Pins and Needles: Minimally Invasive Office Techniques for Facial Rejuvenation

ABSTRACT

The desire for minimally invasive facial rejuvenation has continued to increase from the perspective of both the patients and injectors. For successful rejuvenation, it is important to understand the anatomic changes of the aging face as well as the properties of available neuromodulators and soft tissue fillers. The injector should be knowledgeable of the advantages and disadvantages of each product. Patient selection, perhaps, plays the largest role in success, choosing patients that would truly benefit from and have reasonable expectations for minimally invasive techniques. Unsatisfactory outcomes can be limited by meticulous injection technique and well thought out treatment plans.

KEYWORDS

Injectables - fillers - botulinum toxin - facial rejuvenation - minimally invasive

REFERENCES

• 1 Narins R S, Brandt F S, Lorenc Z P et al.. A randomized, multicenter study of the safety and efficacy of Dermicol-P35 and non-animal-stabilized hyaluronic acid gel for the correction of nasolabial folds.  Dermatol Surg. 2007;  33(Suppl 2) S213-S221 discussion S221
• 2 Narins R S, Brandt F S, Lorenc Z P, Maas C S, Monheit G D, Smith S R. Twelve-month persistency of a novel ribose-cross-linked collagen dermal filler.  Dermatol Surg. 2008;  34(Suppl 1) S31-S39
• 3 Eppley B L, Dadvand B. Injectable soft-tissue fillers: clinical overview.  Plast Reconstr Surg. 2006;  118 98e-106e
• 4 Reisman N R. Ethics, legal issues, and consent for fillers.  Clin Plast Surg. 2006;  33 505-510
• 5 Ali M J, Ende K, Maas C S. Perioral rejuvenation and lip augmentation.  Facial Plast Surg Clin North Am. 2007;  15 491-500
• 6 Engelman D E, Bloom B, Goldberg D J. Dermal fillers: complications and informed consent.  J Cosmet Laser Ther. 2005;  7 29-32
• 7 Maas C S, Yu K C, Egan K K. Neuromodulators and injectable soft tissue substitutes. In: Papel ID, Frodel JL, Holt GH, et al Facial Plastic and Reconstructive Surgery. 3rd ed. New York, NY; Thieme Medical Publishers 2009: 337-353
• 8 Maas C S, Ende K H, Lewis D A. Soft tissue fillers. In: Truswell W Surgical Facial Rejuvenation: A Roadmap to Safe and Reliable Outcomes. New York, NY; Thieme Medical Publishers 2008: 131-138
• 9 Petrus G M, Lewis D, Maas C S. Anatomic considerations for treatment with botulinum toxin.  Facial Plast Surg Clin North Am. 2007;  15 1-9, v
• 10 Maas C S. Botulinum neurotoxins and injectable fillers: minimally invasive management of the aging upper face.  Facial Plast Surg Clin North Am. 2006;  14 241-245
• 11 Ramirez A L, Reeck J, Maas C S. Botulinum toxin type B (MyoBloc) in the management of hyperkinetic facial lines.  Otolaryngol Head Neck Surg. 2002;  126 459-467
• 12 Lowe P L, Patnaik R, Lowe N J. A comparison of two botulinum type a toxin preparations for the treatment of glabellar lines: double-blind, randomized, pilot study.  Dermatol Surg. 2005;  31 1651-1654
• 13 Loos B M, Maas C S. Relevant anatomy for botulinum toxin facial rejuvenation.  Facial Plast Surg Clin North Am. 2003;  11 439-443
• 14 Stupak H D, Maas C S. New procedures in facial plastic surgery using botulinum toxin A.  Facial Plast Surg Clin North Am. 2003;  11 515-520
• 15 Dayan S H, Maas C S. Botulinum toxins for facial wrinkles: beyond glabellar lines.  Facial Plast Surg Clin North Am. 2007;  15 41-49, vi
• 16 Wise J B, Greco T. Injectable treatments for the aging face.  Facial Plast Surg. 2006;  22 140-146
• 17 Allergan, Inc. 10-k sec filing. Available at: http://sec.edgar-online.com/allergan-inc/10-k-annual-report/2007/03/01/Section3.aspx Accessed May 15, 2009
• 18 Monheit G D. Hyaluronic acid fillers: Hylaform and Captique.  Facial Plast Surg Clin North Am. 2007;  15 77-84, vii
• 19 Brandt F S, Cazzaniga A. Hyaluronic acid fillers: Restylane and Perlane.  Facial Plast Surg Clin North Am. 2007;  15 63-76, vii
• 20 Merzpharmaceuticals. Company press release 2005. Available at: http://www.merz.com/press/press-releases/company/2005/05/12/01/ Accessed May 15, 2009
• 21 Ahn M S. Calcium hydroxylapatite: Radiesse.  Facial Plast Surg Clin North Am. 2007;  15 85-90, vii
• 22 Narins R S, Beer K. Liquid injectable silicone: a review of its history, immunology, technical considerations, complications, and potential.  Plast Reconstr Surg. 2006;  118(3 Suppl) 77S-84S
• 23 Finn J C, Cox S. Fillers in the periorbital complex.  Facial Plast Surg Clin North Am. 2007;  15 123-132, viii
• 24 Kelly P E. Injectable success: from fillers to Botox.  Facial Plast Surg. 2007;  23 7-18 discussion 19-20