Ligaments as a Guide to Facial Soft Tissue Filler Augmentation

The effectiveness of this injection technique was likely due to the strategic placement of soft tissue filler directly inferior to the obicularis retaining ligament.

The researchers assessed the effects of soft tissue filler placed directly inferior to the orbicularis retaining ligament.
The researchers assessed the effects of soft tissue filler placed directly inferior to the orbicularis retaining ligament.

Soft tissue filler injections placed in close proximity to facial ligaments can help restore a more youthful appearance by reorienting the ligaments, say authors Francesco P. Bernardini, MD, et al, who published their findings in the Journal of Cosmetic Dermatology (October 22, 2021).

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With the knowledge that the orientation of facial ligaments changes due to age-related loss of bony support, the researchers assessed the aesthetic and anatomic effects of soft tissue filler placed directly inferior to the orbicularis retaining ligament in the infraorbital region.

They treated 163 patients with signs of infraorbital aging using a standardized soft tissue filler injection into and in close proximity to the orbicularis retaining ligament. Eleven blinded and independent evaluators assessed outcomes through two-dimensional frontal images of the infraorbital region taken at baseline and after treatment.

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Following treatment, the evaluators and the treating physicians saw statistically significant improvement in the entire infraorbital region (lid-cheek junction) as well as in the severity of the tear trough (medial aspect of the infraorbital region) and hollowing of the lateral aspect of the infraorbital region. All the results were rated “very much improved” compared to baseline.

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The authors noted that the effectiveness of this injection technique was likely due to the strategic placement of soft tissue filler directly inferior to the obicularis retaining ligament, as the filler helped to reposition the ligaments, which change in orientation during the aging process.

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