Sato Mauricio, Muniz Mariana, Ferreira Luis Ricardo Coelho
IDEL Institute, Dermatology Department, Curitiba, Brazil.
Mariana Muniz Dermatologia, Dermatology Department, São Paulo, Brazil.
Clin Cosmet Investig Dermatol. 2024 Nov 11;17:2545-2553. doi: 10.2147/CCID.S468447. eCollection 2024.
The mid-face has been rendered as the cornerstone of facial aesthetic improvement, since treating the mid-face has also beneficial effects on neighboring esthetic units and therefore should be one of the first areas to be assessed. Retaining ligaments (RL) bind soft tissue layers of the face to the underlying facial skeleton. It remains controversial whether RL suffers laxity with aging or if changes in 42 bone and other structures where ligaments are inserted lead to altered mechanical function of the latter. Enhancement of the supportive effect of the ligaments could help restore the soft tissues to their original anatomical positions and achieve a lifting effect. While injectable hyaluronic acid implants have been used to improve ligament support, calcium hydroxylapatite has one of the highest viscoelasticities when compared with other dermal fillers and can induce collagen synthesis, which could provide long-term laxity correction. In this preliminary report of a case series, our goal was to describe the use of calcium hydroxylapatite in different dilutions and combinations for different aging profiles to treat the midface as an alternative for hyaluronic acid injections and to describe the ultrasonographic behavior in the long run.
中面部已被视为面部美学改善的基石，因为治疗中面部对相邻美学单元也有有益影响，因此应是首先评估的区域之一。保留韧带（RL）将面部软组织层与下方的面部骨骼相连。关于保留韧带是否会随着年龄增长而松弛，或者韧带插入的骨骼和其他结构的变化是否会导致韧带机械功能改变，仍存在争议。增强韧带的支撑作用有助于将软组织恢复到其原始解剖位置并实现提升效果。虽然可注射透明质酸植入物已被用于改善韧带支撑，但与其他真皮填充剂相比，羟基磷灰石具有最高的粘弹性之一，并且可以诱导胶原蛋白合成，这可以提供长期的松弛矫正。在这个病例系列的初步报告中，我们的目标是描述使用不同稀释度和组合的羟基磷灰石针对不同衰老情况治疗中面部，作为透明质酸注射的替代方法，并描述长期的超声表现。
