BOARD-CERTIFIED PLASTIC SURGEONS DISCUSS BEST PRACTICES FOR FACIAL REJUVENATION AT THE AESTHETIC MEETING OF THE AMERICAN SOCIETY FOR AESTHETIC PLASTIC SURGERY

The panel discussed the latest advances, including the ways various dermal fillers can be utilized to produce optimal results for targeted areas. There are thirteen FDA-approved dermal fillers on the market to-date, providing aesthetic plastic surgeons with the ability to customize anti-aging treatments to patients’ needs. “The filler choices are dictated by a patient’s unique aging pattern, the anatomical area to be treated and physiochemical properties,” explains ASAPS member, Dr. Z. Paul Lorenc.

“Stackable treatments,” a facial rejuvenation concept pioneered by Dr. Julius Few, combines dermal fillers with ultrasound technology like Ulthera and procedures including laser resurfacing to restore volume and lift and tighten the skin. “The combined synergistic triple threat is minimally invasive, and allows patients to return to their everyday activities within a day or two.”

“It is ideal for patients in the early to moderate stages of aging,” notes ASAPS member, Dr. Julius Few, “and you don’t have to be overly-aggressive with any of the components as they all feed off of one another to create the desired effect,” he continues.

Targeting various facial zones using different dermal fillers indicated for each respective area is a popular practice that aesthetic plastic surgeons are now using to produce natural-looking results with a longer shelf-life. “The days of using only one product on the entire face are over. What works best in one region might not produce the desired result in another region,” notes ASAPS member, Dr. Jackie Yee. “It is imperative to use the entire toolbox of injectables now at our disposal in order to produce the best possible result tailored to the individual patient,” she explains.

Restoring volume treats the target area, but has a ripple effect through the entire face. The variety of filler options also enables aesthetic plastic surgeons to treat previously neglected areas of the face. “Adding volume to the mid-face region for example will require fillers to be injected into the temple and forehead to balance out a patient’s facial features,” explains Dr. Yee.

Companies are mirroring this trend by manufacturing tailored dermal products. Juvederm Voluma is the first FDA approved filler designed specifically for mid-face rejuvenation, which Yee uses to sculpt and lift creating a very natural non-puffy contour with minimal swelling. It can last 18 – 24 months and is dissolvable. Restylane Silk was recently approved by the FDA specifically for lip definition and augmentation. Yee utilizes this product to address what is referred to as “the barcode” or the smoker’s lines around the mouth, and also to add definition to the lip and augment the lip size. “It’s easy to control so as to avoid the overly-inflated duck lips,” explains Yee. Radiesse just obtained approval from the FDA to include lidocaine in the mix, making it a painless option to treat a wide variety of areas including the nasolabial region. According to Yee, Radiesse is also a great option for the hands, as it’s opaque unlike other fillers, and can therefore conceal what some of her own lighter-skinned patients refer to as their “cadaver hand appearance” they notice as they age.

With more companies seeking FDA approval to expand indications for their products, companies and teaching plastic surgeons are allowed to demonstrate to their colleagues how best to use various dermal fillers to treat previously neglected areas. Prior to obtaining FDA approval, manufacturers were restricted in educating plastic surgeons about off-label yet beneficial uses of their products, and as a result some patients ended up with undesirable results. “Seek a board-certified plastic surgeon with significant experience using fillers because nothing replaces predictability of results as good training,” notes Dr. Z. Paul Lorenc.

Moderator: Steve Cohen, MD

Panelists: Z. Paul Lorenc, MD; Arthur Swift, MD; Jackie Yee, MD

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About ASAPS
The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world’s leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body. ASAPS is comprised of over 2,600 Plastic Surgeons; Active Members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and non-surgical aesthetic procedures. International Active Members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.

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