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.
References
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 http://dermatologyfoundation.org/pdf/pubs/DF_Spring_2015.pdf.
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