Part 1 - Neuromodulator Education

This page contains educational resources specific to the neuromodulators and fillers available at Peach Skin Clinic. This page is not meant to diagnose or recommend. If you have any questions, please contact us at one our facilities. 


Etiology of the aging face

The aging face has common changes that it experience as the patient matures. From the 30s to 50s, bone and collagen are lost and fat is typically redistributed to other areas. These changes results in different contours, proportion, and symmetry when compared to younger facial structure. 

Skin

As the face matures, men and women will experience thinner and drier skin, a reduction in collagen, and less elasticity. 

Collagen

Collagen loss is a major change in the aging process. The middle layer of the ksin become thinner because collagen does not regenerate at the same rate. Loss of collagen manifests in diminished elasticity and moisture.  

Fat

As a patient become more mature, fat redistributes and accumulates in different areas of the face.  For example, fat in the forehead and cheeks will typically be redistributed around the mouth and the jaw line. In addition, fat may clump and appear as pads. 

Bone

There is a significant loss of facial bone with age. Aging of the craniofacial skeleton may be due to changes in the relative dynamics of bone expansion and bone resorption. Without the structural support of bone, there are noticeable changes in the other layers of overlying soft tissue and skin. 


Anatomical approach to aesthetic medicine

 

Rules of thirds

The rule of thirds is a method of analyzing a patient's facial structure to determine what changes have occurred over time and also which treatments are best for the target area. 

Upper Third

This area experiences noticeable wrinkle creases. Dynamic wrinkles (e.g. frowning) become more prominent due to loss of collagen and elasticity. 

Middle Third

This area of the face will see a change in fat and bone structure. The fat in the cheek area will migrate lower causing creased nasiolabial folds and lowered cheek positioning. 

Lower Third

The lower third of the face will see a combination fat loss and wrinkles. Wrinkles may form around the line. Fat loss and diminished elasticity will cause loss of volume in the lips and more prominent marionette lines. 


Rules of Symmetry

The objective of neuromodulators and dermafiller treatments is to make the patient's current facial structure more symmetrical. Every patient has different bone, fat, and collagen distributions and a different optimal symmetrical profile. 

When patients are young (20 - 30), they possess, relative to their facial structure, higher cheekbones, fuller lips, and fuller cheeks as well. As the patient matures, changes to the symmetry start taking place. For example, cheeks may experience a loss of fat which causes them to "sag."  Lips may become less filled as well. 

Considering these points, the objective of the aesthetic health professional is not to create features that were not there but feature that were once present when the patient was younger. For example, introducing hyaluronic acid filler to cheeks where fat was lost. 

Many health professionals will visually super impose a triangle marker during the consultation to help patients visualize the goal of the treatment. Below you will find a few examples of a typically visualization. 

Patients within the age range of 20s - 30s will have certain markers in their facial structure that align with the superimposed triangle that is demonstrated above.  The chin is more sharp, the cheek area is fuller and higher. When a patient's profile align with these markers, the amount of medication and filler used will be minimal.

Patient's within the age range of 40s and above will have certain markers in their facial structure that align with the superimposed triangle that is demonstrated above.  As the patient matures the fullness and tissue in the cheeks become redistributed to a lower position. This causes the chin and the cheeks to appear "sagging." The goal of the aesthetic health professional, in this case, is to move the cheek to a higher position, matching the position that it once was when the patient was younger. 


Tips for aesthetic health professional

  1. When performing a consultation, practice good listening skills.
  2. Provide educational resources to patients. 
  3. Understand and use facial analysis process. 
  4. Walk your patient through the facial analysis process. 
  5. Do not impose a force a standard that you think is appropriate for them. Listen and determine what is it that they want to achieve. 
  6. Do not over promise. 
  7. Be inclusive of all points of views, personalities, and cultures.