How attractive parading faces are, but not too thin! Often one of the problems most felt by patients is that of exaggerated thinness, particularly of the face. In most cases, this is a constitutional problem, in that if it depends on temporary physical conditions, they are to be blamed on disease, and then therapy is directed at the disease.

Other times, the excessive thinness of the face may be due to hypoplasia of the upper jaw (a congenital reduction of the bones of the anterior facial massif), which may cause the malar area (the one under the eyes and at the sides of the nose) to be somewhat concave, whereas it should be slightly convex, fading then into the zygomatic region. The chin appears prominent and perhaps too visible.
Finally, the hollowing of the malar area and cheeks may be due to aging.
For these reasons, quite often, the problem also involves young patients who suffer from this constitutional-type problem such as, for example, the cheek a little too hollowed out compared to the cheekbone especially in the area lateral to the nasal wings, which continues the so-called “valley of tears.”

Excessive corrections are absolutely to be proscribed. It is abundantly clear that the art of filling only and exactly right differentiates one practitioner from another. How often do I see that it is the cheeks that have been “inflated,” while the cheekbone appears poorly projected. Also to be proscribed, of course, is the opposite, an overly projected cheekbone. The art lies in giving a good result without anyone noticing!

Facial aging patient with volume reduction on the sides of the nose before and after augmentation, in my opinion, natural but effective!

Volumizing the face can be performed by:

Resorbable fillers

I do not use nonabsorbable fillers, as I consider them to be dangerous even after some time, and I strongly advise against their implantation to all my patients.

Resorbable fillers are useful for interventions that are not excessive. If the volumes are large, costs increase depending on the number of vials needed.
Resorbable fillers and in particular thehyaluronic acid more or less cross-linked, are excellent for corrections in which the volumetric aspect is predominant, while tissue tone appears good. It should be emphasized that the latest hyaluronic acids that have appeared on the market allow effectively very natural corrections. In particular, I have developed an innovative technique whereby all complications from filler misplacement are absolutely zero. In fact, it happens quite often to see corrections in which one cheekbone is a little higher than the lateral counter. With this technique, however, these problems are zeroed out and even a child could perform the correction without any possibility of error. Moreover, the correction has to be done very deeply: this exposes the use of larger amounts (with higher costs), but the following naturalness will be really good.

Medical treatments of biorestructuring using the newest hybrid fillers

If well conducted, in my opinion, they are the treatment of choice, natural even for large volumes. We use polyolevolactic acid, tricalcium phosphate, calcium hydroxyapatite and polycaprolactone. How many possibilities we have available and how precise the indications must be. Each filler has its own indications that you absolutely must not get wrong.

I personally love very much Sculpra, the polyolevolactic acid. , but we also have today Ganafill Juvelook and Lenisna which are slightly different, perhaps for the better. The trick is to do many injections with very little material each, so they are very uniform. Juvelook is even indicated for the valley of tears. Unbelievable.

At the end, a long massage is performed, which allows a uniformity of correction that is unthinkable with normal fillers. These are not treatments to be performed in 10 minutes; the doctor absolutely must take his time: at least half an hour before the treatment, the patient puts on anesthetic cream, then goes to the treatment room, where he performs the treatment, then at least 20 minutes of massage: in all at least 1 hour, but often more!
Also the results are obtained as mentioned in a few months, as the volumetric and tension results are obtained by the body’s reaction and therefore it takes time. It is not a treatment for those who want immediate results.
I remain one of the few who have published some articles on this material that I know very well. You can of course see the articles in Pub Med, where I recommend you go to see what your experts are publishing!

Medical biorevitalization treatments

Useful more on skin texture and dermal tone than on volume. Personally, if the patient indulges me, I use these treatments to better prepare the tissues. In fact, the subsequent response to volumizing agents will be markedly better and the skin texture will be very positively affected. My favorite biorevitalization treatments are polyvitamins, the use of biointeractive hyaluronic acids, which are low in volume but very hydrating (the so-called Hidroreserve treatment), and the innovative hyper-concentrated platelet (PRP) treatment, which allows very fast healings and better results than the same treatment performed without PRP.