Quantitative Mobility Analysis of the Face and its Relevance for Surgical and Non-surgical Aesthetic Facial Procedures

Hernandez, Claudia A; Alfertshofer, Michael; Frank, Konstantin; Freytag, Lysander; Gavril, Diana L.; Davidović, Kristina; Gotkin, Robert H; Mercado‐Perez, Arnaldo; Mardini, Samir; Cotofana, Sebastian

doi:10.1007/s00266-022-02921-8

Cited by 7 publications

(7 citation statements)

References 35 publications

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“…Objective outcome assessment relied on 3-dimensional (3D) imaging as previously described. 3,16,17 In brief, standardized full-face 3D images were obtained utilizing a Vectra H2 camera system (Canfield). The images were automatically aligned to the baseline image and differences in volume (volume change in cc) were calculated following the internal computational algorithm of the Mirror software toolkit for the middle and lower facial regions (Figure 2).…”

Section: Objective Outcome Scoringmentioning

confidence: 99%

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Clinical validation of the upper face first principle—A clinical, prospective, interventional split‐face study

Hernandez¹,

Zapata²,

Bermudez

et al. 2022

J of Cosmetic Dermatology

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Background Previous clinical and anatomic investigations have identified the clinical relevance of facial biomechanics. Based on this new understanding, principles for facial aesthetic procedures were established: Lateral Face First, Deep Layers First, and Upper Face First. Objective To test the upper face first principle by showing that an injection sequence, starting in the upper face is superior to an injection sequence starting in the lower face. Methods This study was designed as an interventional split‐face study administering the same amount and type of soft tissue filler for the upper, middle, and lower face but in a different sequence: upper, middle, lower face versus lower, middle, and upper face. A total of 15 patients (5 males and 10 females) with a mean age of 39.4 years (9.6) and a mean BMI of 23.4 kg/m2 (1.7) were studied. Follow‐up at D0, D30, and D90 was conducted utilizing semiquantitative scores and objective 3D imaging. Results Despite not reaching statistical significance, midfacial volume and jawline contouring were rated better at every follow‐up visit (D0, D30, D90) when treated with the upper versus the lower face first injection algorithm. The global aesthetic improvement scale showed statistically significantly better values for the upper face first algorithm when compared to the lower face first algorithm at all evaluated time points with all p < 0.001. Conclusion Applying the upper face first injection algorithm seems to result in better aesthetic outcomes when directly compared to the lower face first algorithm. Semiquantitative and objective outcome measurements confirm its clinical effectiveness.

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Section: Objective Outcome Scoringmentioning

confidence: 99%

“…In recent studies, the mobility of the face was investigated with ultrasound imaging and three‐dimensional (3D) photography 1–3 . Based on their results, researchers coined the term facial biomechanics which describes the physiologic movement of facial soft tissues during facial animation and facial aging 4 .…”

Section: Introductionmentioning

confidence: 99%

Clinical validation of the upper face first principle—A clinical, prospective, interventional split‐face study

Hernandez¹,

Zapata²,

Bermudez

et al. 2022

J of Cosmetic Dermatology

Self Cite

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show abstract

“…In addition to the performed multiobserver semiquantitative outcome scoring, objective facial regional analyses were conducted via 3‐dimensional photography 6,13 . The results revealed that the increase in midfacial volume when compared to the facial status before the treatment was (deep vs. superficial) 2.19 cc versus 1.94 cc at the 7 weeks follow‐up.…”

Section: Discussionmentioning

confidence: 99%

“…Objective outcome assessment was conducted using 3‐dimensional (3D) imaging as described previously 6,13–15 . In brief, standardized fullface 3D images were obtained utilizing a Vectra H2 camera system (Canfield, Parsippany, NJ, USA).…”

Section: Methodsmentioning

confidence: 99%

“…Objective outcome assessment was conducted using 3-dimensional (3D) imaging as described previously. 6,[13][14][15] In brief, standardized fullface 3D images were obtained utilizing a Vectra H2 camera system (Canfield, Parsippany, NJ, USA). The images were automatically aligned to the baseline image and differences in volume (volume change in cc) and in skin position (skin vector displacement in mm) were calculated following the internal computational algorithm of the Mirror software tool kit for the middle, lower, medial, and lateral facial regions (Figures 2,3,4).…”

Section: Objective Outcome Assessmentmentioning

confidence: 99%

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Superficial versus deep injections of the upper midface—A prospective interventional split‐face study

Martín,

Revelles,

Aznar

et al. 2023

J of Cosmetic Dermatology

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BackgroundVarious injection algorithms have been proposed in the past which are in line with the three aesthetic principles: upper face first, lateral face first, and deep regions first. However, increasing evidence is provided that the upper midface can be targeted with superficial soft tissue filler injections alone too.ObjectiveTo investigate in a prospective split‐face study design whether superficial or deep upper midfacial injections provide superior aesthetic outcomes.MethodsA total of n = 20 study participants (100% females; age 43.95 (11.7) years; BMI 22.92 (2.6) kg/m2) were treated with superficial soft tissue filler injections on side of their face and deep injections on the contralateral side with a mean volume of 0.78 cc. Outcome was evaluated at 7 weeks follow‐up for midfacial, and lower facial volume, for medial and lateral facial skin vector displacement, and for improvement of nasolabial, crow's feet, and upper cheek fullness severity scores.ResultsNo adverse events related to safety or product tolerability were observed during the entire study period. All semiquantitative scores improved statistically significantly after the observational period (p < 0.001) but displayed no difference between the two applied injection techniques (p > 0.05).ConclusionThe results of this split‐face study revealed that both the superficial and the deep cannula injection technique for midface volumization statistically significantly improve the midfacial volume, reduce nasolabial fold and crow's feet severity. No statistically significant difference was observed between the two injection techniques when compared via semiquantitative and objective outcome evaluation after 7 weeks follow‐up.

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Commentary on: Quantitative Mobility of the Face and its Relevance for Surgical and Nonsurgical Aesthetic Facial Procedures.

Hernandez

Dutton

2022

Aesth Plast Surg

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Quantitative Mobility Analysis of the Face and its Relevance for Surgical and Non-surgical Aesthetic Facial Procedures

Cited by 7 publications

References 35 publications

Clinical validation of the upper face first principle—A clinical, prospective, interventional split‐face study

Clinical validation of the upper face first principle—A clinical, prospective, interventional split‐face study

Superficial versus deep injections of the upper midface—A prospective interventional split‐face study

Commentary on: Quantitative Mobility of the Face and its Relevance for Surgical and Nonsurgical Aesthetic Facial Procedures.

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