How to best utilize the line of ligaments and the surface volume coefficient in facial soft tissue filler injections

• DOI: 10.1111/jocd.13245
• Publication Date: 2019-12-16T05:04:07Z
• Authors: Gabriela Casabona; Francesco P. Bern...; Brent Skippen; Gianna Rosamilia; Hassan Hamade; Konstantin Frank; David L. Freytag; Jonathan Sykes; Emy C. Onishi; Sebastian Cotofana
• Keywords: Adult; Male; Ligaments; Cosmetic Techniques; Middle Aged; Injections; Skin Aging; 03 medical and health sciences; 0302 clinical medicine; Dermal Fillers; Face; Cannula; Humans; Female; Anatomic Landmarks; Retrospective Studies

Abstract Background Recent advances in facial anatomy have increased our understanding of aging and where to best position soft tissue fillers. Aim this study was investigate a novel injection protocol which makes use concepts like the line ligaments or surface ‐ volume coefficient. Materials Methods A total 306 Caucasian patients (270 females, mean age 45.1 ± 11.4 years; 36 males, 45.9 11.6 years) were retrospectively investigated after following standardized protocol. This comprised six boluses one retrograde fanning injections infraorbital area utilizing 22G 25G blunt‐tip cannula, respectively. Medial midfacial distances measured using skin landmarks compared partial algorithm. Results Distances between dermal location lateral SOOF mandibular ligament by 0.17 0.11 mm with P < .001, corner mouth 0.20 0.09 .001 nasal ala .001. The repositioning tissues resulted also decrease height lower eyelid 0.49 0.13 Conclusion results revealed that these anatomic concepts, amount 0.32 cc high G‐prime filler injected can change an average 0.19 mm.