for chin and mandibular augmentation
  • Nonfacial sites
  • Hand rejuvenation – Soft tissue augmentation can camouflage the skin laxity, wrinkling, and prominence of bone that characterize the appearance of the aged hand
  • Neck and chest – Soft tissue fillers can ameliorate signs of flaccidity, atrophy, and wrinkling in the neck and presternal chest

Dermal Fillers in Brooklyn, NY



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