Midfacial rejuvenation by hyaluronic acid fillers and subcutaneous adipose tissue – A new concept

Wollina, Uwe

doi:10.1016/j.mehy.2015.01.023

Cited by 29 publications

(27 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Long-termed skin improvement after injection of different types of SFTs was theoretically connected with activation of the neocollagenesis in dermis, which was criticized as an unrealistic mechanism. 83,89 Independent of the filler type, STFs are generally applied into the deeper located sWAT 90 and thus it affects the AT structure. Moreover, it was shown that a midfacial STF injection demonstrates some beneficial effects also on the neighboring aesthetic units connected with another facial AT compartment.…”

Section: Soft Tissue Fillers Targeting Facial Adipose Tissuementioning

confidence: 99%

The Facial Adipose Tissue: A Revision

Kruglikov¹,

Trujillo

Kristen

et al. 2016

Facial plast Surg

View full text Add to dashboard Cite

Recent advantages in the anatomical understanding of the face have turned the focus toward the subcutaneous and deep facial fat compartments. During facial aging, these fat-filled compartments undergo substantial changes along with other structures in the face. Soft tissue filler and fat grafting are valid methods to fight the signs of facial aging, but little is known about their precise effect on the facial fat. This narrative review summarizes the current knowledge about the facial fat compartments in terms of anatomical location, histologic appearance, immune-histochemical characteristics, cellular interactions, and therapeutic options. Three different types of facial adipose tissue can be identified, which are located either superficially (dermal white adipose tissue) or deep (subcutaneous white adipose tissue): fibrous (perioral locations), structural (major parts of the midface), and deposit (buccal fat pad and deep temporal fat pad). These various fat types differ in the size of the adipocytes and the collagenous composition of their extracellular matrix and thus in their mechanical properties. Minimal invasive (e.g., soft tissue fillers or fat grafting) and surgical interventions aiming to restore the youthful face have to account for the different fat properties in various facial areas. However, little is known about the macro- and microscopic characteristics of the facial fat tissue in different compartments and future studies are needed to reveal new insights to better understand the process of aging and how to fight its signs best.

show abstract

Section: Soft Tissue Fillers Targeting Facial Adipose Tissuementioning

confidence: 99%

The Facial Adipose Tissue: A Revision

Kruglikov¹,

Trujillo

Kristen

et al. 2016

Facial plast Surg

View full text Add to dashboard Cite

show abstract

“…The associated morphophysiological changes described in the literature are cranial bone remodeling, facial sagging due to gravity and loss of soft-tissue fullness in certain areas with hypertrophy of fat in others 1. According to expert consensus, volumetric restoration of the midface is the first essential step in global rejuvenation, as it has the most significant impact on the malar contour and the surrounding areas 2–4…”

Section: Introductionmentioning

confidence: 99%

Effectiveness evaluation of two volumizing hyaluronic acid dermal fillers in a controlled, randomized, double-blind, split-face clinical study

Kerscher¹,

Agsten²,

Kravtsov³

et al. 2017

CCID

View full text Add to dashboard Cite

BackgroundEnhancement of the midface can be achieved with volumizing hyaluronic acid (HA) fillers.ObjectiveThe objective of this study was to compare the safety and effectiveness of Cohesive Polydensified Matrix® 26 mg/mL HA gel (CPM-26) and Vycross® 20 mg/ml HA gel (VYC-20) in a controlled, randomized, evaluator-blind, split-face clinical study.Patients and methodsSubjects with moderate-to-severe malar volume loss on the Merz Aesthetics Scale (MAS) received CPM-26 on one side and VYC-20 on the contralateral side of the face. Effectiveness assessments were performed by blinded evaluators including photographic and live MAS ratings and live Global Aesthetic Improvement Scale (GAIS) ratings. Calculations of anatomical volume variations at month 3 (M3), month 6 (M6), month 12 (M12) and month 18 (M18) were also performed.ResultsNon-inferiority of CPM-26 versus VYC-20 was demonstrated at M3 (primary end point) based on MAS. GAIS rating showed that significantly more subjects had better improvement with CPM-26 than with VYC-20 at month 1, M3, M12 and M18 (p=0.0032, p=0.0074, p=0.0384 and p=0.0110, respectively). Standardized evaluation of volume variations from baseline to M3, M12 and M18 showed that CPM-26 created more volume augmentation at all time points, and the difference was significant at M3.ConclusionCPM-26 was non-inferior to VYC-20 based on MAS ratings at M3 and demonstrated a favorable safety and effectiveness profile for midfacial volume enhancement with results lasting up to M18.

show abstract

“…Usually, the deep facial fat pads are slowly renewing with an average turnover time of about 10 years (Arner et al, ). With this background, the injection into deep facial fat depots with higher concentrated HA filler—known to produce long‐standing volumizing effects—may be explained by activation of adipose tissue‐derived stem cells (Kruglikov & Wollina, ; Wollina, , ; Wollina, Goldman, et al, ; Wollina, Wetzker, et al, ). Facial rejuvenation with HA filler should therefore start with the injection into deep mid‐facial fat pads to achieve optimal results (Wollina, 2015b).…”

Section: Interaction Of Ha‐fillers With White Adipose Tissuementioning

confidence: 99%

Adipose tissue, fillers, and skin tightening

Wollina

Goldman

Abdel-Naser

et al. 2018

Dermatologic Therapy

Self Cite

View full text Add to dashboard Cite

The role of adipose tissue has long been underestimated in esthetic dermatology. With the development of liposculpture and lipolysis, subcutaneous adipose tissue has gained an increasing interest. Harvested tissue has been used for lipofilling. In recent years, a better understanding of adipocyte physiology and its role in aging opened a new road for targeted treatments. Subcutaneous adipose tissue is no longer an innocent bystander in the combat of aging and the correction in esthetics. Adipose tissue is of importance for metabolic function and thermoregulation. Adipose tissue is involved in inflammation. Adipose tissue is heterogeneous in sense of function, color and size of adipocytes. The tissue is an important source of somatic stem cells.

show abstract

Midfacial rejuvenation by hyaluronic acid fillers and subcutaneous adipose tissue – A new concept

Cited by 29 publications

References 42 publications

The Facial Adipose Tissue: A Revision

The Facial Adipose Tissue: A Revision

Effectiveness evaluation of two volumizing hyaluronic acid dermal fillers in a controlled, randomized, double-blind, split-face clinical study

Adipose tissue, fillers, and skin tightening

Contact Info

Product

Resources

About