Gravity in Midfacial Aging: A 3-Dimensional Study

Abstract

Background Volume loss and volume descent are complementary aspects of facial aging, although the respective contribution of each is unclear. Objectives The aim of this study was to quantify in 3 dimensions the effects of gravity on the midface in both upright and supine positions in an older and a younger group of patients. Methods A prospective study was undertaken of 53 female patients who had not undergone treatment with dermal fillers or facial cosmetic surgery. Three-dimensional photography with a VECTRA H1 camera (Canfield Scientific, Fairfield, NJ) was taken in supine and sitting positions. Volume shifts and displacement of structures in 3 dimensions were measured and analyzed. Results Morphologically, upon shifting from sitting to supine position, the tail of the brow elevated, the tear trough filled, the buccal and malar fat shifted posteriosuperiorly, the earlobe decreased in height, the nasiolabial folds and marionette lines diminished, the modiolus shifted laterally, and the jowl diminished. Volumetric analysis revealed that the infraorbital region increased in volume by a mean [SD] of 0.59 [0.55] mL, the tear trough by 0.22 [0.19] mL, and the malar region by 1.2 [1.06] mL. With subjects in the supine position, all facial topographic landmarks displaced significantly from sitting position. Conclusions Facial aging in this cohort was predominantly due to tissue descent rather than volume loss. Reversal of the gravitational force restores the 3D position of the facial subunits and leads to volumization in desirable locations that approximates a more youthful appearance. The volume restored via redistribution of facial fat is comparable to that typically injected during direct volume transfer procedures. Level of Evidence: 4

Objective analysis of the effectiveness of facial massage using breakthrough computed tomographic technology: A preliminary pilot study

“…Therefore, the facial appearance in a supine position is younger than those in standing or sitting positions. 10,11,13,14 Thus, evaluations The workstation is installed with an application that uses various preset reconstruction algorithms, including dedicated face scan algorithms, to reconstruct 3DCT images of the face. 15,16 Volumerendering, based on an edge-detection image processing system, was used in these 3D reconstructions.…”

“…The gravity vector applied to the face is different in the upright and supine positions, and the morphology of the soft tissues is also different. Therefore, the facial appearance in a supine position is younger than those in standing or sitting positions 10,11,13,14 . Thus, evaluations of the facial state should be performed in a standing or sitting position.…”

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“…It is generally considered that the soft tissues are susceptible to gravity. 19,20 When the direction of the gravity vector changes with posture change, the soft tissues move along this direction and the facial appearance changes. 11,12,18,21 This phenomenon was converted to a new method to investigate facial mobility in our study.…”

A Multicenter, Randomized, Double-Blinded, Comparative Study of Two Hyaluronic Acid Filler Products for the Correction of Nasolabial Folds

“…The primary efficacy measurement was the WSRS scores assessed by the evaluating investigators at week 24 compared to baseline WSRS scores. The secondary efficacy endpoints were (1) evaluating investigator-assessed WSRS scores at weeks 3, 12, and 24; (2) Changes in global aesthetic improvement scale (GAIS) scores measured through participants and treating investigators at weeks 3, 12, and 24; (3) proportion of participants with an improvement of ≥ 1 grade in the evaluating and treating investigators-assessed WSRS scores over 24 week period. The five-point scale of WSRS represents wrinkle severity: "none" (1 point), "mild" (2), "moderate" (3), "severe" (4), "extreme" (5).…”

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