Since the basis of aging is volume loss, injection artists use fillers in the:
1st layer | skin: re-drapes skin envelope over bony fundament. Mainly for diminishing lines and wrinkles. 2 D injection.
*G-Prime — one of the key rheological properties of dermal filler. It refers to the viscosity and elasticity
of the product.
2nd layer | Superficial fat: reposition fat pad. Mainly for surface contour and diminish
shadows.
Example: the inferior orbital fat pad can be repositioned upward to cover or camouflage the lower orbital rim to smooth out the lid-cheek junction and rejuvenate the eyes. Use lower G’ filler. Voluma XC is ideal for mid-face Volumization
3rd layer | Muscles: lift lips/mouth corner elevator muscles via lever-pulley system and myomodulation effect. This results in maximal cheek and mouth corner lift.
4th layer | Deep fat and ligament: reflate fat pad and support ligaments. Use higher G’* filler.
Mainly for lifting and projection. 3 D injection.
5th layer | Bone and periosteum: recreate bony foundation.
Example: Ristow space and anterior maxillary region.
Example of medial volume loss
More examples contrast medial vs lateral aging ( volume loss ).
The progression from 1 to 3 demonstrates techniques advancing from basic to advanced. In my experience, Technique 3 carries more risk but delivers better results.
Recognizing these anatomical structures and placing fillers in these locations in a precise manner and the right amount, and at the appropriate depth, can greatly enhance the results of our facial artwork.
Click the link to watch Anatomical Considerations for Midface Injection Video
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