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Novel Injection Techniques
Published in Yates Yen-Yu Chao, Sebastian Cotofana, Anand V Chytra, Nicholas Moellhoff, Zeenit Sheikh, Adapting Dermal Fillers in Clinical Practice, 2022
Yates Yen-Yu Chao, Sebastian Cotofana
Subcision is combined with filler injection in some practices for the deep labiomandibular sulcus. There the muscular and connective tissue fibers adhere to the overlying skin in a vertical line connecting the oral commissure to the mandibular ligament. Disrupting these fascial connections results in an improvement of the marionette lines and a reduction of the visibility of the pre-jowl sulcus. Subcision also creates a space to accommodate filler materials.
Dermal fillers
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
Marionette lines are vertical lines extending inferiorly from the corner of the mouth, with their name deriving from the characteristic appearance of the mouths of string puppets. These lines are due to age-related volume loss and movement of the mouth. Many patients state that their marionette lines give them a “sad” appearance due to the volume loss causing a slight down-turning of the corners of the mouth.
Anatomy of the Lower Face and Neck
Published in Neil S. Sadick, Illustrated Manual of Injectable Fillers, 2020
Evan Ransom, Stephen A. Goldstein
Relative to the forehead and midface, rhytides and pronounced soft tissue folds are less prominent in the lower face. For example, perioral rhytides are frequently finer than in the glabellar region. An exception to this is marionette lines. In some individuals, a deep sulcus following the labiomandibular fold forms with age. This is not an anatomical continuation of the nasolabial fold (NLF), but rather represents a distinct fold, generally following the arc of the depressor anguli oris inferolaterally from the modiolus.
Clinical efficacy and safety of a focused-radiofrequency device on middle and lower face rejuvenation: a retrospective clinical study
Published in Journal of Cosmetic and Laser Therapy, 2021
Yiqiu Zhang, Min Yan, Jing Mi, Ying Zeng, Huyan Lin, Min Yao, Jiying Dong, Shen Wang
It should be noted that researchers usually use a single subjective assessment method to evaluate the efficacy of facial rejuvenation, such as ACGS (33), GAIS (34) and the Fitzpatrick Wrinkle & Elastosis Scale (35), which had unavoidable subjective errors and lower credibility. A few studies have used the relatively objective assessment measures of the melanin and erythema indices using a Mexameter MX18 (33) and VISIA (36); however, the procedures were somewhat simple and one sided in the experiments. Thus, we aimed to construct a more reliably comprehensive assessment system for facial rejuvenation. As shown in Figure 2, we used the facial width, nasolabial folds, marionette lines, and cheek lines as the facial parameters to measure. We then added the objective assessment (i.e., VISIA) and subjective assessment (i.e., ACGS and GAIS) for supplementary ratings, which provided a multiple and convincing assessment system. This system provided a facial evaluation based on various aspects of facial contour, wrinkles, spots, texture, laxity, erythema, and pores, which helped the clinicians to clearly estimate the patient’s skin condition and aging level. In view of specific aspects provided by this assessment system, clinicians can choose a more suitable nonsurgical treatment to reduce the signs of aging in skin.
Granuloma as a complication of polycaprolactone-based dermal filler injection: ultrasound and histopathology studies
Published in Journal of Cosmetic and Laser Therapy, 2019
Ewa Skrzypek, Barbara Górnicka, Daisy Miriam Skrzypek, Mlosek Robert Krzysztof
As the discussed papers show, PCL-based dermal filler is considered effective and highly valued by both patients and physicians. It is generally recommended as well tolerated by human tissues, safe and not associated with serious adverse effects. The complications reported up to date typically developed shortly after the procedure and resolved spontaneously within a short period of time. Gritzalas (15) reported oedema in 12 of his 40 patients. The oedema persisted for about 2 days and resolved spontaneously afterwards and bruises, which occurred in 2 cases, resolved by Day 7. Moers-Capri and Sherwood (8) reported oedema and bruises (in 34% and 5% of cases, respectively), which resolved spontaneously. No late complications manifesting as granulomas or nodules were observed. Galadari (6) observed mild adverse effects, which resolved spontaneously, in 48% of his patients. The 24-week follow up by Figueiredo (9) showed mild dorsal hand oedema in two of five patients, with an onset within 24 hours following an injection and a resolution within subsequent 24 hours, after using non-steroid anti-inflammatory drugs (NSAIDs). He did not report nodules, granulomas and other complications, either. It should be noted, though that marionette lines and oral commissures are areas difficult to treat, due to the absent structural support and the dynamics of major muscles in the perioral area. Inexperienced clinician or improper technique may contribute to long-term complications, just as it is the case with any other dermal filler (16).
Broadband light treatment using static operation and constant motion techniques for skin tightening in Asian patients
Published in Journal of Cosmetic and Laser Therapy, 2019
Seunggyun In, Henry Park, Heejin Song, Jiho Park, Heesu Kim, Sung Bin Cho
In group 3, the patients (median age, 41 years; IQR, 36–45 years; age range, 27–60 years) were treated with BBL via the 590ST-cutoff filter using a constant motion technique. At 2 months after the final treatment, patients exhibited marked clinical improvements in overall skin texture, skin tone, and fine wrinkles, with a median GAIS score of 2 (IQR, 2–3). The median GAIS scores of assessment parameters were 1 (IQR, 1–2) in the upper face, 3 (IQR, 2–3) in the mid-face, and 2 (IQR, 2–2) in the lower face. Particularly, zygomatic wrinkles or mid-cheek furrows, nasolabial folds, and marionette lines were found to have noticeably improved after 590ST BBL treatment (Figures 5 and 6).