Facial Volumization with Fillers

Advancements in anatomical understanding, aided by cadaver dissection and medical imaging over three decades, have highlighted volume loss as a major factor in facial aging. While initial volumization techniques focused on dermal and superficial subcutaneous injections, a recent paradigm shift emphasizes deep tissue correction. As minimally invasive cosmetic interventions rapidly expand, it is crucial for aesthetic surgeons to stay proficient, ensuring longitudinal and comprehensive patient outcomes. Equally important is educating noncore medical specialists engaging in nonsurgical cosmetic rejuvenation about limitations and potential dangers.

This article provides insights into tissue dynamics of the aging face, current temporary soft-tissue fillers (hyaluronic acid and calcium hydroxylapatite), injection techniques, detailed methods for correcting specific facial zones with volume loss, and potential complications. Additional alternatives, such as polymethylmethacrylate, poly-L-lactic acid, and autologous fat, with unique properties and injection techniques, are also discussed.

Hyaluronic acid fillers, introduced in the U.S. in 2003, dominate soft-tissue augmentation, produced through non-animal stabilized hyaluronic acid technology. Calcium hydroxylapatite, another temporary filler with properties similar to hyaluronic acids, is also explored. The focus in this article is on hyaluronic acid and calcium hydroxylapatite-based soft-tissue facial augmentation.