Superficial Nasal Filler Injections-How I do It.

Nasal enhancement is one of the most challenging and intriguing of aesthetic procedures. Although the nose is the most central and prominent facial feature, it should not be dominant while maintaining both a harmonious relationship with the face and its own intrinsic beauty. In this article, the first author shares his experience on how to specifically apply intradermal soft-tissue fillers (for particular indications) in nasal enhancement and incorporates patient assessment, anatomy of the nose, and injection techniques to provide guidance. Intradermal injections are required for specific regions, as for example in the treatment of internal and external valve collapse; however, several precautionary measures need to be implemented to minimize risks resulting in vascular compromise.

Effective Rejuvenation with Hyaluronic Acid Fillers: Current Advanced Concepts.

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Process several patient-specific factors before reaching an optimal treatment strategy with appreciation for facial balance. 2. Define the advantages and disadvantages of various hyaluronic acid preparations and delivery techniques, to achieve a specific goal. 3. Perform advanced facial rejuvenation techniques adapted to each facial zone, combining safety considerations. 4. Prevent and treat complications caused by inadvertent intraarterial injections of hyaluronic acid. SUMMARY: The growing sophistication and diversity of modern hyaluronic acid fillers combined with an increased understanding of various delivery techniques has allowed injectable filler rejuvenation to become a customizable instrument offering a variety of different ways to improve the face: volume restoration, contouring, balancing, and feature positioning/shaping-beyond simply fading skin creases. As more advanced applications for hyaluronic acid facial rejuvenation are incorporated into practice, an increased understanding of injection anatomy is important to optimize patient safety.

BeautiPHIcation™: a global approach to facial beauty.

The recent availability of safe volumizing fillers has provided cosmetic physicians with the tools necessary to contour facial features non-surgically and cost-effectively. This review focuses on outlining objective parameters necessary for creating a template to maximize each individual's facial beauty. Phi relationships can be approached for all facial features and rely on the establishment of smooth ogee curves in all dimensions. Once goals have been determined and a budget established, a logical syntax is used to create an algorithm for selecting products and procedures. The methodology leads to consistent and pleasing results with a high rate of patient satisfaction.

Randomized, double-blind comparison of the efficacy of two hyaluronic acid derivatives, restylane perlane and hylaform, in the treatment of nasolabial folds.

BACKGROUND: Cross-linked hyaluronic acid gels may offer longer-lasting cosmetic correction and a lower risk of immunogenicity than other soft tissue augmentation agents. OBJECTIVE: To compare the efficacy and safety of a non-animal-stabilized hyaluronic acid gel (Restylane Perlane, Q-Med, Uppsala, Sweden) with that of a hylan B gel (Hylaform, Genzyme Corp., Cambridge, MA, USA), a cross-linked hyaluronic acid from chicken combs, for treatment of nasolabial folds. METHODS: One hundred fifty patients with moderate or severe nasolabial folds were randomized to contralateral treatment with Restylane Perlane and Hylaform. Efficacy was assessed using semi-objective outcome instruments at 3, 4.5, and 6 months after achievement of an "optimal cosmetic result". Patients subsequently underwent open-label bilateral retreatment with Restylane Perlane (if required) and were followed up for a further 6 months. RESULTS: The two products were equally effective in producing an optimal cosmetic result, although fewer treatment sessions were required with Restylane Perlane. At 6 months post-treatment, a higher proportion of patients showed a > or = 1-grade improvement in Wrinkle Severity Rating Scale (WSRS) score with Restylane Perlane (75%) than with Hylaform (38%). Restylane Perlane was considered superior in 64% of patients, whereas Hylaform was superior in 8% of patients. Treatment-related adverse events tended to be more frequent with Restylane Perlane. Local injection-site reactions were generally transient and mild or moderate in intensity and were no more frequent after Restylane Perlane retreatment. CONCLUSIONS: Restylane Perlane provides a more durable esthetic improvement than Hylaform and offers acceptable tolerability.