Phi, Fat, and the Mathematics of a Beautiful Midface

Stein, Ran; Holds, John B.; Wulc, Allan E.; Swift, Arthur; Hartstein, Morris E.

doi:10.1097/iop.0000000000001167

Cited by 15 publications

(9 citation statements)

References 26 publications

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“…The green line is the baseline X, then the blue line is 1.618 X, the black line is 0.618 X, the orange line is 0.382 X, and all the same color lines are the same length; 1.618, 0.618, and 0.382 are all gold ratios (the theory of proportion markers from Dr Arthur Swift). 14 (B, C) Female, 48 years old, before (lower left) and 3 months after injection (lower right) according to “Cui Codes” design method.…”

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confidence: 99%

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An Innovative Approach for Facial Rejuvenation and Contouring Injections in Asian Patients

Cui

Zhao

et al. 2021

Aesthetic Surgery Journal Open Forum

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An increasing number of Asian people are seeking nonsurgical facial aesthetic treatments. Ethnic Asians differ from Western populations in both facial appearance and baseline structural facial anatomy. And there is a lack of clinical instruction to doctors who provide facial aesthetic treatment for Asian patients. The authors proposed the “未来 Future Codes” design in Chinese calligraphy describing the art of facial injection in Asians to help doctors perform well. “未来” are pictograph of 2 Chinese characters, translated into English as “Future,” which represent beautiful meanings and vividly describe the procedure and operating area of the design methods. The concept encompasses a systematic overall design for the art of facial injection in Asians, and these procedures are easy to learn and perform safely. This is the first systematic solution available in the clinic that can be used to design facial aesthetics and rejuvenation in Asians through Eastern philosophy and culture. Level of Evidence: 5

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confidence: 99%

“…Therefore, proportional aesthetics are an important feature of beauty and occupy an important position in formal aesthetics. 14 …”

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confidence: 99%

An Innovative Approach for Facial Rejuvenation and Contouring Injections in Asian Patients

Cui

Zhao

et al. 2021

Aesthetic Surgery Journal Open Forum

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“…In their article [16], Stein et al, presented their theoretical work of a beautiful midface by combining the shaping of the mid-face fat with each lower eyelid blepharoplasty to achieve a "Phi point". This agrees with our work, that blepharoplasty and facial fat reshaping will achieve aesthetic results without the need of full facelift.…”

Section: Discussionmentioning

confidence: 99%

Fat Injection for Restoration of Facial Volume and Aesthetics Versus Conventional Facelift Surgery

Sherif

Kamel

Naggary

2019

The Egyptian Journal of Plastic and Reconstructive Surgery

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Facial rejuvenation has increased in demand recently. Standard facelift surgery has been challenged by more recent, less invasive techniques; those are heralded to provide a safer and cheaper alternative to selected patients. In this work, we compare simple fat grafting to a full facelift procedure. Patient satisfaction scores were statistically significantly higher in the fat graft group, while surgeons' satisfaction was comparable in both groups. Complication rates were higher in the full facelift group. Blepharoplasty combined with lipofilling seems to be an effective and satisfactory means for facial rejuvenation in suited female patients.

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“…8 Injectable fillers and autologous fat are versatile as they may be used alone for midfacial rejuvenation or as an effective adjunct in surgical blepharoplasty or facelift. 9,10 The ideal soft tissue filler is effective, nonimmunogenic, nontoxic, noncarcinogenic, nonmigratory, easily applied, nonpalpable, painless, and long lasting. 11 The fact that no single agent meets all of these ideals explains the multiple options that practitioners have available in their arsenal.…”

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confidence: 99%

“…15 Still others have focused on Phi, the golden ratio, to determine the aesthetic ideals of the midface. 9 Jacono and Rousso have developed a classification system of midfacial aging and developed an algorithm for treatment. 16 The various efforts by these authors underscore the central role the midface plays in facial aesthetics.…”

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confidence: 99%

Non-Hyaluronic Acid Fillers for Midface Augmentation: A Systematic Review

Trinh

Gupta

2021

Facial Plast Surg

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There has been an increasing role in the use of injectable fillers for rejuvenation of the aging face. In this systematic review, we aim to evaluate the existing literature related to soft tissue fillers of the midface. Specifically, we focus on the non-hyaluronic acid fillers including polymethylmethacrylate (PMMA), poly-L-lactic acid (PLLA), calcium hydroxyapatite (CaHA), and autologous fat. A systematic review was conducted in November 2020 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with PubMed and Embase databases. Medical Subject Headings terms used were “cheek” OR “midface” OR “malar” and “filler” OR “poly-L-lactic acid” OR “calcium hydroxyapatite,” “autologous fat” OR “polymethylmethacrylate” OR “Artefill” OR “Bellafill” OR “Radiesse” OR “Sculptra.” The initial search identified 271 articles. After 145 duplicates were removed, 126 studies were screened for relevance by title and abstract. A total of 114 studies were eliminated based on inclusion and exclusion criteria. Twelve articles underwent full-text review. Seven articles were included in the final analysis consisting of four non-hyaluronic filler products: PMMA, PLLA, CaHA, autologous fat. Most patients were highly satisfied with their results. Due to the gradual volumizing effects of PMMA, PLLA, and CaHA, patient satisfaction generally improved over time. Minor adverse reactions related to treatment included bruising, swelling, and pain. Nodule formation was reported in PLLA and CaHA studies. For autologous fat, 32% of the original injection volume remained at 16 months post-treatment, which still provided clinically improved malar enhancement. Dermal fillers are an attractive treatment option for the aging face due to their high patient satisfaction, long-lasting effects, and low side-effect profile. Patients should be appropriately counseled on the delayed effects of non-HA fillers. Autologous fat is a good option in many patients with the major drawback of unpredictable longevity, which may require a secondary procedure. Future studies should examine the longevity and long-term side effects of these fillers.

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Phi, Fat, and the Mathematics of a Beautiful Midface

Abstract: Lower blepharoplasty combined with autologous fat transfer to reshape the Phi point is a safe and reliable technique and another step further in our quest for recreating the beautiful face.

Cited by 15 publications

References 26 publications

An Innovative Approach for Facial Rejuvenation and Contouring Injections in Asian Patients

An Innovative Approach for Facial Rejuvenation and Contouring Injections in Asian Patients

Fat Injection for Restoration of Facial Volume and Aesthetics Versus Conventional Facelift Surgery

Non-Hyaluronic Acid Fillers for Midface Augmentation: A Systematic Review

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