中面年轻化是透明质酸真皮填充剂最有价值的适应症之一,因为颌骨突起和丰满的上脸颊显着有助于年轻的外观。透明质酸填充剂在过去的20年中已经进化以满足特定的临床需求,例如强大的投射能力和对面部活力的适应性。因此,它们现在通过提供非侵入性治疗的潜力,代表了整个年龄段的中面年轻化治疗的选择,立竿见影的结果,和最小的停机时间。因为中面的5层结构在人脸中起着核心作用,注射中面区域还可以间接改善其他美学问题,例如眶下凹陷和鼻唇沟。尽管如此,中面年轻化需要量身定制的治疗方法和全面的解剖学知识,以最大限度地减少手术风险,实现自然的结果。本文提供了对中面以及附近循环的血管结构的通常过程和深度的广泛解剖描述,以描绘治疗区域并最大程度地减少手术风险。此外,考虑到中间面每一层的差异移动性和机械约束,提出了一种多层治疗算法,用于使治疗策略适应患者的具体情况(包括年龄,性别,皮肤类型,和形态学)。还将重点放在期望的填料性质上,以一方面产生深的结构支撑,另一方面伴随面部运动。
Midface rejuvenation is among the most valuable indications of hyaluronic acid dermal fillers, because malar projection and full upper cheeks significantly contribute to a youthful appearance. Hyaluronic acid fillers have evolved over the past 2 decades to meet specific clinical needs such as strong projection capacity and adaptability to facial dynamism. As a result, they now represent the treatment of choice for midface rejuvenation throughout age ranges by offering the potential for noninvasive treatment, immediate results, and minimal downtime. Because the 5-layered structure of the midface plays a central role in the human face, injecting the midface area may also indirectly improve other aesthetic concerns such as infraorbital hollowing and nasolabial folds. Nonetheless, midface rejuvenation requires a tailored treatment approach and a thorough knowledge of anatomy to minimize procedural risks and achieve natural-looking results. This article provides an extensive anatomical description of the midface and of the usual course and depth of vascular structures circulating nearby to delineate a treatment area and minimize procedural risks. Furthermore, considering the differential mobility and mechanical constraints of each layer of the midface, a multilayer treatment algorithm is proposed for adapting the treatment strategy to patient specificities (including age, gender, skin type, and morphology). Emphasis is also placed on desirable filler properties to create deep structural support on the one hand and accompany facial movement on the other hand.