The idea of the Lift© Concept is to achieve the best possible result of volumising procedures, not by using more product, but by taking into account the anatomical, physiological and ageing peculiarities of the patient’s face. The aim of the study was to investigate the following parameters: symmetry and asymmetry; the ‘golden ratio’ in practice, and whether it is generally useful; how patients see themselves and how the investigators saw them; and how to obtain the best results, with a youthful and natural effect.
Patients and methods
All patients were female (n=90) aged between 25 and 50 years, and were divided into three groups according to face shape: triangular, round, or rectangular. After dividing the patients into these groups, the authors then randomly divided the patients from groups 1 and 2 into two further groups. Half of the patients (n=30) were injected using a traditional volumising technique with approximately 4 cc per patient of Juvéderm® Voluma™. The remaining 30 patients were injected according to the principles of the LIFT Concept, and obtained the same results. All patients were also administered injections of onabotulinumtoxin A.
The authors attempted to analyse the areas in which the hyaluronic acid as administered and found an interesting conclusion — the quantity of product used is much less important compared with injecting the right place.
It is necessary to start volumisation carefully, taking into account the type of face and to combine with botulinum toxin. If hyaluronic acid is injected precisely, using all the principles described in this article, two-times less product is used. And combined with botulinum toxin, will give patients a more youthful look.
When Offering a new dimension in facial volumisation, it is necessary to consider that many plastic surgeons and aesthetic medicine specialists (e.g. dermatologists), when discussing less-invasive facial treatments, are actually referring to injections in general. It was true that 10–15 years ago, when there was a poor assortment of dermal fillers available, volume restoration was often carried out using fat, and it was usually fashionable among patients to look like as though they had undergone cosmetic surgery. Patients were overdoing facial treatments; too many botulinum toxin injections, for example, resulted in a frozen, expressionless look, while the over-use of dermal fillers resulted in puffy and artificial-looking face and lips. However, times have changed and it is now most common that patients want to retain the secret of their youthful look, as well as to look as natural as possible.
The ageing face
Dr Richard Glogau made the following classifications with regard to the ageing face:
- ■ 20s and 30s. People have minimal wrinkles, often caused by sun damage. Treatments can include sunscreens and skin care products containing retinol
- ■ Late 30s and 40s. An age for ‘wrinkles in motion’, or lines that appear when people smile or use other expressions. These can be treated with injectables, such as botulinum toxin or dermal fillers
- ■ 50s. People often have ‘wrinkles at rest’, or lines etched into an otherwise expressionless face. A combination of treatments can be used, including laser resurfacing or chemical peels, as well as injectable fillers. Cosmetic surgery may also be considered
- ■ 60s and older. A time of ‘only wrinkles’, when the face no longer has smooth skin. Treatments can include laser resurfacing or plastic surgery.