Monday, November 2, 2015

Dermatology Foundation Clinical Symposia: Focus on Soft Tissue Augmentation

The highly esteemed Dermatology Foundation Clinical Symposia provided the latest clinically relevant research and information on various surgical and aesthetic dermotological procedures. Hedi A. Waldorf, MD presented the address A Practical Approach to Soft Tissue Augmentation Based on Art, Science, and Economics that focused on three-dimensional facial rejuvenation.

The art. In the past, two-dimensional facial rejuvenation was used, which simply flattened wrinkled skin by deep abrasion or pulled the skin taut using surgical measures. This resulted in an artificial appearance. Today, this technique is replaced by a three-dimension approach that, according to Dr. Waldorf, is what “makes us look normal.” This third-dimensional approach addresses the dynamic reality of the full face, not just isolated features. Waldorf explained that the face must be assessed from multiple angles to determine which products and procedures will result in a more natural-looking and youthful appearance.

The science. Waldorf discussed the individual characteristics of different filling agents—cross-linking, chain length, particle size, concentration, viscosity—and their uses, such as filling, lifting, shaping, and boosting the skin. Not one product does it all, so varied products that work well together should be selected to create a natural, blended look. To maximize results and minimize complications, Waldorf advised using injection technique plus product choice and placement. For example, she suggested using only a very low viscosity hyaluronic acid gel injected superficially to reduce the risk of vascular occlusion in the treatment of glabellar lines.

The economics.  The patient’s finances and social and work obligations determine the timeframe for how quickly or slowly the work can be performed. Typically, the same results can be achieved with either one or two syringes of product at regular intervals over a year or two, or with multiple syringes in one or two sessions.
During her presentation, Waldorf discussed specific case studies including the patient’s presenting complaint, respective solution (e.g., where to treat, with what, how much, and over what period of time), and the results.

Dermatology Foundation. (Spring 2015). A practical approach to soft tissue augmentation based on art, science, and economics by Heidi A. Waldorf, MD. Dermatology Focus 34(1), 17-18. Retrieved October 17, 2015, from

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