Surgery

The most common complications associated with surgical procedure are:

  • Alopecia
  • Haematoma
  • Hypertophic scars
  • Infections
  • Skin loss close to the incision border
  • Minimal skin loss
  • Mobility disorders caused by the marginal mandibular nerve paresis
  • Seroma
  • Severe and prolonged oedema
  • Superficial cutaneous necrosis.
  • Costs.

Aesthetic surgery, particularly the use of biodegradable dermal fillers, is a growing field. According to the American Association of Plastic Surgeons more than 244000 surgical rhinoplasties, and 119000 facelifts were performed in 2011, representing an increase of 1% and 9%, respectively, over those performed the previous year. The average cost of these procedures exceeds $8000 per rhinoplasty and $12000–15000 per facelift. During the same period, the real growth in cosmetic procedures was in dermal injections and this trend was even higher in 2012. Botulinum toxin injections increased by more than 150% and HA treatments are growing each year with a cost which is approximately $500–$1500 per treatment area.

Conclusions

Injectable facial fillers offer an excellent option in the treatment of facial ageing, wrinkling, and contour defects. They are a viable alternative to surgery for patients seeking a safe, minimally-invasive, and affordable means of maintaining a youthful appearance. It is imperative for the aesthetic surgeon to have a thorough knowledge of all the available products and their properties. This knowledge will enable optimal pairing of facial filler with specific defects and consequently, maximum efficacy and patient satisfaction6.

Botulinum toxin and dermal fillers can also be combined with particular types of lasers or light sources in order to produce non-ablative or fractional skin rejuvenation, vascular alterations, and adequate skin tightening, as well as improve pigmented lesions, wrinkles, and acne scars. The concept is to treat the wrinkles and folds, and also improve the photodamage related to the ageing process and skin laxity.

Facial plastic surgery procedures, such as cervicofacial rhytidectomy or blepharoplasty, are the most common procedures used in combination with fillers and botulinum toxin. Whether the optimal moment for injecting botulinum toxin is before or after the surgery remains a subject of debate. A potential advantage of its use prior to surgical intervention is the stabilisation of cutaneous or even myocutaneous tissues. This, in turn, would facilitate their adequate accommodation, decreasing tension in the incision, suture, flaps and traction areas, thus improving the quality of the scarring process8.

The literature indicates that rejuvenation of the mid-face is a rapidly evolving field attracting broad interdisciplinary interest. Success in mid-facial rejuvenation depends on eliciting patient concerns, arriving at an accurate diagnosis, and executing a treatment plan accordingly. Emphasis should be placed on long-lasting results. As with rejuvenation elsewhere in the face, a combination of tissue suspension and volume augmentation is often necessary in order to produce the most satisfied patients10–12.

 

Pages: 1 2 3 4 5