Facial contouring with hyaluronic acid preparations: photos before and after treatment

Author

Chistyakova Olga Valentinovna

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Dermatologist

until March 31

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Contour plastic

– this is the correction of the macrorelief of the skin (elimination of cosmetic defects) using special preparations – fillers. In modern cosmetology, contour plastic surgery is considered as an alternative to plastic surgery, allowing one to achieve an impressive effect non-surgically and with instant results.

What is contour plastic surgery? The essence of the method

Contour plastic

Fillers are injected intradermally (and in some cases subcutaneously) using injections. Fillers (from English to fill - “fill”) are gels that create volume at the injection site. The filler lifts the tissues above it, eliminating surface defects. As a result, wrinkles are smoothed out.

Currently, as a rule, biodegradable gels based on collagen or hyaluronic acid (a natural polymer originally present in skin tissue) are used. Preparations based on synthetic polymers are used only in certain cases (for example, to eliminate the consequences of injuries). Biodegradable gels are harmoniously integrated into the skin, and over time they are completely absorbed and removed from the body.

Granulomas after correction

Granulomas can appear on the skin as a result of the body’s protective reaction to an injected drug of poor quality. The body isolates the foreign substance and encloses it in capsules.

As you can see in the picture, red plaques and nodules appear on the skin at the injection site.

Laser exposure is used as a modern method of treating granulomas. There are also drug treatment regimens for granulomas. In any case, the treatment tactics are determined by the doctor during the consultation.

Advantages of facial contouring with hyaluronic acid preparations

Injectable preparations based on hyaluronic acid increase the firmness and elasticity of the skin, even out its relief, eliminate wrinkles, strengthen the facial contour, and allow you to correct the shape of the cheekbones, chin and nose.
Modern drugs, as a rule, do not cause an allergic reaction. The risk of complications when using them is minimal. They do not affect your facial expressions and facial expressions in any way, since they do not affect the work of facial muscles.
Displacement of fillers based on hyaluronic acid is excluded, while synthetic preparations can migrate and thicken over time, causing deformation and provoking inflammation in the injection area.

Fillers and their features

All fillers used for contouring can be divided into the following types, depending on their composition:

collagen-based fillers;
fillers based on hyaluronic acid;
fillers based on poly-L-lactic acid;
fillers based on calcium hydroxyapatite;
fillers based on polymethyl methacrylate microspheres.

Today, fillers based on hyaluronic acid are the most popular because they are characterized by a high level of safety, ease of administration, effectiveness in correcting various imperfections in appearance and provide good volume.

The duration of preservation of the effect of facial contouring depends on the drug used for it. Thus, with the help of products based on hyaluronic acid, it is possible to obtain a result that will last for about a year, and preparations based on calcium hydroxyapatite or polylactic acid will give an effect for 2 years. When using collagen-based products, the effect lasts 6-8 months.

Permanent fillers last the longest – 10 years or more. But today they try not to use them, since they do not dissolve and in the future they can only be removed surgically.

Fillers based on hyaluronic acid

Hyaluronic acid is a polysaccharide constantly produced by skin cells to maintain skin tone and normal moisture. Gels based on hyaluronic acid are sterile, viscoelastic preparations that completely dissolve in tissues over time. Thus, they are biodegradable, which makes them absolutely safe.

All of them act comprehensively and not only provide effective and, most importantly, instant correction of facial skin imperfections, but also stimulate the processes of synthesis of their own collagen and elastin fibers at the injection sites. At the same time, they additionally produce a moisturizing effect, which improves the color and texture of the skin, making it radiant, velvety and absolutely healthy.

There are several types of fillers of this type, differing not only in manufacturer, but also in viscosity. In this case, the choice of a specific one is primarily determined based on which area of the face needs correction. Thus, high-density fillers are used to eliminate deep wrinkles and folds of the skin, products with medium viscosity are selected to create the desired volume of the cheeks, cheekbones, and chin, and the softest ones are used to correct the area around the lips and eyes.

The most popular hyaluronic acid fillers are:

Restylane (Sweden) - created on the basis of incompletely hydrated hyaluronic acid of animal origin, which is isolated by bacterial fermentation. The concentration of the active substance in it is 20 mg/ml. The fact that the filler is not fully hydrated means that during the first 24 hours of being in the tissue it will absorb moisture. The consequence of this will be an additional increase in volume, which the doctor must take into account when administering. Restylane is usually used to correct nasolabial folds, marionette lines, post-acne, lifting the tip of the nose and correcting its overall appearance. The line of drugs includes several representatives: Touch, Lip, Sub-Q, each of which has its own viscosity, and therefore its area of application.
Perlane (Sweden) is a filler that can be classified as a member of the Restylane line of drugs, but it is distinguished by significantly higher viscosity and density while maintaining the same concentration of hyaluronic acid. It is used to correct deep wrinkles and skin folds, and the effect lasts for about 9 months.
Juvederm (USA) is one of the most popular fillers based on hyaluronic acid, also obtained by bacterial fermentation. Unlike Restylane, it is completely hydrated, so the final result is formed almost immediately after contouring. The line of drugs includes many fillers, the main ones being Juvederm Ultra and Juvederm Ultra Plus. Both of them contain 24 mg/ml hyaluronic acid, but they differ greatly in density. Therefore, the second one, as it is denser, is used to correct deep wrinkles and scars, and the first one is used to eliminate moderate imperfections and correct the appearance of the lips.
Belotero (Switzerland) is considered a “smart filler” that is able to independently distribute itself evenly in tissues. This property will ensure the absence of discomfort and the feeling of a foreign body in the face. The product line includes 3 options: Soft (20 mg/ml), Balance and Intense, each containing 22.5 mg/ml hyaluronic acid.

Collagen based fillers

Collagen is a natural component of human skin that maintains its elasticity and strength. Normally, its amount is about 70% of the dry mass, and there are more than 11 types of collagen, slightly different in their structure and functions. The main ones are collagen types I and II. That's why they are used to create modern fillers.

Depending on the origin of collagen, collagen is classified as porcine, bovine, human, or bioengineered. Today, genetic engineering is most often used to produce such fillers, as well as the innovative Glymatrix technology.

Collagen-based fillers have been used in cosmetology since 1981. But in Russia they are not popular due to the short duration of preservation of the result. But they are absolutely hypoallergenic, and are much less likely than others to provoke the occurrence of edema and local hemorrhages.

The main representatives of drugs in this group are:

CosmoDerm 1 and CosmoDerm 2 (USA) - they are based on human recombinant collagen, which is obtained by cultivating fibroblasts (skin cells that produce collagen) in laboratories. These preparations contain 35 mg/cm3 and 70 mg/cm3 of collagen, respectively, and a 0.3% lidocaine solution. Therefore, CosmoDerm 1 is usually used to eliminate superficial wrinkles and scars, in particular smokers' wrinkles around the mouth, and CosmoDerm 2 is used to solve more pronounced problems, including smoothing the skin texture due to post-acne.
CosmoPlast (USA) – contains 35 mg/cm3 of collagen and glutaraldehyde. The presence of the latter component ensures a slower breakdown of the filler in tissues, which makes it possible to use it to correct deep wrinkles and scars. In particularly difficult cases, it is combined with injections of hyaluronic acid-based fillers.
Evolence (Israel) is one of the latest and most advanced collagen-based fillers to enter the market. It contains completely purified pork collagen types 1 and 3 with a concentration of 35 mg/cm3 and is ideally compatible with human collagen. It is obtained using Glymatrix technology, which implies the production of collagen with a 3-dimensional structure, which significantly increases the effectiveness of contour correction using it. Evolence filler is the only drug of its kind that ensures that the effect is maintained for 12-18 months. It is produced in 2 variations, which allows you to choose a product for correcting wrinkles of different depths, changing the contour of the red border of the lips and changing their shape.

Poly-L-lactic acid fillers

Polylactic acid is a synthetic, absolutely biologically compatible polypeptide that does not cause allergic reactions. It consists of microspherical particles of poly-L-lactic acid and is obtained in laboratory conditions. This compound is the basis of Sculptra filler (UK).

It is difficult to call it a filler in the traditional sense, so many cosmetologists call it a skin stimulant. Poly-L-lactic acid provokes the formation of new collagen in the skin, which ensures gradual smoothing of wrinkles and restoration of the previous volume of soft tissues. The effect of its administration can be compared with lipofilling, i.e., the introduction of one’s own fat suspension in the area of volume deficiency.

Therefore, the effect of contouring is not observed immediately after the procedure, as when working with other fillers, but only after 4 weeks. In this case, the cosmetologist needs to very strictly control the amount of the drug administered to avoid overcorrection. Sculptra filler must be injected regularly every 4-6 weeks until the desired results are achieved. This causes the high price of contour plastic surgery and the impossibility of predicting the final cost in advance. To speed up the desired effect, Sculptra is often combined with other fillers.

Poly-L-lactic acid fillers work best in pre- and postmenopausal women who are receiving hormone replacement therapy. If hormonal levels are not corrected, the drugs will work worse. For men, Sculptra gives good, long-lasting results.

This type of filler is used for:

increasing the volume of the cheekbones;
replenishment of tissue deficiency in the cheek area;
correction of nasolabial folds;
smoothing out deep wrinkles, scars, etc.

Working with such fillers requires a lot of experience and special training.

Fillers based on calcium hydroxyapatite

Calcium hydroxyapatite is a synthetic analogue of bone tissue that is completely hypoallergenic and does not lead to the development of adverse effects. The most famous filler of this group is Radiesse (USA). It consists of microsphere particles of 30% calcium hydroxyapatite, the size of which is in the range of 25-45 microns. These microspheres are distributed as a suspension in a gel carrier. It acts as a base and dissolves 2-3 months after administration.

From this moment, skin cells directly interact with microspheres of calcium hydroxyapatite, which leads to activation of fibroblasts and the formation of their own collagen in the area of influence. Therefore, the drug is used for contour plastic surgery:

nasolabial folds;
cheekbone;
cheeks;
marionette wrinkles;
eliminating scars, etc.

Calcium hydroxyapatite provides a visible cosmetic result and at the same time remains in the tissues much longer. Fillers based on it are used more often to correct the face of mature patients and with a pronounced lack of soft tissue volume.

Fillers based on polymethyl methacrylate microspheres

A prominent representative of this group of drugs is Artefill. It is capable of giving a lasting result that will last up to 10 years, but due to the too high cost and complexity of administration in Russia, it is practically not used.

Thus, contour plastic surgery has truly become a worthy alternative to plastic surgery. With the correct selection of filler, it is possible to eliminate almost any imperfections on the face and get rid of the marks of the years. The procedures are almost completely painless and have a short recovery period, which cannot be said about aesthetic surgery. The only drawback is the need to regularly re-correct problem areas, but given the significantly lower price of contouring and the absence of the need to exclude social contacts for several weeks, this drawback cannot be called significant.

Areas of application of the contour plastic method

Fillers can be used on any areas of the skin that require correction. Facial contouring is especially in demand.

Contour plastic surgery: before and after photos

The following problems can be successfully solved with the help of contour plastic surgery:

elimination of frontal wrinkles (wrinkles on the forehead) and wrinkles between the eyebrows;
elimination of “crow’s feet” – wrinkles in the corners of the eyes;
correction of nasolabial folds and cheekbones;
correction of the corners of the mouth, elimination of wrinkles above the upper lip (perioral wrinkles);
contouring and increasing lip volume;
volumetric facial plastic surgery (cheekbones, chin).

Features of the procedure

Before the injection rejuvenation session, a consultation with a cosmetologist is carried out. The doctor examines the patient and selects the most effective drug individually for each, the desired and final results are discussed, and contraindications are excluded.

Before the injection of fillers, local anesthesia is performed. During the session, the gel-like preparation is injected using several injections (the required amount is determined by the cosmetologist) into problem areas of the skin.

The effect is visible after the end of the session, and its duration is determined by the chosen drug. If it is necessary to eliminate the resulting effect or correct it in the future, additional injection of filler or a means to accelerate its removal is carried out.

Facial contouring with hyaluronic acid at “Family Doctor”

The cosmetologists at the “Family Doctor” are professionals of the highest class, masters of beauty, capable of providing truly high-quality results. Check out the benefits of facial contouring at Family Doctor clinics:

The entire procedure takes on average 30-40 minutes. Of these, 20-30 minutes are occupied by anesthesia of the injection zone with an anesthetic cream, which includes one or more anesthetics (lidocaine, ultracaine, procaine).
Microneedles are used for injections, leaving no traces.
The effect of the procedure is noticeable immediately.
After the procedure, slight bruising and swelling may appear, which will disappear in a few days, and then the effect will become even more obvious.

Benefits of the procedure

The introduction of injectable implants is a safe procedure with multiple advantages:

· the procedure is performed in the clinic on an outpatient basis, there is no need to go to the inpatient department;

· the first result becomes noticeable immediately after the end of the session;

· there is no need for specific preparation, as with surgical intervention;

· short rehabilitation period;

· manipulation lasts from 20 to 40 minutes;

· the procedure is performed at any age;

· the procedure can be combined with other rejuvenation methods (for example, hardware);

· fillers saturate the skin with oxygen and nutrients;

· there is no negative effect on tissue trophism;

· has the smallest list of restrictions.

Contour plastic surgery is performed to prevent side effects and risks of surgical treatment.

PROMOTION

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Consultation with a cosmetologist is FREE!

Consultation with a cosmetologist-dermatologist at the Clinic is free of charge when professional procedures are simultaneously performed.

Make an appointment with a cosmetologist by calling the Clinic (4852) 37-00-85 Daily from 8:00 to 20:00

Facial contouring involves the introduction of special fillers (fillers) under the skin, which increase the volume of selected areas. With the help of “beauty injections” you can get rid of wrinkles, model the oval of the face or correct the shape of individual parts of it. Our Clinic uses modern fillers based on stabilized hyaluronic acid, which allows you to get the most natural and long-lasting results.

First stage: correction of the angle of the lower jaw

The angle of the mandible is formed by the connection of the posterior border of the ramus and the lower edge of the body of the jaw. X-ray studies have shown that the average mandibular angle in women is 125 degrees, but this value varies even in aesthetically attractive patients.

The main goal when correcting the lower part of the face is to emphasize and make the patient’s natural mandibular angle more pronounced.

Technique

1. Determine volume loss in the preauricular space.

2. By palpation, find and mark the angle of the lower jaw.

3. Using a 23-gauge needle, create an entry point located superomedial (often at a distance of 0.5 cm) in relation to the mandibular angle.

4. Mark the future lower border and the posterior part of the body of the lower jaw (Fig. 1).

5. Use a 25-gauge (4 cm) cannula to aspirate to avoid intravascular injection of filler.

6. Using the linear-retrograde technique, inject filler (0.1 ml per line) in a volume of 0.5–1 ml in each direction.

7. Shape the product to achieve the ideal angular contour by gently palpating between the tips of two fingers.

Potential Risks

During correction of the posterior ramus of the mandible, the facial nerve and parotid gland are at risk because these two structures are located deep. You can avoid affecting them by injecting filler into the subdermal plane. When introducing the product into the lower edge of the maxillary branch, it must be remembered that the facial artery runs along the anterior edge of the masticatory muscle. It must first be palpated and excluded from the injection area.

Brief description: Purpose: to make the mandibular angle clearer.
Depth of injection: superficial/subdermal.

Volume: 0.5–1 ml per side.

Technique: cannula. Products of choice: Restylane Defyne, Restylane Volyme or Restylane Lyft

Second stage: contouring of the chin area (H3)

To determine the ideal proportions of the face, it is usually divided into three equal horizontal thirds and five vertical sectors (Fig. 2). Ideally, the chin occupies the central vertical sector.

Contraindications

Like other injection procedures, contour plastic surgery is contraindicated:

Pregnant and lactating;
For bleeding disorders of any etiology (including within 2 weeks after taking anticoagulants);
With a tendency to form hypertrophic/keloid scars;
For any acute inflammatory diseases or exacerbation of chronic diseases;
In case of an allergic reaction to the components of the drugs;
Oncological diseases, without remission;
Mental disorders;
Excessive demands from the procedure, when expectations exceed the possibilities of correction;
Persons under 18 years of age;
Diabetes mellitus without compensation.

Gel lifting

Allows you to strengthen the oval of your face without surgery. With the help of modern gels, you can perform a similar bioreinforcement procedure - create a frame under the skin that will keep it from sagging.

Properly performed reinforcement provides natural lifting. The face simply “flies” up: the jowls are tightened, the nasolabial folds are smoothed out, and the contours of a youthful face are restored. The procedure is perfectly combined with thermolifting and fractional thermolysis.

Rosa Syabitova. Cheekbone augmentation in combination with gel lifting with Radiesse. Photos before the procedure and 7 days after. Done by Andrey Iskornev.

The result is high, youthful and plump cheekbones. Elimination of nasolabial folds. Smoothing the lower jaw line. General pronounced lifting. The skin got rid of the “spider web effect” - a network of small wrinkles.

The effect of contouring will increase over several weeks. The result will delight Rose for up to 1.5 years.

What does a vessel embolism look like?

Vessel embolism is one of the most serious complications that occur in injected areas. As a rule, in the area of the nasolabial triangle and lips.

Vessel embolism results from:

The filler has entered the lumen of the vessel (As a rule, a total blockage of the vessel occurs and the blood flow stops completely);
The gel is injected in large quantities directly close to the vessel, this compresses it and makes it difficult for blood to pass through.

All this leads to the fact that the vessels are compressed, blood circulation is disrupted, and swelling of neighboring tissues increases.

It is difficult not to notice them: the injured area will be very painful, the area of the skin deprived of blood supply will turn white, and a clearly visible “mesh” of burgundy or blue color may appear around it - due to the overflow of blood in the surrounding vessels.

Visually, a vessel embolism looks like this:

The blockage area turns white;
Around the area, on the contrary, spots of a purple or bluish tint appear;
Severe pain in the injured area.

All of the problems described above require urgent contact with your cosmetologist. If you try to treat it yourself, you may end up with tissue necrosis.

Reasons for changes in facial oval

The main reason for this aesthetic problem is the forces of gravity. Under their influence, fat packets shift down: the nasolabial folds deepen, the oval of the face is “blurred”, and jowls appear. It is curious that it is this factor that seriously affects the perception of the face by others - age-related changes begin to be easily “read”.

Until recently, plastic surgery was primarily used to correct the shape of the face. However, today the surgeon’s intervention can be significantly delayed or even avoided altogether by resorting to the possibilities of modern cosmetology.

Correction of facial contours: hardware technologies

For gravitational ptosis, procedure No. 1 is the Ultraformer SMAS lift. It allows you to restore the structure that holds the fat packet. The modern HIFU device is unparalleled: with the help of focused ultrasound, it literally “reflashes” the tissue. They instantly tighten up, as if after a surgeon’s intervention. 6 months after the procedure, intensive production of your own collagen occurs, due to which the rejuvenation effect increases. SMAS-lifting Ultraformer is done once, the result of the tightening will last up to 2 years.
If changes have not yet affected the muscular aponeurotic layer of tissue (SMAS), a course of Face Anti-Gravity procedures on the ACCENT device will help restore clarity to the oval of the face and eliminate jowls. The procedure works against all signs of aging, you can evaluate the effect on the same day! Ultra-powerful RF of the new generation remodels the skin layer by layer at the superficial, medium and deep levels, returning elasticity and firmness to the tissues. The skin becomes smooth and tightened.
If you have a pronounced double chin, the Just Perfect program is relevant (performed on the legendary ACCENT device). Being an absolute analogue of plastic surgery, the procedure allows you to achieve results quickly, without pain and rehabilitation.
Just Perfect is carried out in 2 stages:
Using ultrasound, the doctor eliminates fat deposits in the area of the double chin, targeting the membranes of fat cells (adipocytes). The double chin is going away.
After this, turbolifting of the skin of the lower third of the face is carried out - this allows you to instantly tighten the skin.

Summary

I will be honest with you: I do not consider this correction method a worthy alternative to plastic surgery. As practice shows, fillers do not give the result that the patient would like to see. And the use of budget synthetic fillers even leads to the need for surgical intervention in some cases.

A facelift with fillers is suitable for targeted corrections of subtle age-related changes. When you just notice the first strokes and want to hide them immediately.

Pronounced age-related changes require more serious procedures. Here I would recommend surgical methods of correction. Because the devices also do not always cope with complex tasks.

To summarize the above, I would add that each case is unique. Therefore, a specialist can advise you on a suitable correction method only after a personal conversation. To choose the best one for you, we need to look, evaluate and take a history. Do not forget about this and do not make a decision about a particular procedure without a personal conversation with a specialist.