Facial Rejuvenation with Soft Tissue Fillers

The decision to undergo facial rejuvenation surgery can involve a variety of choices. The first step is to determine the patient's facial aesthetic concerns. Most people can point immediately to the areas in which they would like to see improvement. There are typically three aspects involved in producing a positive change in one's appearance. These are appropriate facial anatomic positioning, clean skin quality, and youthful facial soft tissue volumes.

As we age, our facial skin and soft tissue becomes less elastic, suffers repeated sun damage and undergoes fat volume loss. Most patients have some combination of these problems that produce the changes which are recognized in the aging face. As most patients understand, facial surgery may be necessary to improve deep facial structure loss. The most common procedures are facelifts and browlifts. Skin quality is managed by many interventions, ranging from topical skin programs to ablative laser surgery. The least familiar of the facial rejuvenation treatments may be the injectable agents. In the past, this branch of care was limited to collagen injections.

Modern injectable filler agents now include hyaluronic acid products such as Restylane which has been very helpful, particularly around the lips and nasolabial folds. Aesthetic facial surgeons have long recognized that loss of facial fat cannot be reliably restored on a long term basis with any off-the-shelf product. This is where Sculptra comes in.

Sculptra is injected into the skin for restoration of the signs of fat loss. It is effective, well tolerated and long-lasting. It is synthetic, compatible with the skin and biodegradable. It is made from a material which has been used in dissolvable suture material and soft tissue implants for years.

Sculptra is injected with local anesthesia below the skin surface in areas which have suffered volume loss. It provides a gradual increase in the thickness of the skin. It will not correct the cause of fat loss but will substitute for it with increasing skin thickness.

Sculptra works differently than the injectable which preceded it, in that its result is accomplished over time rather than immediately. This allows the body time to respond to the product. Most patients require a series of two to three sessions spread out over about three months. However, also unlike other injectables, it requires a reinjection only about every two years to maintain the correction once maximum improvement has been obtained. Sculptra is indicated for the treatment of lipoatrophy in immunocompromised patients, but is being used off-label for a number of soft tissue augmentation procedures on the face.

Sculptra is injected using a skin ointment anesthesia. As with any injections, there may be minor discomfort. After, some bruising may be anticipated which is self-limited and quickly absorbed with massage and ice pack application.

So, when considering a facial rejuvenation, it is important to recognize the elements that compose a youthful facial balance. Restoration of the facial positional architectural, skin quality, and volume should all be addressed for each individual to produce an elegant harmony. It is only through this thoughtful consideration that the "operated" look is avoided.