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How to best utilize the line of ligaments and the surface volume coefficient in facial soft tissue filler injections
Author(s) -
Casabona Gabriela,
Bernardini Francesco P.,
Skippen Brent,
Rosamilia Gianna,
Hamade Hassan,
Frank Konstantin,
Freytag David L.,
Sykes Jonathan,
Onishi Emy C.,
Cotofana Sebastian
Publication year - 2020
Publication title -
journal of cosmetic dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.626
H-Index - 44
eISSN - 1473-2165
pISSN - 1473-2130
DOI - 10.1111/jocd.13245
Subject(s) - soft tissue , medicine , cannula , anatomy , eyelid , ligament , orthodontics , nuclear medicine , surgery
Background Recent advances in facial anatomy have increased our understanding of facial aging and where to best position facial soft tissue fillers. Aim Aim of this study was to investigate a novel injection protocol which makes use of concepts like the line of ligaments or the surface ‐ volume coefficient. Materials and Methods A total of 306 Caucasian patients (270 females, mean age 45.1 ± 11.4 years; 36 males, mean age 45.9 ± 11.6 years) were retrospectively investigated after the injection following a standardized protocol. This protocol comprised a total of six boluses and one retrograde fanning injections in the infraorbital area utilizing a 22G and a 25G blunt‐tip cannula, respectively. Medial midfacial distances were measured using skin surface landmarks and compared after the injection of the partial and the total algorithm. Results Distances between the dermal location of the lateral SOOF and the dermal location of the mandibular ligament increased by 0.17 ± 0.11 mm with P < .001, to the corner of the mouth by 0.20 ± 0.09 mm with P < .001 and to the nasal ala by 0.20 ± 0.11 mm with P < .001. The repositioning of the facial soft tissues resulted also in a decrease of the height of the lower eyelid by 0.49 ± 0.13 mm with P < .001. Conclusion The results revealed that utilizing these novel anatomic concepts, a mean amount of 0.32 cc high G‐prime soft tissue filler injected in the lateral SOOF can change midfacial distances by an average of 0.19 mm.