From private practice; the Department for Hand, Plastic, and Aesthetic Surgery, Ludwig Maximilian University; the Division of Anatomy, Department of Medical Education, Albany Medical College; Skin Associates of South Florida; and the Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic.
Riyadh, Saudi Arabia; Munich, Germany; Albany, N.Y.; Coral Gables, Fla.; New York, N.Y.; and Rochester, Minn.
Plast Reconstr Surg. 2021 May 1;147(5):765e-776e. doi: 10.1097/PRS.0000000000007857.
Although injectable soft-tissue fillers are frequently used for facial rejuvenation, there is a dearth of objective data evaluating the tissue-lifting effects. Current practices for efficacy evaluation include some subjectivity. This study seeks to evaluate the lifting effects of facial soft-tissue fillers in a quantifiable, objective setting.
Twenty fresh hemifaces obtained from 10 Caucasian body donors (seven women and three men) with a mean age of 83.5 ± 6.8 years and a mean body mass index of 25.3 ± 4.3 kg/m2 were injected with soft-tissue fillers following a predefined treatment algorithm. Three-dimensional surface scanning procedures were performed to assess postinjection effects.
Injections in the medial face [i.e., forehead, medial midface, and perioral (chin and labiomandibular sulcus)] increased the local surface volume by 0.67, 0.56, and 0.87 cc and created local (but not regional) lifting effects of 1.11, 0.11, and 0.74 mm. Injections in the lateral face (temple, lateral midface, and jawline) changed the local surface volume by 0.45, 0.02, and -0.38 cc, and created local lifting effects of 0.57, 0.81, and 0.29 mm, respectively. Lateral face injections, however, created additional regional lifting effects by co-influencing neighboring lateral facial regions, which was not observed for medial face injections.
This cadaveric study provides evidence that soft-tissue fillers, although typically classified as volumizers, can induce lifting effects of the face. Whereas temporal deep supraperiosteal injections have limited lifting effects, the combined effects of subdermal injections of the temple, lateral midface, and mandibular angle can induce lifting effects of the total lateral face.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
尽管注射用软组织填充剂常用于面部年轻化,但缺乏评估组织提升效果的客观数据。目前的疗效评估方法包括一些主观性。本研究旨在评估面部软组织填充剂在可量化、客观的环境中的提升效果。
从 10 名白种人体供体(7 名女性和 3 名男性)中获得 20 个新鲜半面,平均年龄为 83.5 ± 6.8 岁,平均体重指数为 25.3 ± 4.3 kg/m2,根据预定义的治疗方案注射软组织填充剂。进行三维表面扫描程序以评估注射后的效果。
在面部内侧(即额头、内侧中面部和口周(下巴和唇颏沟))注射后,局部表面体积增加了 0.67、0.56 和 0.87 cc,并产生了 1.11、0.11 和 0.74 mm 的局部(而非区域)提升效果。在外侧(太阳穴、外侧中面部和下颌线)注射后,局部表面体积分别改变了 0.45、0.02 和 -0.38 cc,并产生了 0.57、0.81 和 0.29 mm 的局部提升效果,然而,外侧面部注射会通过共同影响相邻的外侧面部区域产生额外的区域提升效果,而内侧面部注射则没有观察到这种效果。
这项尸体研究提供了证据,表明软组织填充剂虽然通常被归类为体积填充剂,但可以引起面部提升效果。虽然颞深骨膜上注射的提升效果有限,但太阳穴、外侧中面部和下颌角的皮下注射联合作用可以引起整个外侧面部的提升效果。
临床问题/证据水平:治疗,V 级。