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Effective Rejuvenation with Hyaluronic Acid Fillers

Current Advanced Concepts

Mckee, Daniel, M.D.; Remington, Kent, M.D.; Swift, Arthur, M.D.; Lambros, Val, M.D.; Comstock, Jody, M.D.; Lalonde, Don, M.D.

Plastic and Reconstructive Surgery: June 2019 - Volume 143 - Issue 6 - p 1277e–1289e
doi: 10.1097/PRS.0000000000005607
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Learning Objectives: After studying this article, the participant should be able to: 1. Process several patient-specific factors before reaching an optimal treatment strategy with appreciation for facial balance. 2. Define the advantages and disadvantages of various hyaluronic acid preparations and delivery techniques, to achieve a specific goal. 3. Perform advanced facial rejuvenation techniques adapted to each facial zone, combining safety considerations. 4. Prevent and treat complications caused by inadvertent intraarterial injections of hyaluronic acid.

Summary: The growing sophistication and diversity of modern hyaluronic acid fillers combined with an increased understanding of various delivery techniques has allowed injectable filler rejuvenation to become a customizable instrument offering a variety of different ways to improve the face: volume restoration, contouring, balancing, and feature positioning/shaping—beyond simply fading skin creases. As more advanced applications for hyaluronic acid facial rejuvenation are incorporated into practice, an increased understanding of injection anatomy is important to optimize patient safety.

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Vancouver, British Columbia; Calgary, Alberta; Montreal, Quebec; and Saint John, New Brunswick, Canada; Newport Beach, Calif.; and Tucson, Ariz.

From the University of British Columbia; Remington Laser; McGill University; private practice; Skin Spectrum; and Dalhousie University.

Received for publication August 29, 2018; accepted January 11, 2019.

Disclosure:Dr. Swift is a consultant/clinical investigator for Allergan, Merz, and Galderma. Dr. Remington is a consultant and advisory board member for Galderma and Allergan. Dr. Comstock is a consultant and advisory board member for Allergan, Galderma, Colorescience, Skinceuticals, Revance, and skinbetter science. Drs. Mckee, Lambros, and Lalonde have no financial interest in any of the products mentioned in this article.

Related Video content is available for this article. The videos can be found under the “Related Videos” section of the full-text article, or, for Ovid users, using the URL citations published in the article.

Daniel Mckee, M.D., Division of Plastic Surgery, Department of Surgery, University of British Columbia, 2775 Laurel Street, 11133-2 Vancouver, British Columbia V5Z 1M9, Canada,, Instagram: @drdanielmckee

©2019American Society of Plastic Surgeons