Techniques to enhance lower face results

Paris - Lower-facelifting in anti-aging medicine is one of the most sought after procedures by patients.

Aside from invasive surgical lifts, there are many other noninvasive treatment modalities at the disposal of the aesthetic physician that he or she can offer patients, ranging from laser resurfacing techniques, peels, mesolifts as well as collagen and hyaluronic acid fillers.

Marie-Therese Bousquet, M.D., an aesthetic physician from Paris, offers her long experience and insight on facial rejuvenation techniques, and spoke of her favorite treatment methods when treating the lower face, at the Anti-Aging Medicine World Congress, here.

To maximize cosmetic results in her patients, Dr. Bousquet tells Dermatology Times that she likes to combine different techniques like a mesolift, lasers or even photodynamic therapy (PDT), with botulinum toxin or collagen injections and standard fillers like hyaluronic acids and polylactic acids.

In her patients, the aesthetic physician very often opts for a mesolift technique, which is establishing itself as a safe and natural alternative to traditional cosmetic facial procedures. This is a treatment modality where improved tonicity and elasticity of the skin can be achieved through a series of micro-injections, consisting of vitamins, amino acids, minerals, co-enzymes and nucleic acids, all of which are crucial for a good exogenous biological balance and a strengthening of the architecture of the skin.

"This technique is very effective in my patients, giving their aging facial skin a well-needed rehydration by infusing it with potent antioxidants and vitamins, effecting a rejuvenated, revitalized, more radiant and youthful glow. These series of injections will help stimulate the skin to increase collagen and elastin formation, which effectively slows down the aging processes of the facial skin. The procedure is painless and there is no downtime for the patients," Dr. Bousquet explains.

Taking proactive, early approach

She says the trick in maintaining a youthful and bright facial expression in her patients is in the prevention of a loosening and relaxation of the skin, made evident in the fine lines and wrinkles seen.

According to the physician, the tonicity of the skin can be maintained through early noninvasive interventions (before wrinkles go deep), mesolifts, peelings and fillers. When these techniques are carefully combined, they can significantly postpone any eventual surgical lifting procedures.

Dr. Bousquet says that when she wants to effect a "revitalization" of the aging skin, she likes to perform a superficial peeling and combine it with cosmeceuticals (e.g. wrinkle creams, moisturizers and sunscreens). For a "brighter" look, the aesthetic physician usually performs a deeper peel with trichloracetic acid.

A "stimulating" treatment that Dr. Bousquet often uses is a combination of a 20 percent to 30 percent trichloracetic acid peel with a rejuvenating pulsed light therapy. This thermal treatment produces a rejuvenating effect by reorganizing subcutaneous tissues, by activating fibroblasts and by stimulating the formation of collagen tissue in the skin.

When treating the aging facial skin in her patients, Dr. Bousquet likes to use an array of fillers including Restylane (Q-Med), Hydrafill Softline (Corneal), Esthelis Soft (Anteis) and Zyplast/Cosmoplast (Allergan) fillers. The physician usually administers two injections of these fillers over a period of four to six weeks, with the third injection occurring at six months, and follows up with a maintenance injection at nine to 12 months or 12 to 18 months, the target depth being the mid-dermis. She says that the side effects are minimal and include edema and ecchymosis, but this lasts only for 12 to 36 hours post-procedure.

Analysis, approach, expectations

"Before I perform any aesthetic intervention in my patients, I always examine them thoroughly, take documentation photos and above all, 'listen' to them concerning their needs and expectations.

"Then I offer them my best thought-out solution for their cosmetic problem and allow them ample time to reflect on the eventual upcoming therapy proposed.

"Laying down the ground rules of expectations from patients and attainable goals achieved by the physician before treatment is crucial for a successful procedure and satisfying for both patient and physician alike," Dr. Bousquet says.