Facial filler philosophy has been characterized by an overwhelming focus on skin and fat as opposed to muscle action.  When it comes to facial aesthetics, injectors will often focus on static wrinkles and volume loss rather than muscle interaction.  Hyperactive muscles are commonly addressed by neuromodulators like botulinum and other toxins; for example, masseter hyperplasia may be treated with botulinum.  However, a Brazilian study by Mauricio de Maio identified a link between injectable fillers and muscle movement, or myomodulation.  Let’s take a look at the findings:

Myomodulation & Biomechanics: How our faces move

Facial muscles, or mimetic muscles, are in charge of facial expression.  Three key aspects dictate such muscle movement:

1. Length-Tension Relationship
2. Muscle Pulley and Lever Systems
3. Functional Muscle Groups

Length-Tension Relationship

The length-tension relationship is dictated by two components: contractile and...

Natural looks are trending, and as more people open up about getting injectables, many are reversing the effects of their fillers.  While injections may fade over time, hyaluronidases can help speed up the process.

What are hyaluronidases?

Hyaluronidases are a family of enzymes that break down hyaluronic acid (HA).  The body degrades HA via thermal pathways, free radicals, and naturally occurring hyaluronidases.  While these natural processes will help dissolve the filler over time, patients finding complications with their treatment may look for alternative methods of dissolution.

When to get hyaluronidase injections

Adverse effects and complications from hyaluronic acid fillers may include the following:

• Cosmetic overcorrection
• Inflammatory nodules
• Delayed onset nodules
• Vascular occlusion
• Blindness
• Tyndall effect
• Allergic or immunogenic reaction to HA filler
• Necrosis

Each of these occurrences may prompt patients to seek correction via...

The epidermis (the outer portion of your skin) is composed of multiple layers of epidermal cells. These cells help maintain your skins internal temperature and prevent dehydration by providing a barrier against the external environment, the epidermis in turn protects your tissue. 

Tonofilaments (microscopic fibers) run between individual cells and anchor them together. An extracellular surrounds each cell, and acts as glue, to keep the cells together. Over time these cells are shed through the body’s means of exfoliation. Acids within the chemical peel raise the acidity of the skin to a 3.8 pH level. Normally, skin has a pH of 5.5, but by changing the pH level the cells that form the “glue” between dead skin and healthy skin are chemically loosened. Therefore, exfoliation occurs as dead skin is removed to reveal healthy skin underneath. By speeding up this process, you restore a more youthful glow to the skin and help to eliminate signs of aging.

...

An On and Off Label Approach to Injectables

The most seasoned plastic surgeons and sought after injectors can attest to the importance of training and innovation. 

As the aesthetics field continues to flourish, a good injector will be up-to-date with the latest on-label and off-label procedures, the newest fillers on the market, and proper protocols for handling an adverse reaction. 

Luckily, there is a multitude of ways you can perfect your technique and learn from the best. In recent years, the idea of shadowing expert injectors has started to fade. Many physicians like myself offer in person, one on one shadowing to other injectors.

Is there an injector that you admire on Instagram or Youtube? Are you eager to learn a new off-label procedure that seems to be taking off? Reach out to the provider or visit their website to see if they offer any form of training! Even if they don't have it listed on their website, it doesn't hurt to ask. 

Whether you're an advanced...