With the hands of a visual artist and a good sense of aesthetics, the fill has incredible transformative power. There are currently two patient profiles that come to me, the older patient seeking rejuvenation, and the young patient seeking harmony with more attractiveness.
In both cases, the filling is fundamental, because we can literally “draw” on this patient’s face, projecting malar, mandibular contour, chin (chin), redefining the lip contour and highlighting the cupid’s bow, among other details that can harmonize and give more attractiveness on one face.

Already in the older patient, the constant search for rejuvenate and, of course, rejuvenate naturally. In such cases, it is critical for the patient to perform facial filling to correct tissue reduction over the years, when the skin thins, the lip thins, creating the famous “barcode”. The malar projection decreases, temporal sinks and mandibular loses its definition. Even bone decreases with age, and patients between the ages of 70 and 90 are often advised against dental implants due to lack of bone.

I estimate that over 60% of the sagging aspect is due to tissue loss and not just loss of elastin and collagen. If we can perform harmonic correction and if the product is a good neocollagen stimulator, this gain in the youthful aspect we have is even greater. Besides the possibility of a facial harmonization of details that can show more attractiveness and harmony.
Aged appearance over 60% due to tissue loss, whether bone, subcutaneous or dermal. If we seek natural rejuvenation, we need to act on these three layers.

At the same time, it is very important for the patient to perform an adjunctive treatment on the quality of the skin, which, in addition to greatly improving the filling and application of substances such as polylactic acid, calcium hydroxyapatite and polymethyl methacrylate (both good collagen stimulators). should perform an adjuvant laser treatment for improvement in skin quality. (see more in laser treatments)

Loss of bone and subcutaneous tissue of the malar region, this tissue loss promotes sagging appearance, contributes to tiredness and increased nasojugal groove, also called tear drop or, popularly, that deep dark circles. Often, the patient does not need inferior blepharoplasty, in many cases what he needs is filling the malar and nasojugal region.

The combination of techniques provides the most natural and harmonious result to the eye of the beholder, although the facial surgical treatment still has space, the number of this procedure has been decreasing and much with the advent of new technologies and filling techniques. In addition, plastic surgery does not treat skin quality, does not stimulate collagen, does not treat blemishes, does not correct tissue loss, and if not performed by combining these treatments (filler and laser), the result can be an old and stretched face, unnaturally.

By Dr. Roberto Chacur