You can read the full text of this article if you:

Your message has been successfully sent to your colleague.

Trévidic, Patrick M.D.; Trévidic, Thibault M.D.; Imanilov, Alexander M.D.; Criollo-Lamilla, Gisella M.D.

Paris, France; and Budapest, Hungary

From the Expert2expert Group.

Received for publication January 12, 2021; accepted August 27, 2021.

Disclosure:Dr. P. Trévidic is the chief scientific officer for Teoxane Laboratories Geneva. The remaining authors have no financial interests in any of the products, devices, or drugs mentioned in this article. No funding was received for this article.

Related digital media are available in the full-text version of the article on www.PRSJournal.com .

Patrick Trévidic, M.D., Expert2Expert, 7 rue de Sontay, 75116 Paris, France, [email protected]

Understanding age-related changes in compartmentalized facial fat and their role in facial dynamics and aesthetics is essential to target filler injections for midface rejuvenation.

A novel anatomical approach (“smiling cadavers”) was used to identify the main midface fat compartments involved during muscular contraction when smiling and their motion and behavior with and without filler injections. Based on these insights and the literature, a multilayering filler injection approach was developed to optimize midface rejuvenation by restoring fat volumes using rheologically different products injected into different fat compartments.

Twenty-four hemifacial dissections confirmed the presence of two fat compartment layers, separated by the orbicularis oculi muscle in the horizontal plane and by the septa in the vertical plane, and revealed the anatomical effects of facial movement. The midface is composed of deep static fat compartments and a superficial dynamic adipose layer that follows the facial movements, creating a natural dynamic appearance. A proof-of-concept study involved 130 White patients (36 to 56 years; 91 percent women). After the procedure, 95 percent of patients and 98 percent of practitioners rated facial appearance as “improved” or “much/very much improved.” No major complications were reported.

The smiling cadavers method enhances understanding of dynamic facial anatomy by showing the superficial and deep fat compartments of the midface at rest and their motion during a procedure to represent a smile. The multilayered injection technique takes into account these anatomical findings to rejuvenate the midface, achieving a natural appearance at rest and during motion.

Your message has been successfully sent to your colleague.

David H. Song, M.D., M.B.A. is the President-elect of the American Society of Plastic Surgeons (ASPS). He is a consultant with BioMet, Emmi Solutions, LLC, a consortium-member providing senior debt for Brava, and consultant with and investor in HealthEngine.com. He receives author royalties from Elsevier. Scot Glasberg, M.D. is the President of the American Society of Plastic Surgeons (ASPS). He is a consultant with LifeCell Corp and Mentor Corp and an investor with Strathspey Crown. The authors have no sources of funding to report related to the writing or submission of this discussion.

The location and affiliation information should read as follows: Arlington Heights, Ill. From the American Society of Plastic Surgeons/Plastic Surgery Foundation.

David H. Song, M.D., M.B.A., 444 E. Algonquin Rd. Arlington Heights, IL 60005, [email protected]

Your message has been successfully sent to your colleague.

This website uses cookies. By continuing to use this website you are giving consent to cookies being used. For information on cookies and how you can disable them visit our Privacy and Cookie Policy.