WHO IS THE FACIAL SPECIALIST ? HYALURONIC ACID FILLERS : OPTIMISATION OF AESTHETIC DENTISTRY AND PATIENT LOYALTY
Figure 4 . Aesthetic regions of the face . The main aesthetic regions of the face are : the frontal region ( F ), the temporal region ( T ), the orbital region ( O ), the zygomatic region ( Z ), the buccal region ( B ), the nasal region ( N ), the mandibular ( M ), and the lip and perioral region ( L ). Drawn by Aldo Zupi using ZygoteBody™ 3D Anatomy Viewer . Zygote Media Group Inc ., American Forks , UT
these areas has particular anatomic features : skin , subcutaneous tissues , muscles , fat , movements and mimic . The therapeutic options will be different for each different area . In addition , we need to consider the changes associated to aging and this allows us to understand how important it is to know the face anatomy before any intervention . Careful attention must be paid to the exterior margin of the vermilion . It is surrounded by a thin line and slightly detected skin called the lip white roll ( Fig . 5 ). It is very noticeable in young lips , which highlights the red border of the lip . The presence of this area is one of the secrets best kept by plastic surgeons . Its presence and its use allow as to obtain excellent aesthetic results with no invasive treatment .
6 . Skin analysis The next step is the skin analysis : a glowing and well-maintained skin improves the beauty of a face and a smile . We need to be able to do an initial screening of the status of the skin and eventually we need to be able to spot injuries or diseases , which will be evaluated by the dermatologist . It is important to asses the skin surface . We will examine as many elements as possible ( Tab . 1 ). Hair , eyebrows , eyelashes , colours of the eyes and make up are considered characteristics , which are perceived as parts of a person ’ s personality . When the main physiological parameters of function get closer to ‘ normality ’ the skin will look bright , light , compact , well hydrated , soft , elastic and smooth . An important parameter to evaluate in the analysis of the skin is the texture ( also called webbing or skin profile ). The skin texture is formed of the set of lines , which fused together on the skin surface surround quadrangular or rhomboid areas with primary and secondary lines . It is very hard to observe this in children and babies with a naked eye . With age , these lines become less frequent , deeper and messy . The skin texture can be evaluated through macrophotography according to Beagley and Gibson 16 or through profilometry 17 and it is conditioned by the form and function of the structures , which cover it . The skin examination is obviously completed with the observation of wrinkles . A good reference for this evaluation is the classification of Glogau 18 , which links age , wrinkles and texture quality ( Tab . 2 ). To be able to understand the difference between the wrinkles and the rationale of their treatment it is necessary to remember the structure of the skin . The skin of the face is a layered structure . The main layers are the epidermis and the dermis . Below them there is the adipose tissue . The depth of these layers gradually varies depending on the area of the body and face examined . It is very thin in the periocular region ; it becomes thicker on the cheeks , it gets thinner again on the mandibular region to then become once again thicker in the perioral region . The epidermis is subdivided in a keratinized superficial portion with the cellular elements at the end of its life cycle and in a deeper portion with vital cellular elements . In the deepest zones of this layer the melanocytes have been localised , which explains the difficulties in treating the skin spots . Below the epidermis , the dermis and the connective tissue can be found , also with variable thickness . The dermis is the layer where the HA is positioned . Here is where the increase in volume happens , which has an impact on the layers above achieving a filling or smoothing of the wrinkle .
7 . Analysis of the expressive quality of the face A last evaluation is the quality of the facial expression . This evaluation has to happen with the analysis of the static and dynamic mimic activity . Each face is unique because of some important characteristics : the mimic , the skeletal muscle activity of the face and the neck , the head posture , the look , and the smile ( the heart of the face ).
8 . Surgical procedure : how and where The filler procedure is extremely simple and it only requires easy injections technique knowledge . Dentists are the best specialists in this field . A dentist , generally , performs dozens of injections everyday ; probably thousands every year . For a dentist , an injection is a very familiar act . The layer where the filler injection happens is , in
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