Dermal fillers are compounds that are injected directly into the dermis to restore volume and reduce the appearance of lines and wrinkles. Both Restylane and Juvederm are popular brands that are used to smooth wrinkles and facial folds, smooth lines around the mouth, and add lift and volume to the cheeks. Voluma is injected deeper into the skin, so it is important to consult an experienced injector for the best cosmetic results. The dermis is one of the most injected layers of skin by aesthetic professionals to reduce lines and wrinkles.
By injecting into this layer, we can rebuild, support, and strengthen the skin to prevent the breakdown and thinning of the reticular dermal layer that is directly underneath. In cases of very deep wrinkles, you can already see the impact that begins to manifest on the reticular dermis, which can shine like a pink area. The double plane technique is when a facial filler is administered within two different levels of the skin in a single area. Most commonly, one of these areas is the dermis, or middle layer of the skin.
To increase this initial injection, a filler will also be administered in the subdermal plane, which is a level directly below the skin. In some situations, two different types of infill will be used for these two different planes. For superficial injection at the level of the skin, a thinner filler will be used, while a thicker filler will be used for injection into the subdermal plane. The medial compartment of the superficial fat pad of the cheek is located medially to the paroticutaneous ligament and is the next compartment to be injected.
Again, the injection plane is superficial; in the subcutaneous layer and port, a 40 mm 25 G microcannula is chosen medial to the parotidoctaneous ligament in the upper lateral area of the compartment. The cannula is then directed inferomedially in a fan-shaped manner to uniformly deliver filling into this compartment. It is not always necessary to approach this compartment since when filling preauricular areas it often moves backwards, achieving a vector directed upwards and backwards. For this region, cohesive gels with moderate G' and G are used to spread evenly in subcutaneous tissue without weighing down on skin in this area. When injected into skin, dermal fillers can replace volume loss caused by illness or age and diminish appearance of wrinkles, wrinkles, and fine lines.
The development of safe, effective, and durable filling products; recent approval by Food and Drug Administration of Sculptra Aesthetic for cosmetic volume increase; and increased price pressures in traditional cosmetic surgery due to economic downturn have highlighted role of facial treatment fillers in non-surgical facial rejuvenation. For upper part of face, cosmetic fillers can be used to treat returned eyebrow or hollow lacrimal under eyes provided correct filler is chosen. How are dermal filler techniques chosen? Physician administering selected filler needs to meet each unique treatment goal in particular application region. Most important aspect of successful facial filler injection is competence to understand relevant anatomy which improves results and minimizes complications. Depending on patient's goals, treatment area, and physician preference not only will particular filler be chosen but also specific injection technique will be used. As cosmetic procedure fillers are generally safe as long as they are injected by certified medical professional with sufficient experience, training, and technical knowledge in treatment.
To avoid injury or compression of vessels filler injections at tip and back should be performed in preperiosteal and preperichondral layers. For each type of filling and target area there are several injection techniques depending on objectives of specialist and patient. Fillers are often classified according to their longevity in fabrics or source of filling material. Although rarely occurs with fillers necrosis is an adverse event that results from accidental intravascular injection of filler and causes death of skin tissue cells due to failure in blood supply. Risk of filling injections in nose is even greater if patient has undergone previous surgery on nose as this creates situation in which anatomy including blood supply of nose is less predictable. The double-plane technique is based on anatomy of deep and superficial fat pads; therefore each individual compartment must be injected separately since there is no propagation of filling from one compartment to another due to fibrous septa separating fat pads. To choose right dermal filler and inject it accurately it is important to understand layers of skin.
Viscoelasticity describes hardness or softness of gel and is defined by its elasticity (modulus of elasticity G') that is how filling is able to retain its shape when force is applied and its viscosity (modulus of viscosity G) that is how filling resists gradual deformation due to shear stress. As a cosmetic procedure fillers are generally safe as long as they are injected by certified medical professional with sufficient experience, training, and technical knowledge in treatment. To avoid injury or compression of vessels filler injections at tip and back should be performed in preperiosteal and preperichondral layers. In conclusion, understanding layers of skin as well as different types of fillers available can help you make an informed decision when considering dermal filler injections for facial rejuvenation.
