Index

A

Acne, acupuncture for, 162 Actinic keratoses, 151

photodynamic therapy for patients and methods, 151 results, 151 – 152, 152f, 153f

Acupuncture, facial. See Facial acupuncture Adatosil, 48

Adipocyte cell viability, controversies in harvesting techniques, 60 – 61 transfer techniques, 61 – 62

Adipocytes

harvesting techniques, 60 – 61 transfer techniques, 61 – 62 trauma to, 60

Advanced glycation end products, 169 Aesthetic dentistry, Golden proportion of, 144 AGE (advanced glycation end products), 169 Aging effects. See also Photoaging

on dentition, 144, 145f, 146 on facial dimensions, 146 on forehead, 90 – 91, 91f on neck, 65

AHAs (alpha hydroxy acids). See Alpha hydroxy acid peels 5-ALA (5-aminolevulinic acid), in protoporphyrin synthesis, 153,

155f, 156 Alloderm, 51

Alloplastic chin implants, 138

Alpha hydroxy acid peels, 25 – 26, 26f application method, 27 complications of, 27 – 28

consent form for, 28

for neck rejuvenation, 67 neutralization of, 27

peel strength selection and, 27 postpeel care for, 27

Alpha hydroxy acids. See Alpha hydroxy acid peels 5-Aminolevulinic acid, in protoporphyrin synthesis, 153, 155f, 156 Anesthesia

for endoscopic forehead rejuvenation, 96

local, in subperiosteal cheek lifting, 105 topical

Botox injections, 38, 68 injectable filling agents, 50

tumescent. See Tumescent anesthesia Angiogenesis, adipocyte transfer and, 61 Antioxidants, 172

Arcus marginalis, lifting of SOOF into, 114

Arnica montana C5 pellets in Botox preparation, 33

before eyelid rejuvenation techniques, 84 before filler use, 51

in filler preparation, 49 before neuromodulation, 35 in peri-operative care, 80

Artefill, 51

Augmentation, of lips, 46, 47f, 131f – 132f, 132 – 133 Aurora DS system, for hair removal, 18 – 19, 19t, 22

Aurora SR system, for skin rejuvenation, 19 – 20, 19t, 20f, 20t, 22 Autogenous fat, 43, 48

Autologen, 50 Autologous fat

harvesting of. See Lipoharvesting injections of. See Autologous fat transfer transposition of, in eyelid rejuvenation

lower lid blepharoplasty, 73 vaporization of, in eyelid rejuvenation

lower lid, 82 – 83, 82f – 83f upper lid, 82

Autologous fat transfer

adverse sequelae and complications of, 59 clinical applications of, 56

clinical examples of, 59 – 60, 60f controversies in

adipocyte harvesting techniques, 60 – 61 adipocyte transfer techniques, 61 – 62

follow-up injections, of frozen fat, 59 history of, 56

indications for, 56 – 57 outcomes of, 62 – 63, 62f

patient selection for, 57 preoperative evaluation in, 57

techniques of, 56, 58 – 59, 58f – 59f, 62 – 63, 62f

B

Bags under eyes, acupuncture for, 162 Basal cell carcinomas, 151

photodynamic therapy for patients and methods, 151 results, 151 – 152

Biopsy, after autologous fat transfer, 62, 62f

Bipolar system, of electrical current flow, 15 – 16, 16f Bleaching, of teeth, 144

Blepharoplasty

lower lid, 82 – 84, 82f – 83f

patient evaluation for, 75 – 76, 75f – 76f upper lid, 81 – 82, 81f

Blepharoptosis acupuncture for, 162

brow compensation of, 72, 73 neuromodulation correcting, 36, 36f

Blood pressure, skin and, 168 Blood vessels

in body temperature regulation, 167 – 168 obliteration of, intense pulsed light, 7 – 11 Bloodless sculpting, in eyelid rejuvenation, 82

Body temperature, regulation of, 167 – 168 Botulinum toxin type A (Botox/Botox Cosmetic)

Botox browlift, 34

clinical applications of, 35

combination therapies, 2,3,4, 31, 35, 38, 43, 45, 50, 51, 63, 65, 66, 68

with CO2 laser, 2, 3, 4 with IPL, 39, 65

with Restylane, 31,35, 38, 43, 45, 50, 51 dosage by anatomic area, 35

mechanism of action of, 32

in neck rejuvenation, 68 – 69, 69f

in perioral rejuvenation, 129 – 130, 129f – 131f Bovine collagen, 43

Brow. See Eyebrow Buccinator muscle, 142

“Bunny lines,” neuromodulation correcting, 39, 39f

C

Canthotomy, 104f Caprylic acid, 171 Carbon dioxide laser

for eyelid rejuvenation, 77 – 78 brow stabilization, 80 – 81 lower lid, 82 – 83, 82f – 83f upper lid, 81 – 82

in photoaging management, 24

for rhytid ablation, preoperative care and, 5, 5f L-Carnosine, 172

Cementoenamel junction, 146 Cephalometric analysis, 140 – 141

of facial bones and soft tissue profile, 134, 135f of labiomental sulcus, 136 – 137

of lip incompetence, 139, 139f

of lip projection, 134, 135, 135f, 136f

Channel selection, in facial acupuncture, 160 – 161, 161f Channel theory, in traditional Chinese medicine, 158 Cheek lifting

subperiosteal. See Subperiosteal cheek lifting Thermage techniques, 4, 5, 6

Chemical peeling history of, 24 medium-depth, 24

patient selection for, 24 – 25, 25f – 26f superficial. See Superficial chemical peels

Chemocautery, of malignant lesion, 152

Chemodenervation. See Botulinum toxin type A (Botox/Botox Cosmetic); Neuromodulation

Chin

alloplastic implants for, 138 augmentation with filling agents, 44 cobble, neuromodulation of, 39 – 40, 40f double, acupuncture for, 162

projection in facial profile, 137 Chlorophyll, 171

Cleansing, for chemical peel medium-depth, 28 superficial, 27

CO2 laser. See Carbon dioxide laser

Cobble chin, neuromodulation of, 39 – 40, 40f Cold compresses

in blepharoplasty postoperative care, 79, 80 with Botox, 33, 68

in cheek lift postoperative care, 108 with fillers, 49, 50

Natragel masks, 28, 33, 49, 50, 68, 79, 80 with TCA peels, 28

Collagen, 49 – 50, 166 – 167 acupuncture and, 160 bovine, 43, 50

damage to, 169 human-derived fibroblast, 50 stimulation

ablative lasers, 1 IPL, 11

nonablative lasers, 2, 3, 4 synthesis of, 172 – 173 Thermage, 4, 5, 6

Collagen injections

complications associated with, 53 patient preparation for, 52 results of, 53

Color wheel, for micropigmentation, 85, 86f

Congenital euryblepharon, subperiosteal cheek lifting results in, 110f Consent form, for chemical peels

alpha hydroxy acid, 28 medium-depth, 31

Coolglide laser, 68 CoolTouch II laser, 68 Corrugator muscles

in forehead anatomy, 92, 92f, 93f neuromodulation of, 33, 33f

Cosmoderm, 50, 52

Cosmoplast, 50, 52

for lip augmentation, 46, 47f, 132 Coupling gel, for IPL use, 11

Crow’s feet

Botox dosage for, 35 fillers for, 45

neuromodulation of, 38, 38f Crusting

as AHA peel complication, 27 post-TCA peel management, 28

Cryosurgery, of malignant lesion, 152

Curettage and dermabrasion, of malignant lesion, 152 Cyclooxygenase-2 inhibitors, in cheek lift postoperative care, 108 Cymetra, 51

D

Damage to skin

causes of, 169 – 170. See also Photoaging reversing, 170 – 172

“Dark circles,” 112 management of, TCA peel, 26

orbicularis oculi muscles and, 113

Deep temporalis fascia, in forehead anatomy, 93, 93f Deflux, 54

Degreasing of skin

prior to medium-depth peel, 28 prior to superficial peel, 27

Dental aesthetic improvement

muscle distribution and nerve supply in, 142 – 143 patient selection for, 143

smile design in, 144, 145f, 146, 147f Dentition

aging effects on, 144, 145f, 146 facial dimensions and, 146

in smile design, 144, 145f, 146 structural loss in, 146

Depressor anguli oris muscle, 142 Botox dosage for, 32 marionette lines, 32, 33, 37, 38 melomental folds, 32, 33, 37, 38 neuromodulation of, 34, 34f

fillers concomitant with, 45

Depressor supercilii muscles, neuromodulation of, 36, 37f, 38 Botox dosage for, 35

Dermalogen, 50 Detoxification, 171 – 172

DHA (omega-3 fatty acid), 172 Diet, in skin rejuvenation, 170 – 172 Diode laser energy, 22

Disease patterns, in traditional Chinese medicine, 159 – 160 “Dolphin shot,” 45

Double chin, acupuncture for, 162 Drinker’s nose, acupuncture for, 162 Dry face, acupuncture for, 162 Dynamic tetrafluoroethane spray, 3

Dyschromia, medium-depth chemical peels for, 24 Dyspigmentation, early, superficial chemical peels for, 24

E

e-PTFE (expanded polytetrafluoroethylene implants), orbital rim, for midface restoration, 112 – 119. See also Midface restoration

ElaMax topical anesthesia, 21 – 22 Electrical conductivity

of different tissue types, 16 – 17, 17f, 17t temperature dependence of, 17, 18f

Electrical current

bipolar system and, 15 – 16, 16f calculating distribution of, method for, 15 clinical applications of, 17 – 22

and conductivity. See Electrical conductivity unipolar system and, 15, 15f

use in medicine, 14 – 16 Electron-optical Syneron, 18, 22 Electrosurgery, of malignant lesion, 152 Elimination diet, 170 – 171

ELOS (electron-optical Syneron), 18, 22 Endoscopic forehead rejuvenation, 90 – 102

after e-PTFE orbital rim implantation, 118, 119f anatomical considerations in, 91 – 94, 92f – 93f fixation techniques in, 100, 101f

patient evaluation and selection for, 94 – 96 surgical technique for, 96 – 100, 97f – 99f vs. open procedures, 96

Epinephrine, in midface restoration procedure, 115 Erbium:yttrium-aluminum-garnet (Er:YAG) laser, for rhytid ablation

in lower eyelid rejuvenation, 84 preoperative care in, 4 – 5, 4f – 6f for rhytid ablation, 3 – 4

Euryblepharon, congenital, subperiosteal cheek lifting results in, 110f Exophthalmos, subperiosteal cheek lifting results in, 109f Expanded polytetrafluoroethylene implants, orbital rim, for

midface restoration, 112 – 119. See also Midface restoration Eyebrow

in eyelid rejuvenation

contour, males vs. females, 80, 80f micropigmentation, 85, 87f

single follicular unit grafting, 80, 81 stabilization and elevation, 80 – 81

in facial analysis, 94, 95f

follicle implantation sites in, 87 – 88, 87f – 88f neuromodulation of, 36, 37f, 38

Botox dosage for, 35 ptotic eyebrow and, 33

shape and position of, male vs. female, 80, 80f, 94, 95f Eyelash enhancement, in eyelid rejuvenation

micropigmentation, 85, 87f

single follicular unit grafting, 88, 88f Eyelids

lower

Botox dosage for, 35

creases around, fillers for, 45 evaluation of, 76 – 77, 77f – 78f

minimally invasive rejuvenation of, 82 – 84, 82f – 83f neuromodulation of, 33 – 34, 34f

technique, 38 – 39, 39f

minimally invasive rejuvenation of, 75 – 88 anatomic structure and position, 76 – 77, 76f – 78f lower lid, 82 – 84

micropigmentation and, 84 – 87, 84f – 87f patient evaluation for, 75 – 76, 75f – 76f perioperative care, 84

procedures for, 78, 78f – 79f protocol for, 77 – 78

for rhytidosis, lesions, and periorbital veins, 78 – 80, 79f single follicular unit hair transplantation, 84, 87 – 88, 87f – 88f stabilizing brow level and contour, 80 – 81, 80f

upper lid, 81 – 82 upper

creases around, fillers for, 44, 45f

eyebrow level and contour and, 76, 76f – 77f minimally invasive rejuvenation of, 81 – 82 neuromodulation of, 33

F

Face color, and health, diagnostic relationship between, 159 Facelifts. See S-Lift rhytidectomy; S-Plus Lift; Subperiosteal cheek

lifting Facial acupuncture

contraindications for, 161 general benefits of, 160

general effects of, 163 – 164, 163f indications for, 160t

mechanism of action on skin, 160 specific treatments, 162

strategies and recommendations in, 160 – 161, 161f, 161t treatment protocols, 162 – 163, 163f

Facial areas, in traditional Chinese medicine, 160t Facial beauty

dental and bony architecture and, 134 – 135 orthognathic principles of, 134

smile and, 139

straight profile and, 134 Facial bones

cephalometric tracing of, 134, 135f eyelids and, 76 – 77, 76f – 77f misaligned, and lip incompetence, 139 recontouring with fillers, 46, 47f

Facial dimensions aging effects on, 146

forehead and brow in, 94, 95f vertical height

aging effects on, 146 disproportional, 138 – 140 ideal proportions, 134

Facial expression, muscles of, 142 Facial nerve, 142

in forehead anatomy, 93f, 94 in S-lift, 121

Facial profile, 135 – 138 cephalometric tracing of, 134, 135f chin projection in, 137 labiomental sulcus in, 136 – 137

lip projection in, 135 – 136, 135f, 136f Facial telangiectasias, IPL for, 10 – 11, 11f – 12f

FAMI (fat autograft muscle injection) technique, for adipocyte transfer, 61

Fascia, in forehead anatomy, 92 – 93, 93f Fat. See also Adipocytes

autogenous, 43

autologous. See Autologous fat submental reduction of

Lipo-dissolve, 63, 68

Thermage techniques, 6, 63, 65, 66, 68

Fat autograft muscle injection technique, for adipocyte transfer, 61 Fat contouring, in noninvasive neck rejuvenation, 69 – 70, 70f

Fat pockets

bulging vs., in upper eyelid rejuvenation, 81 in lower eyelid rejuvenation, 82 – 83, 83f

Filling agents

future directions for, 54 ideal constituents of, 43 injectable, 43 – 54

indications for use, 44 – 48 natural, 43

permanent, 48 synthetic, 44 temporary, 48 – 51 treatment using

complications, 53 – 54 patient preparation, 51 – 52 results, 52 – 53

Fish oils, 172

Fixation techniques, permanent, in endoscopic forehead rejuvenation, 99 – 100, 99f

temporary vs., 100, 101f Flaxseed oil, 172

Food and Drug Administration Modernization Act (1997), 48 Forehead

aging effects on, 90 – 91, 91f anatomy of, 91 – 94, 92f – 93f Botox dosage for, 35

creases in, fillers for, 44, 44f

endoscopic rejuvenation of. See Endoscopic forehead rejuvenation

in facial analysis, 94, 95f neuromodulation of, 32 – 33, 33f

technique, 35f, 36, 36f – 37f skin tightening protocol for, 8

Free radicals, 169 – 170 Frontalis muscle

in blepharoptosis, 36, 36f neuromodulation of, 32, 33f, 35f, 36, 36f

Frozen fat

follow-up lipoinjections using, 59 use of, controversy over, 61

Fruit, in detoxification process, 171

G

Galea aponeurotica, in forehead anatomy, 92 Garlic, in detoxification process, 171

Gas exchange, skin and, 168

Genioplast, for dentofacial deformities, 137 – 138 Ginger, skin rejuvenation and, 171

Gingival tissues, in smile design, 144 Glabellar creases

at rest, endoscopic forehead rejuvenation and, 95 Botox dosage for, 35

fillers for, 44, 45f neuromodulation of, 33, 33f

combined with fillers, 40 technique, 36, 37f, 38

Glands sebaceous, 167

sweat. See Sweat glands Glycation, 169

Glycolic acid, for superficial chemical peeling, 25 – 26 Golden proportion, of aesthetic dentistry, 144 Gummy smile, 139 – 140, 140f

neuromodulation correcting, 39, 39f

H

Hair

and health, diagnostic relationship between, 159 removal of

laser treatment for, 68 radiofrequency energy for, 17 – 19, 19t

single follicular unit transplantation in eyebrow rejuvenation, 80, 81

in eyelash rejuvenation, 80, 81

in eyelid rejuvenation, 87 – 88, 87f – 88f

Hair quality, endoscopic forehead rejuvenation and, 96 Hairline, endoscopic forehead rejuvenation and, 96 Health

and facial appearance, 159 – 160

and hair, diagnostic relationship between, 159 Herpes simplex

management following AHA peel, 27 management following TCA peel, 30

Hyaluron, 48 – 49 Hyaluronic acid, 43, 48 – 49

non-animal stabilized, 49 Hyaluronic acid injections

complications associated with, 53 patient preparation for, 52 results of, 53

Hydration, 171 Hylaform, 48, 49 Hylaform Plus, 48, 49

Hyperpigmentation, as TCA peel complication, 30 Hypertrichosis, laser treatment of, 68

Hypopigmentation, as TCA peel complication, 30

Hypoplasia, midfacial, subperiosteal cheek lifting results in, 109f

I

Ice-cold coupling gel, IPL use with, 11 Implants

alloplastic chin, 138 for midface restoration

e-PTFE. See Midface restoration early, 113 – 114

Incisions cutaneous

upper lid crease in blepharoplasty, 74, 75, 77 upper lid crease in lateral canthoplasty, 74

for endoscopic forehead rejuvenation, 97, 97f transconjunctival, in lower lid blepharoplasty, 78

Infections

after e-PTFE orbital rim implantation, 117 as AHA peel complication, 27

as lipoinjection complication, 59 Inferior border osteotomy, 137 – 138 Inflammation, prevention of, 172 Injectable fillers, 43 – 54

complications of, 51, 52 indications for, 44 – 48 natural, 43

synthetic, 44

Innervation, of facial muscles, 142

Instrumentation, for endoscopic forehead rejuvenation, 96 Intense pulsed light, 9 – 13

equipment for, 9 – 10, 10f, 10t indications for, 10 – 13, 11f – 13f, 11t – 12t for neck rejuvenation, 67 neuromodulation as pretreatment for, 41 use guidelines for, 12t

Interocclusal space, loss of, 146 IPL. See Intense pulsed light Isolagen, 50

L

L-Carnosine, 172

Labiomental sulcus, in facial profile, 136 – 137 Lacrimal gland, in upper eyelid rejuvenation, 82 Laser resurfacing

of lower eyelid, 82

neuromodulation as pretreatment for, 41 photoaging managed by, 24

of upper lid, 77

of upper lip skin, 130, 131f

Laser surgery. See also individual laser types of malignant lesion, 152

Lateral canthotomy, in midface restoration procedure, 115 Lateral canthus

asymmetric, after e-PTFE orbital rim implantation, 117 – 118 creases in, fillers for, 45

in eyelid evaluation, 33 – 34, 34f, 76 – 77, 77f in lower eyelid rejuvenation, 83 – 84, 83f neuromodulation of, 33 – 34, 34f

Lateral tarsal strip

in lateral canthoplasty, 79

in lower lid blepharoplasty, 79

in subperiosteal cheek lifting, 107 LEDs (light-emitting diodes), 3 Lentigines, solar, IPL for, 12 – 13, 12f – 13f Levator anguli oris muscle, 142

Levlulan (5-ALA), in photodynamic therapy, 146

Lidocaine

for endoscopic forehead rejuvenation, 96 in tumescent anesthesia, 61

Light-based therapies, principles of, 14 Light-emitting diodes, 3

Lip(s)

acupuncture for, 162

augmentation of, 46, 47f, 131f – 133f, 132 – 133 color of, and health relationship, 159 competent (closure at rest), 138 incompetent, causes of, 139, 139f micropigmentation of, 131f – 133f, 132 – 133 upper

Botox dosage for, 35

laser resurfacing of, 130, 131f

vertical rhytids of, filling agents for correcting, 44, 45 vertical rhytids of, neuromodulation correcting, 39, 39f

Lip projection

in facial profile, 135 – 136, 135f, 136f factors influencing, 135

Lipocytes, harvesting of, 57 Lipoharvesting, 57 – 58

controversies in, 60 – 62 technique, 58, 58f

tumescent anesthetic for, 57 – 58, 58t “Liporecycling” technique, for adipocyte transfer, 61 Lipostabil, for fat contouring in neck, 69 – 70 “Lipostructure” technique, for adipocyte transfer, 61 Lipotransfer. See Autologous fat transfer Lipovaporization, in eyelid rejuvenation, 82

Liquid injectable silicone, patient preparation for, 52 Liver, skin rejuvenation and, 171

Liver spots, IPL for, 12 – 13, 12f – 13f Long-flap facelift procedure. See S-Plus Lift Lower eyelids. See Eyelids, lower

M

Macrolane, 54

Magnetic resonance imaging (MRI), after autologous fat transfer, 62 – 63

Malar fat pads

corrective approaches to, 113 – 114 elevation of, Thermage techniques, 4, 5, 6 ptosis of, 112

restoration with e-PTFE orbital rim implants. See Midface restoration

Malar orbital rim implants, 106 – 107, 107f

Malignant skin lesions, treatment options for, 152. See also Photodynamic therapy, for superficial malignant skin lesions

Marginal reflex distance, in eyelid evaluation, 76 Marionette lines. See Melomental folds Marking

prior to endoscopic forehead rejuvenation, 96 prior to lipoinjection, 58, 58f

prior to midfacial restoration, 14, 114f Matridex, 51

Medium-depth chemical peels, 24, 28 – 31 additional coats, evaluating need for, 29 – 30 application steps, 28 – 29

complications of, 30 – 31 consent form for, 31

for dyschromia, 24 patient preparation for, 28

peel depth determination, 29 – 30 postpeel care for, 30

precautions with, 30 for rhytidosis, 24

technical considerations in, 29 Melomental folds

Botox dosage for, 35 fillers for, 45 neuromodulation of

combined with fillers, 40 technique, 39 – 40, 40f

Mentalis muscle, 142

lip competence/incompetence and, 138 – 139, 139f Mentolabial groove, 146

Meridian system, in acupuncture, 158 source point selection and, 161, 161t

Metvix (5-ALA methyl ester 16% cream), photodynamic therapy with patients and selection for, 151

results of, 151 – 152, 152f, 153f

Microdroplet liquid injectable silicone, patient preparation for, 52 Micropigmentation

in eyelid rejuvenation, 84, 84f – 85f brow shaping, 85, 87f

eyelash enhancement, 85, 87f principles, 85, 86f

technique, 85 – 87

of lips, 132 – 133, 132f – 133f Microspheres

complications associated with, 53 results with, 53

Midface rejuvenation, rhytidectomy for. See S-Lift rhytidectomy; S-Plus Lift

Midface restoration

hand-crafted orbital rim e-PTFE implants for, 112 – 119 anatomical considerations, 112 – 113

case studies, 118, 118f, 119f complications, 117 – 118 history, 113 – 114

patient assessment, 114 results, 117 – 118

surgical procedure, 114 – 117, 114f – 116f

lifting procedure for. See Subperiosteal cheek lifting non-surgical lifting techniques, Thermage protocol, 4, 5, 6

Modernization Act (1997), 48

Motor injury, after e-PTFE orbital rim implantation, 117 Motor innervation, of facial muscles, 142

MRD (marginal reflex distance), in eyelid evaluation, 76 Muscles. See also individually named muscles

brow depressors, 30, 31 eyelids, 31

facial, 142 – 143

motor innervation of, 142

relaxing, concept of. See Neuromodulation forehead, 92, 92f

glabella, 30, 31

neck, relaxation of, 68 – 69, 69f perioral complex, 34, 34f scalp, 92, 92f

N

Nasial deformities, corrections with Perlane, 46 Nasolabial folds

neuromodulation of, 39, 39f tightening techniques, Thermage, 6, 36

Nasolabial groove, fillers for, 45, 46f Natragel mask, 3

before filler use, 51 – 52 following TCA chemical peel, 30 for lips, 132

in neck rejuvenation

after neuromodulation, 69 after skin tightening, 70

before neuromodulation, 35 – 36

Nd:YAG laser. See Neodynium:yttrium-aluminum-garnet laser Neck

aging effects on, 65

appearance of, factors affecting, 65 male vs. female types of, 65

skin tightening protocol for, 8 Neck rejuvenation

noninvasive options for, 65, 66 – 71 complications, 66

fat contouring, 69 – 70, 70f muscle relaxation, 68 – 69, 69f patient evaluation, 66

patient priorities, 66 photographic documentation, 66 posttreatment follow-up, 66 principles, 65 – 66

setting for, 66

skin rejuvenation, 67 – 68 skin tightening, 70 – 71

surgical options for, 65 Neodynium:yttrium-aluminum-garnet laser, 3

for neck rejuvenation, 68

Neurofibromatosis, e-PTFE orbital rim implantation inpatient with, 118, 118f

Neuromodulation

clinical applications of, 35 facial anatomy and, 32 – 34 fillers concomitant with, 45

results, 53

mechanism of action of, 32. See also Botulinum toxin type A (Botox/Botox Cosmetic)

patient preparation for, 35 – 36

as pretreatment for other therapeutic modalities, 41 techniques of, 35 – 40

Neuromodulation plus soft tissue filling in glabellar fold ablation, 31, 35, 38

in perioral rejuvenation, 129 – 130, 129f – 131f Neurovascular structures, in forehead anatomy, 92f, 93f, 94 Neutralization, of AHAs, 27

New Fill. See Sculptra

Non-animal stabilized hyaluronic acid (NASHA), 43, 49 Nonablative devices

intense pulsed light

coherent and noncoherent, 9, 10t treatment algorithm for, 9, 10t

laser

Nd:YAG laser, 3

neuromodulation as pretreatment for, 41 vascular-specific, 9, 10t

Nose, drinker’s, acupuncture for, 162 Nutrition, skin rejuvenation and, 171 – 172

O

Occipitofrontalis muscle, in forehead anatomy, 92 Omega-3 fatty acids, 172

Omega-6 fatty acids, 172

Oral commissures. See Melomental folds Orbicularis oculi muscle

“dark circle” and, 113

hypertrophic pretarsal, neuromodulation correcting, 38 – 39 neuromodulation of, 33 – 34, 34f, 38, 38f

Orbicularis oris muscle, 142 neuromodulation of, 34

Orbital rim implants

in cheek lifting procedure, 106 – 107, 107f e-PTFE, 112 – 119. See also Midface restoration

Orbital septum, in upper eyelid rejuvenation, 82

Orthodontics, in perioral rejuvenation, 140 – 141. See also Dental aesthetic improvement

Orthognathic principles, of facial beauty, 134 Orthognathic surgery, 137 – 138, 140 – 141 Osteotomy, inferior border, 137 – 138

P

Pale face, acupuncture for, 162

“Panfacial” technique, for adipocyte transfer, 61 Pars orbitalis, in forehead anatomy, 92, 92f PDT. See Photodynamic therapy

Perioral complex, musculature of, 34, 34f Perioral rejuvenation, five-step approach to, 129

augmentation and micropigmentation of the lips, 131f – 133f, 132 – 133

dental aesthetic improvement, 142 – 147 dental and bony architecture and, 134 – 141 laser resurfacing of upper lip skin, 130, 131f

neuromodulation plus soft tissue filling, 129 – 130, 129f – 131f Periorbital veins, removal of, 80, 80f

Periosteal incisions, in midface restoration procedure, 116, 116f Periosteum. See Suborbicularis oculi fat; Subperiosteal dissection Perlane, 48, 49

for correction of nasal deformities, 46, 47f for lip augmentation, 46, 47f, 132, 132f for nasolabial folds, 45, 46f

in perioral rejuvenation, 130, 130f – 131f Photoaging, reversal of

CO2 laser resurfacing for, 24 dietary approaches to, 170 – 172

erbium:YAG laser resurfacing for, 1, 2, 3 Nd:YAG laser treatment for, 68 photodynamic therapy, 141 – 146

TCA peel, 22

Photocaine anesthetic cream before Botox, 33, 68 before injectable fillers,50

before neuromodulation, 35

Photodynamic therapy, for superficial malignant skin lesions, 151 – 156

history of, 153

mechanisms of action of, 153, 154f – 155f, 156 patients and methods for, 151

results of, 151 – 152, 152f, 153f

vs. other treatment modalities, 152

Photographic documentation, before and after noninvasive neck rejuvenation, 66

Photomodulation, neuromodulation as pretreatment for, 41 Photorejuvenation. See Intense pulsed light Photothermolysis

mechanism of action of, 14 tenets of, 14

Phytochemicals, in detoxification process, 171 Pigmentation. See also Micropigmentation

disturbances in, as AHA peel complication, 27 disturbances in, TCA peel, 26, 28, 29 techniques for improving, 3

Platysma bands

Botox dosage for, 35

in neck rejuvenation, 68 – 69, 69f neuromodulation of, 34

technique, 40, 41f

Platysmaplasty, with S-Lift or S-Plus Lift, 122

PMMA (polymethylmethacrylate) microspheres, complications associated with, 53

Point selection, in facial acupuncture, 160 – 161, 161t Polaris WR(tm), 22

Polylactic acid injections complications associated with, 54 patient preparation for, 52 results of, 53

Polymethylmethacrylate microspheres, complications associated with, 53

Procerus muscle

in forehead anatomy, 92, 92f, 93f neuromodulation of, 33

Protein, skin rejuvenation and, 171 – 172

Protoporphyrin biosynthesis, intracellular, 153, 154f, 155f Ptosis

blepharotosis

levator aponeurotic disinsertion, 72, 73, 74 lid crease retraction, 72, 73

superior sulcus deformity, 33, 72, 73, 77

of brow, endoscopic forehead rejuvenation for, 101f eyelid

deep superior sulcus, 33, 72, 73, 77 levator aponeurotic disinsertion, 72, 73, 74 lid crease retraction, 72, 73

of malar fat pads, 112

corrective approaches to, 113 – 114. See also Midface restoration

non-surgical approaches to, 4, 5, 6 Puffiness, acupuncture for

of eyelids, 162 facial, 162

Q

Qi, in traditional Chinese medicine, 159

Quercetin, 173

R

Radiofrequency energy. See also Electrical conductivity; Electrical current

for facial contouring, 4, 5, 6 for hair removal, 17 – 19, 19t

for non-surgical face lifting, 4, 5, 6

for skin rejuvenation, 19 – 20, 19t, 20f, 20t for superficial skin lesion removal, 68

for wrinkle reduction, 20 – 22, 21f Radiotherapy, of malignant lesion, 152 Red face, acupuncture for, 162 Restylane, 48, 49

in combination with Botox, 31, 35, 38, 43, 45, 50, 51 for correction of acne scarring, 46, 48f

for lip augmentation, 46, 47f, 131f, 132 for nasolabial folds, 45, 46f

in perioral rejuvenation, 130, 130f – 131f Restylane Touch (Restylane Fine Lines), 48, 49 Resurfacing devices

laser. See Laser resurfacing radiofrequency, 20 – 21, 21f

Rhytidectomy, for midface rejuvenation. See S-Lift rhytidectomy; S-Plus Lift

Rhytidosis (skin texture)

eyelid, rejuvenation methods for, 78 – 79, 79f laser ablation for, 3 – 5, 4f – 6f

moderate, medium-depth chemical peels for, 24 static rhytids, fillers for, 44 – 47

Risorius muscle, 142

S

S-Lift rhytidectomy, 120 – 125 advantages of, 120 – 121

candidate selection for, 124, 124f, 125f complications following, 123, 123t disadvantages of, 121

elective nature of, 120, 123 indications for, 122, 123t

patient considerations in, 120, 120f with platysmaplasty, 122

retrospective case review of, 122 – 123, 123t technical considerations in, 121 – 122, 121f – 123f

S-Plus Lift, 120, 123f, 124 with platysmaplasty, 122

Sagging cheeks acupuncture for, 162

radiofrequency energy correction, 4, 5, 6 Scarring

as AHA peel complication, 27 as TCA peel complication, 30

Sculptra, 50 – 51, 51f Sebaceous glands, 167

Short-flap facelift procedure. See S-Lift rhytidectomy Silicone injections

complications associated with, 54

liquid injectable, patient preparation for, 52 microdroplet technique, 44, 48

Silikon, 48 Skin

aging process and, 90. See also Photoaging composition of, 165 – 166

damage to

causes of, 169 – 170. See also Photoaging reversing, 170 – 172

layers of, 166 – 168

in noninvasive neck rejuvenation rejuvenating technique, 67 – 68 tightening technique, 70 – 71

preparation for chemical peeling medium-depth peel, 28 superficial peel, 27

Skin breathing, 168 Skin lesion removal

from eyelids, 79 – 80

malignant lesions, treatment options for, 152. See also Photodynamic therapy, for superficial malignant skin lesions

superficial lesions, radiofrequency technology for, 68

Skin rejuvenation. See also specific approaches and techniques dietary approaches to, 170 – 172

laser resurfacing, 1 – 4 of neck skin, 67 – 68 peeling agents, 22 – 26

radiofrequency energy for, 19 – 20, 19t, 20f, 20t Skin texture

techniques for improving, 3

wrinkling. See Rhytidosis (skin texture) Skin tightening, 6, 7f

in neck rejuvenation, 69f, 70 – 71, 70f. See also Thermage, for skin tightening

patient preparation for, 7 principles and protocols for, 8

Sliding osteotomy technique, 137 – 138

SMAS. See Superficial musculoaponeurotic system SMASectomy, 120, 124

S-Plus Lift and, 124 Smile

facial beauty and, 139 gummy, 139 – 140, 140f high lipline, 146

low lipline, 140, 146 Smile design

dentition in, 144, 145f, 146 determinants in, 144 facial dimensions in, 146 Golden proportion of, 144 protocol and theory, 144

Soft tissue

defects in, improving with fillers, 46, 87f

in facial profile, cephalometric tracing of, 134, 135f Solar lentigines, IPL for, 12 – 13, 12f – 13f

SOOF. See Suborbicularis oculi fat Static rhytids, fillers for, 44 – 47 Subcutaneous fat, 167 Suborbicularis oculi fat, 113

in canthotomy, 104, 104f

elevation and fixation of, 104f, 107 – 108, 108f lifting into arcus marginalis, 114

Subperiosteal cheek lifting

background and history of, 103 – 104, 104f complications of, 110

indications for, 104 – 105 patient selection for, 104 postoperative care in, 108 results of, 108, 109f – 110f, 110 surgical technique in, 105 – 108

lateral tarsal strip, 107

malar orbital rim implant, 106 – 107, 107f multistep closure method, 108

patient preparation, 105 SOOF, 107 – 108, 108f

subperiosteal dissection and release, 105 – 106, 106f transconjunctival approach, 105

Subperiosteal dissection

in endoscopic forehead rejuvenation, 97 – 99, 98f in midface restoration procedure, 115 – 116

and release, in cheek lifting, 105 – 106, 106f Sun spots, IPL for, 12 – 13, 12f – 13f

Superficial chemical peels, 24, 25 – 28 application method for, 27 – 28 complications following, 27 – 28 for early dyspigmentation, 24 postpeel care for, 27

strength selection in, 27

Superficial musculoaponeurotic system forehead anatomy and, 93, 93f midface ptosis and, 113

S-Lift rhytidectomy and, 120, 124 Superficial temporal fascia

in endoscopic forehead dissection, 98 in forehead anatomy, 93, 93f

Superior sulcus, in eyelid rejuvenation brow stabilization and, 80 – 81 upper lid and, 81, 81f

Supraorbital nerve, in forehead anatomy, 92f, 94 Supratrochlear nerve, in forehead anatomy, 92f, 94 Sweat glands, 167

in body temperature regulation, 168

T

Tangential “shave” excision, of malignant lesion, 152 Tarsal strips, lateral, in subperiosteal cheek lifting, 107 TCA. See Trichloroacetic acid chemical peel

TCM. See Traditional Chinese medicine

Tear trough deformity implant correction of, 43

fat transposition correction of, 73

“Tear trough” implant, for midface restoration, 113 – 144 Teeth. See Dentition

Telangiectasias, facial, IPL for, 10 – 11, 11f – 12f Temporal fascia, in forehead anatomy, 93, 93f Tetracaine, in eyelid rejuvenation protocol, 78 Tetrafluoroethane spray, 3

Therma-lifting

Botox pretreatment, 5 platysma and, 34

“Therma-lifting” procedure. See Skin tightening ThermaCool TC. See Thermage, for skin tightening Thermage, for skin tightening, 6, 7f, 21 – 22

in neck rejuvenation, 69f, 70 – 71, 70f neuromodulation as pretreatment for, 41 patient preparation for, 7

in perioral rejuvenation, 130, 131f principles and protocols for, 8

Tooth bleaching, 144

Topical therapy, of malignant lesion, 152 Traditional Chinese medicine, 158

channel theory in, 158

disease and diagnosis in, 159 – 160, 160t

and facial acupuncture. See Facial acupuncture Qi in, 159

Yin/Yang concepts in, 158 – 159 Transconjunctival approach, in cheek lifting, 105 Trichloroacetic acid chemical peel

application method for, 28 – 29 consent form for, 31

depth determination in, 29 – 30 erythema appearance with, 29 – 30 frosting level in, 29 medium-depth, 28

postpeel care for, 30 precautions with, 30

superficial, 26, 26f technique dependence of, 29

“Tuck up” procedure, following S-Lift rhytidectomy, 124 Tumescent anesthesia

lidocaine in, 61

in lipoharvesting, 57 – 58, 58t in S-Lift rhytidectomy, 123

U

Unipolar system, of electrical current flow, 15, 15f Upper eyelids. See Eyelids, upper

Upper lip. See Lip(s), upper

V

Vascular occlusions, as lipoinjection complication, 59 Vegetables, skin rejuvenation and, 171

Veins, periorbital, removal of, 80, 80f

Vermilion border, micropigmentation and, 132 – 133, 132f – 133f Vessel blurring, with IPL use, 11

Visage device, 20 – 21, 21f, 22 Vital tooth bleaching, 144 Vitamin C, 172 – 173

W

Washing, of harvested fat samples, 61

Wrinkle reduction. See individual methods and techniques

Y

Yin/Yang concepts, in traditional Chinese medicine, 158 – 159

Z

Zyderm, 50, 52

Zygomatic arch, in endoscopic forehead rejuvenation, 98 – 99 Zygomaticus major muscle, 34, 142

Zygomaticus minor muscle, 34 Zyplast, 50, 52