Refining the goals of oculofacial rejuvenation with dynamic ultrasonography.
Volume enhancement/restoration addresses a key component of facial aging and plays an increasingly central role in facial rejuvenation. Advancing our understanding of the structure and morphology of facial aging-and the changes that can be induced with currently-available fillers-will optimize treatment and provide a consensus for appropriate selection of agents and procedures. By elucidating anatomic relationships-particularly dynamic relationships-ultrasonography may facilitate the selection and application of rejuvenation agents and procedures such as lower eyelid blepharoplasty with hyaluronic acid reinforcement of the middle lamella and lateral canthal retinaculum, en glove lysis and dermal fat grafting in the retractor plane for lower eyelid retraction, "posterior girdle" effect with high-viscosity fillers for malar festoons, dynamic analysis of hyaluronic acid within the levator plane for upper eyelid retraction, and serial distribution and integration of autologous fat injection in the lower lid compartments. In this article, the authors describe use of dynamic high-resolution ultrasonography as a tool in defining and improving the outcomes of periocular facial rejuvenation.
Jules Stein Eye Institute, Division of Orbital and Oculoplastic Surgery, University of California-Los Angeles, CA 90095, USA. papagks@yahoo.com
Konstantinos
K
Papageorgiou
Holly Shu-Hong
HS
Chang
David
D
Isaacs
Danica
D
Fiaschetti
Michael
M
Ang
Robert
R
Goldberg
D000328:Adult; D000368:Aged; D000375:Aging / Q000473:pathology*; D001672:Biocompatible Materials; D019882:Blepharoplasty / Q000379:methods; D005143:Eyelids / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage; D007267:Injections; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012060:Rejuvenation; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
D001672:Biocompatible Materials; D006820:Hyaluronic Acid