There are many of the benefits of soft tissue fillers. Here is a summary:
- Fills in wrinkles of the forehead and between the eyes.
- Fills out the temple hollow.
- Plumps up the upper lid and eyebrow giving appearance of a brow lift
- Fills in hollow of upper eyelid giving a more youthful appearance
- Fills in the crease below the lower eyelid.
- Camouflages lower eyelid bags by filling in the crease.
- Fills in the tear trough located under the eye close to the nose.
- Does a remarkable job of creating fuller cheeks.
- Improves upper lip crease (naso-labial fold)
- Provides excellent lip augmentation that can be adjusted according to patient desires.
- Fills in fine wrinkles above and below the lips.
- Fills in Marionette lines.
- Diminishes acne scars.
- Can help to fill in depressed scars.
- Is quick with minimal discomfort.
- More of it can be added until the
desired results are achieved.
- It is safe and relatively low cost.
Why do we need soft tissue fillers?
As mentioned above, the last ten years have uncovered many major developments in the field of plastic surgery. Many of these developments were focused on what really is the cause of facial aging. No longer is the appearance of aging attributed primarily to sagging skin. Now, the focus is on what goes on beneath the skin and within the skin itself.
As we age the skin loses its elastic properties and stretches. The stretching part can be markedly improved by skin tightening. The elastic component is more difficult to correct and, to date, only minor advancements have been made. These include chemical peeling or laser resurfacing, a good skin care regimen, retinoic acid (Retin-A), and staying out of the sun for prolonged periods of time.
This presentation focuses on what goes on underneath the skin. This is where significant developments have been made and will continue to be made.
Lets look at the aging face below. As we age we notice that the cheek fat that was once firmly perched on top of the cheek bones begins to descend. This descent goes primarily to two places. One, above the upper lip creating a more pronounced upper lip fold (naso-labial fold). The second place is over the jaw line resulting in jowling.
When these two problems become significant, correction is most effectively treated with a face lift by a skilled plastic surgeon. Soft tissue fillers, however, do a very good job of filling in the wrinkles and depressions left behind by the descending or loss of facial fat.
Again, look at the pictures above and notice where fat descent or fat loss creates the obvious signs of aging. This may surprise you. Many people seek consultation with Dr. Cruise saying "Dr. Cruise, please remove the excess skin from my eyelids and cheeks." Skin excess often is not the main culprit especially in younger patients. Volume loss is usually a main component of the problem.
From top to bottom, lets review the areas where volume loss and/or descent is the major issue. The treatment options that Dr. Cruise favors for each of the next 8 problem areas are outlined in the Dr. Cruise's Philosophy section.
1) Forehead Wrinkles.
As we age, the forehead wrinkles become more and more evident. This is not because the muscles have gotten larger but because the subcutaneous fat over the muscles has gone away. With the fat gone, there is no longer a nice, cushy buffer between the skin and muscle. Therefore, the muscle acts directly on the skin; hence, the wrinkles.
2) Temple hollowing.
Another sign of aging is the gaunt look that begins to develop within the temple area. Eventually, you can see the outline of the skull as the fat descends or goes away.
3) Eye Brow and Upper Eyelid Sag.
As described above, This is an area that patients of Dr. Cruise often ask for skin removal or brow elevation. While this may be the case, fat loss is often to blame as well. To help explain this, look at the picture of the young model and the older woman. Look at the position of the brow. In this example the younger woman has actually lower eyebrow. If so, what causes the appearance of aging eyes?
Now look at the soft tissue volume. In the young model the eyebrow and upper eyelid is full and youthful. The older person has significantly less fat. This creates a hollow, older appearance.
In reality, both the appearance of brow sag and the excess of upper eyelid skin are caused primarily by the same problem; loss of soft tissue volume. The reason why the brows appear to sag in the older woman is because without this plump fat BELOW the eyebrow there is a deep, hollow crease. This gives a sunken, aged appearance.
Ironically, aggressive removal of the excess skin will accentuate this hollowness. Some surgeons still remove fat from the eyelid which is almost never necessary except in some ethnic groups such as asians.
4) Lower Eyelid Bags, Lid/Cheek Crease
With the descent of the cheek fat, the fat leaves the lower eyelid as it heads south. This exposes the underlying skull bone and creates a crease. You can feel this by pushing down on this area with your fingers. Sometimes, this crease is present even in young patients. When this crease occurs there is often an excess of fat just above the crease, i.e. bags. There are many factors involved in this area with the aging process but, soft tissue loss, is a significant factor. The section Dr. Cruise's Philosophy will go over each area specifically and its treatment.
5) Loss of Cheek Mound.
As depicted in the figure to the left, cheek fat descends with age. Some of the fat simply goes away. This accounts for the loss of cheek fullness and gaunt look of the face. The fat ends up above the upper lip creating an unattractive lip fold or it descends over the jaw line creating a jowl.
6) Naso-Labial Crease
The deepening of this crease is caused by the exact process that causes loss of cheek fat. As the cheek fat descends it gathers in this fold. Just below this fold forms a deeper crease.
7) Lip Augmentation
LIps are different than the other areas of the face. Soft tissue fillers are used in other areas to rejuvenate but fillers in the lips are also performed to enhance the sensual component of the lip. This is why the lips are unique. Consequently, this is the reason why it is the most common area augmented with fillers. One should not underestimate the rejuvenation effects of soft tissue fillers on the lips. Lip augmentation is an excellent way to make the entire face look younger. This is because as we age our lips get smaller.
8) Marionette Lines
Marionette lines are extensions of the naso-labial folds. They extend from the corner of the mouth down to the jaw line. It is named because these lines look like the lines formed by the moving mouth of a marionette puppet. It is not uncommon to see these lines in young people as well. Filling these wrinkles in with soft tissue fillers can effectively improve or eliminate these lines.
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