The inferior third of the face: therapeutic news.

(Presentation at the congress of Rome 2004)

Redaelli A. M.D. Milan, mail@docredaelli.com

Wrinkles and facial hollows are the last expressions of numerous etiological factors that, combined according to the already well codified laws, cause the aging that aesthetic doctors want to face.

The third inferior of the face, in particular the peribuccal and the cheeks zone, represents a part of the face which is difficult to correct, because more than one etiological factor often co-exist:

·the relaxation of the SMAS, with an imbalance of the agonist and antagonist forces

·the quantitative reduction of the subcutaneous, that particularly in the cheeks zone make small wrinkles appear and make them difficult to correct

·the thinning of the epidermis and the skin for the reduction of collagen, elastin and hyaluronic acid..

So far, only the surgical techniques as lifting or Coleman’s liporeconstruction allowed making this part of the face look younger, but however facing only certain aspects of the aging.

The aesthetic medicine, facing the multiple faults of this physical district with a polyfactorial approach, make itself a valid integration of surgery but in many cases it is also an alternative to it.

In fact in the last few years new techniques, that allow also the aesthetic doctors to get closer to the treatment of this area, were added:

·the botulinic toxin that, according to the recent literature, allows a remodelling of the profile of the inferior of the face especially modulating the force of the depressor muscle of the lip’s angle and of the platism in its mandibular insertions.

·the polylactic acid that allows to give the important volumes back, when it is necessary, but also give the tones and the turgidity back to the cheeks with a very delicate action if injected with low dosages but very often from the chin to the tragus with an innovative technique of liporeconstruction.

Both these techniques impose accurate indications and especially a rigorous executive technique to avoid unwanted effects that can and has to be reduced to the minimum.

The relation wants to make the point about the most recent literature and that is why it reports the indications, dosages, technical details, possible collateral effects and the obtained results.