Until the 1990s, the concept of rejuvenation was reduced essentially to the absence of lines and folds. During the last decade, there have been significant advances in the technology embedded in hyaluronic acid (HA) products, as well as a refinement of application techniques that, together, also permitted the HA to become a gold standard as a volumizing agent. The main modification in the facial aesthetic treatment has been the exchange of the two-dimensional focus, to the appreciation of the three-dimensional concept, which also recognizes volumetric losses due to bone resorption, gingival retraction, and redistribution of facial fat as signs of aging. The concept is based on balance and facial harmony, respecting patients’ gender, ethnicity, and objectives, and allows for more natural results without “frozen” or distorted expressions. The aim of this chapter is to show a practical view of the use of HA for volumizing the malar region (important anatomical concepts, areas of risk, kinds of fillers and rheological concepts, techniques with needle and cannula, adverse events and treatment of complications), with literature-based information and tips from the author. The midfacial area (malar area) is the starting point for the three-dimensional approach in rejuvenation treatment. The use of HA in this area is effective and safe.
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