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Facial Assessment and Injection Guide for Botulinum Toxin and Injectable Hyaluronic Acid Fillers: Focus on the Lower Face

de Maio, Maurício M.D.; Wu, Woffles T. L. M.D.; Goodman, Greg J. M.D.; Monheit, Gary M.D.; on behalf of the Alliance for the Future of Aesthetics Consensus Committee

Plastic and Reconstructive Surgery: September 2017 - Volume 140 - Issue 3 - p 393e-404e
doi: 10.1097/PRS.0000000000003646
Cosmetic: Original Articles
Best Paper

Summary: This third article of a three-part series addresses techniques and recommendations for aesthetic treatment of the lower face. The lower face is considered an advanced area for facial aesthetic treatment. In this region, soft-tissue fillers play a more important role than neuromodulators and should be used first to provide structure and support before neuromodulators are considered for treatment of dynamic lines. Treatment of the lip, perioral region, and chin, in addition to maintaining balance of the lower face with the face overall, is challenging. Procedures on the lip should avoid overcorrection while respecting the projection of the lips on the profile view and the ratio of lip size to chin. The chin is often neglected, but reshaping the jawline can provide dramatic improvement in facial aesthetics. Both profile and anterior views are critical in assessment and treatment of the lower face. Finally, rejuvenation of the neck region requires fillers for structural support of the chin and jawline and neuromodulators for treatment of the masseter and platysma.

São Paulo, Brazil; Singapore; South Yarra, Melbourne, Victoria, Australia; and Birmingham, Ala.

From the Clinica Dr. Maurício de Maio; the Woffles Wu Aesthetic Surgery and Laser Centre; the Dermatology Institute of Victoria; and the Total Skin and Beauty Dermatology Center.

Received for publication April 13, 2016; accepted February 10, 2017.

Disclosure:Dr. de Maio and Dr. Goodman are Allergan plc consultants for speaking events and marketing strategy. Dr. Wu is a consultant for Allergan plc, Galderma, and Merz for speaking events and advisory boards. Dr. Monheit has no conflicts to disclose.

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Maurício de Maio, M.D., Clinica Dr. Maurício de Maio, Avenida Ibirapuera, 2907 cj 1202, Moema EP 04029200, São Paulo-SP, Brazil,

Copyright © 2017 by the American Society of Plastic Surgeons