Chin up
Facial contour correction is a unifying term for several entirely different skin treatments using dermal fillers, but is usually conducted with the same purpose – to correct the shape of the face. Patients who are seeking facial contour correction may not explicitly request cheek or chin augmentation. However, such procedures are most commonly performed to restore lost volume in the cheeks and chin, in an attempt to restore facial contour and shape.
In my clinical experience, Perfectha is one of the most versatile dermal fillers for this purpose. It’s the latest-generation of hyaluronic acid cross-linked with the E-brid technology that can be used to fill wrinkles, augment tissue volume and lip contour. Perfectha fillers are very easy to inject and easily malleable, allowing physicians to mould the treatment areas.
I perform a number of chin augmentations and I find that Perfectha Derm Sub-Skin is an excellent product for this procedure. The product has a number of benefits. These include excellent plasticity, where the hyaluronic acid is naturally distributed without injuring the surrounding tissue and conforms to the space that needs to be filled. It produces instantly visible results, as the effect of augmentation becomes apparent after the first procedure. Since there is no swelling around the injection area that would interfere with the visibility and evaluation of the results, the treatment can be controlled visually. This control is particularly important as the balance between forward projection and elongation of the chin plays a vital role in the end result; an exaggeration in either one can result in facial imbalance. The following case study highlights this.
CASE STUDY
A 24-year-old full-time model presented for facial contouring, hoping to achieve a more balanced visage. Due to the nature of her work, the lack of definition was a real concern. Upon physical analysis, the lower third of her face was, indeed, slightly shorter compared to the middle and upper thirds. On lateral view, chin projection was assessed using Riedel’s line, and forward projection was indicated in this case. The injection of Perfectha Sub-Skin periosteally was proposed. The subject was fit and healthy, and was not on any medications. She was not pregnant or breastfeeding, and there were no obvious contraindications to the proposed treatment. The potential side effects were fully explained to the subject (bleeding, bruising, swelling, redness and tenderness). She accepted the treatment and gave an informed consent for the procedure. Photos were taken prior to the start of the procedure. The area to be injected was cleaned with 0.2% clorexidine, sterile gloves were used and asepsis rules were followed. A total of 1ml of Perfectha Derm Sub-Skin was injected into the chin. The procedure was well tolerated by the patient and no swelling or bruising was reported post-procedure. Clinical improvement was documented by photos and was reported by the patient. As shown in Figure 1 and 2, the proposed treatment was very successful and the patient was very pleased with the outcome.
DISCUSSION
Facial balance is, in most cases, an attainable goal with aesthetics treatments. The relationship between the main features of the face (e.g. nose, chin and cheeks) plays an important role in overall facial balance. Disruption of this balance usually presents with one feature being more prominent than others and sometimes “too prominent”. In many cases, this can be corrected with strategic placement of dermal fillers, without resorting to surgery. The safety of the selected dermal filler is a very essential factor. Perfectha is made of non-animal origin and obtained by fermentation of biotechnologically modified bacteria, which is highly biocompatible. The pH of the product is between 6.5 and 7.5. Apart from having a low endotoxin level, it is also sterile of aerobic, anaerobic bacteria and fungi. The undetectable level of the cross-linking agent (BDDE) in the final product makes it superior to all other HA fillers. In my opinion Perfectha is an evolution of HA as it gives more volume for a better lifting effect with a uniform degradation. The major factor which makes Perfectha a unique HA is the E-Brid technology which induces the formation of covalent bonds (C=O) within and between the HA particles, allowing the superposition of an additional framework of cross-linked hyaluronic acid particles. The three-dimensional crosslinking framework, of the E-Brid technology provides the following advantages to the gel of the Perfectha products: The E-Brid gives an improvement of rheological properties (elasticity, plasticity, viscosity) for a greater capacity for filling (mechanical) Enhancement of hygroscopic properties for a better cutaneous hydration of treated areas by the capture of water molecules in the cross linking framework Dense framework more resistant to the action of free radicals. The complete range of fillers allows doctors to solve any aesthetic problem from the correction of wrinkles to re-model the shape and volume of the lips and biological reinforcement of the face.
Dr Vincent Wong is the founder of La Maison de l’Esthetique and a member of the European College of Aesthetic Medicine. He has presented his work at several national and international conferences, including those hosted by the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Association of Dermatology (BAD). Dr Wong also provides medical aesthetic training for other practitioners through his London Academy of Medical Aesthetics (LAMA).
