title: Facial Contouring With Fillers, Neuromodulators, and Lipolysis to Achieve a Natural Look in Patients With Facial Fullness.
abstract: BACKGROUND
  The desire for and use of nonsurgical injectable esthetic facial treatments is on a rise in Asia. Recent advances, including more versatile facial fillers, refined injection techniques, and adoption of a global facial approach, have in turn contributed to improved patient outcomes and increased patient satisfaction. The sought after nonsurgical treatments include the use of botulinum toxin, con- touring of the face with soft tissue fillers, and thinning of the face with injection lipolysis.
  
  
  OBJECTIVE
  To achieve a leaner, oval face shape with smooth contours.
  
  
  METHODS
  A combination technique was applied, whereby narrowing of face was achieved with use of botulinum toxin, contouring with soft tissue llers, and thinning the face with injection lipolysis. Treatments were applied on 15 women aged between 25 and 40 years and observed with follow up for 12 weeks. Hyaluronic acid (HA)-based dermal fillers (Perlane, Voluma, and Juvederm), botulinum toxin type A (Botox), and a lipolytic solution of phosphatidylcholine with deoxycholate (Dermastabilion, Aesthetic Dermal, Spain) were used to achieve a natural look in these patients with a fuller appearance of the face. The procedure was performed to reduce the facial width using botulinum toxin type A and the reduction of submental and cheek fat by injecting lipolysis injection.
  
  
  RESULTS
  All the women (n = 15) had edema for up to 2 weeks after undergoing lipolysis; however, two patients had edema for 3 weeks. After injecting the patient with botulinum toxin type A, no adverse event was observed; however, after using HA-based filler, one patient was observed to have bruising on the chin.
  
  
  CONCLUSIONS
  Use of HA-based fillers, neuromodulators (botulinum toxin), and injectable lipolytics are well-tolerated and are effective nonsurgical modalities to achieve facial recontouring for slimming of the face. J Drugs Dermatol. 2016;15(12):1536-1542.
authors.forename: Chytra
authors.initials: C
authors.lastname: Anand
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D003357:Cosmetic Techniques / Q000009:adverse effects; D000067548:Dermal Fillers / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D004487:Edema / Q000139:chemically induced; D005145:Face; D005260:Female; D006801:Humans; D008066:Lipolysis / Q000187:drug effects* / Q000502:physiology; D018377:Neurotransmitter Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017060:Patient Satisfaction
chemical_list: D000067548:Dermal Fillers; D018377:Neurotransmitter Agents; D019274:Botulinum Toxins, Type A