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Midline Volume Filler Injection for Facial Rejuvenation and Contouring in Asians

  • Original Article
  • Non-Surgical Aesthetic
  • Published:
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Abstract

Background

Hyaluronic acid (HA) injection is popular in cosmetic surgery because of its minimal invasion and immediate recovery. However, few injection techniques are specifically designed for Asians, considering their aesthetic and structural differences from those of Caucasians.

Methods

The midline volume injection technique was performed on 37 Asian females and 3 males at sites including the forehead, glabella, nasal dorsum, nasal base and chin. The treatment focused on improving the facial profile projection. 3D image data were collected, and facial aesthetic angles were calculated. Volume changes in facial parts were analyzed before injection and during follow-up. Patient satisfaction was assessed using the visual analog scale (VAS).

Results

The average injected filler volume was 6.14 ± 2.82 ml. The treatment optimized the facial contour and produced instant facial rejuvenation. On 3D images, the average midline volume increased by 6.02 ± 2.23 ml. An average volume decrease of 3.92 ± 1.94 ml was observed in the cheeks and was positively related to the increased midline volume. The average nasolabial and nasal facial angles were increased from 100.00 ± 7.37° to 107.93 ± 9.01° and 28.78 ± 3.28° to 31.78 ± 2.97°, while the mentolabial angle was decreased from 146.55 ± 7.83° to 141.13 ± 6.23°. The mean VAS scores were 2.28 ± 1.27 immediately after injection and 2.56 ± 1.20 after 6 months.

Conclusions

The midline volume injection technique of HA fillers is suitable for Asians. It greatly enhances the facial profile, as illustrated by volume changes in 3D images, leading to a more attractive facial appearance.

Level of Evidence V

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References

  1. Wirthlin J, Kau CH, English JD, Pan F, Zhou H (2013) Comparison of facial morphologies between adult Chinese and Houstonian Caucasian populations using three-dimensional imaging. Int J Oral Maxillofac Surg 42:1100–1107

    Article  CAS  Google Scholar 

  2. Jones D, Murphy DK (2013) Volumizing hyaluronic acid filler for midface volume deficit: 2-year results from a pivotal single-blind randomized controlled study. Dermatol Surg 39:1602–1612

    Article  CAS  Google Scholar 

  3. Glaser DA, Kenkel JM, Paradkar-Mitragotri D, Murphy DK, Romagnano L, Drinkwater A (2015) Duration of effect by injection volume and facial subregion for a volumizing hyaluronic acid filler in treating midface volume deficit. Dermatol Surg 41:942–949

    Article  CAS  Google Scholar 

  4. de Maio M, DeBoulle K, Braz A, Rohrich RJ (2017) Facial assessment and injection guide for botulinum toxin and injectable hyaluronic acid fillers: focus on the midface. Plast Reconstr Surg 140:540e–550e

    Article  Google Scholar 

  5. Skvara H, Burnett P, Jones J, Duschek N, Plassmann P, Thirion JP (2012) Quantification of skin lesions with a 3D stereovision camera system: validation and clinical applications. Skin Res Technol 19:e182–e190

    Article  Google Scholar 

  6. Voutilainen A, Pitkaaho T, Kvist T, Vehvilainen-Julkunen K (2016) How to ask about patient satisfaction? The visual analogue scale is less vulnerable to confounding factors and ceiling effect than a symmetric Likert scale. J Adv Nurs 72:946–957

    Article  Google Scholar 

  7. Armijo BS, Brown M, Guyuron B (2012) Defining the ideal nasolabial angle. Plast Reconstr Surg 129:759–764

    Article  CAS  Google Scholar 

  8. Swift A, Remington K (2011) BeautiPHIcation: a global approach to facial beauty. Clin Plast Surg 38:347–377

    Article  Google Scholar 

  9. de Maio M, Swift A, Signorini M, Fagien S (2017) Facial assessment and injection guide for botulinum toxin and injectable hyaluronic acid fillers: focus on the upper face. Plast Reconstr Surg 140:265e–276e

    Article  Google Scholar 

  10. Kestemont P, Cartier H, Trevidic P, Rzany B, Sattler G, Kerrouche N, Dhuin JC (2012) Sustained efficacy and high patient satisfaction after cheek enhancement with a new hyaluronic acid dermal filler. J Drugs Dermatol 11:s9–s16

    CAS  PubMed  Google Scholar 

  11. Han X, Hu J, Cheng L, Li F (2015) Multiplane hyaluronic acid (EME) in female Chinese rhinoplasty using blunt and sharp needle technique. J Plast Reconstr Aesthet Surg 68:1504–1509

    Article  Google Scholar 

  12. Mendelson B, Wong CH (2012) Changes in the facial skeleton with aging: implications and clinical applications in facial rejuvenation. Aesthet Plast Surg 36:753–760

    Article  Google Scholar 

  13. Beer K, Solish N (2006) Reshaping the nose with injectable agents. Cosmet Dermatol 19:745–752

    Google Scholar 

  14. Lambros V (2009) Volumizing the brow with hyaluronic acid fillers. Aesthet Surg J 29:174–179

    Article  Google Scholar 

  15. Wilson MJV, Jones IT, Butterwick K, Fabi SG (2018) Role of nonsurgical chin augmentation in full face rejuvenation: a review and our experience. Dermatol Surg 44:985–993

    Article  Google Scholar 

  16. Braz AV, Louvain D, Mukamal LV (2013) Combined treatment with botulinum toxin and hyaluronic acid to correct unsightly lateral-chin depression. An Bras Dermatol 88:138–140

    Article  Google Scholar 

  17. Dayan SH, Kempiners JJ (2005) Treatment of the lower third of the nose and dynamic nasal tip ptosis with Botox. Plast Reconstr Surg 115:1784–1785

    Article  CAS  Google Scholar 

  18. Redaelli A (2008) Medical rhinoplasty with hyaluronic acid and botulinum toxin A: a very simple and quite effective technique. J Cosmet Dermatol 7:210–220

    Article  Google Scholar 

  19. Hsu AK, Frankel AS (2017) Modification of chin projection and aesthetics with onabotulinumtoxin A injection. JAMA Facial Plast Surg 19:522–527

    Article  Google Scholar 

  20. Xue K, Chiang CA, Liu K, Gu B, Li Q (2012) Multiplane hyaluronic acid rhinoplasty. Plast Reconstr Surg 129:371e–372e

    Article  CAS  Google Scholar 

  21. Park TH, Seo SW, Kim JK, Chang CH (2011) Clinical experience with hyaluronic acid-filler complications. J Plast Reconstr Aesthet Surg 64:892–896

    Article  Google Scholar 

  22. Ozturk CN, Li Y, Tung R, Parker L, Piliang MP, Zins JE (2013) Complications following injection of soft-tissue fillers. Aesthet Surg J 33:862–877

    Article  Google Scholar 

  23. Beleznay K, Carruthers JD, Humphrey S, Jones D (2015) Avoiding and treating blindness from fillers: a review of the world literature. Dermatol Surg 41:1097–1117

    Article  CAS  Google Scholar 

  24. Tansatit T, Moon HJ, Rungsawang C, Jitaree B, Uruwan S, Apinuntrum P, Phetudom T (2016) Safe planes for injection rhinoplasty: a histological analysis of midline longitudinal sections of the Asian nose. Aesthet Plast Surg 40:236–244

    Article  Google Scholar 

  25. Schenck TL, Koban KC, Schlattau A, Frank K, Sykes JM, Targosinski S, Erlbacher K, Cotofana S (2018) The functional anatomy of the superficial fat compartments of the face: a detailed imaging study. Plast Reconstr Surg 141:1351–1359

    Article  CAS  Google Scholar 

  26. Gierloff M, Stohring C, Buder T, Gassling V, Acil Y, Wiltfang J (2012) Aging changes of the midfacial fat compartments: a computed tomographic study. Plast Reconstr Surg 129:263–273

    Article  CAS  Google Scholar 

  27. Mendelson BC, Muzaffar AR, Adams WP Jr. (2002) Surgical anatomy of the midcheek and malar mounds. Plast Reconstr Surg 110: 885–896 (discussion 897–911)

    Article  Google Scholar 

  28. Mendelson BC, Freeman ME, Wu W, Huggins RJ (2008) Surgical anatomy of the lower face: the premasseter space, the jowl, and the labiomandibular fold. Aesthetic Plast Surg 32:185–195

    Article  Google Scholar 

  29. Wong CH, Mendelson B (2013) Facial soft-tissue spaces and retaining ligaments of the midcheek: defining the premaxillary space. Plast Reconstr Surg 132:49–56

    Article  CAS  Google Scholar 

Download references

Funding

The authors received no financial support for the research and authorship of this article.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, No. 639, Zhizaojv Road, Shanghai, 200011, People’s Republic of China

    Zhezhen Xiong

  2. Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaojv Road, Shanghai, 200011, People’s Republic of China

    Kai Liu

  3. Yestar Plastic Surgery Hospital, No. 149, North Jianguo Road, Hangzhou, 310000, People’s Republic of China

    Zhengzheng Jiang

Authors
  1. Zhezhen Xiong
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  2. Zhengzheng Jiang
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Correspondence to Zhengzheng Jiang or Kai Liu.

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Conflict of interest

The author has no conflicts of interest to declare with respect to the authorship and publication of this article.

Ethical Approval

This study was reviewed and approved by the Ethics Committee of Shanghai Ninth Hospital, Shanghai Jiao Tong University School of Medicine. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

The patients were fully informed about the treatment procedure and possible side effects. An informed consent form was signed by all patients.

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Xiong, Z., Jiang, Z. & Liu, K. Midline Volume Filler Injection for Facial Rejuvenation and Contouring in Asians. Aesth Plast Surg 43, 1624–1634 (2019). https://doi.org/10.1007/s00266-019-01498-z

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  • DOI: https://doi.org/10.1007/s00266-019-01498-z

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