When it comes to performing an Aesthetic Medicine intervention, what is important is not what is put, but where it is put.
When I started the specialty of Dermatology more than 22 years ago, we lacked the arsenal doctors use today to rejuvenate their patients. We had a couple of different types of collagen injected where it seemed to be missing: on the lips, in the folds and wrinkles of the face, like the silicone , used in our field to create prostheses and implants .
In the articles that doctors write about filling materials or rejuvenation techniques we strive to discuss which is better or which more durable.
Many of my patients make me the observation that all people treated in aesthetic medicine end up looking enormously. Moreover, I would say that when I look at the television, which I do less and less, I observe that some protagonists of night programs have a disproportionately large upper lip compared to the rest of their face, acquiring even a simian aspect. Others and others, on the other hand, obtain through the interventions an excessively large cheek. In the case of men, this change is even more unnatural; Since the large, prominent and generous cheeks are characteristic of the female sex or people of Asian origin but not of the men.
The other day a patient asked me to inject one of these materials into the "ictus". - "Riccus?" I replied.. What I mean is that many patients get carried away by the fashions of aesthetics without knowing enough about what they really need.
In fact our patients see the wrinkles of the upper lip, the eyebrows under the eye or the nasogenian furrows, which leads us to inject stuffing material wherever they want it.
Thus, between injection in the cheekbone and infiltration in the lip our patients are gaining volume in facial regions that are not the only ones to lose thickness and collagen as we age. We have forgotten that the face is a surface of more than 300 cm2 where upper lip and cheeks do not exceed 15% of the total while they receive 92% of the fillings. Therefore, the result is asymmetrical and lacking in naturalness.
The fundamental thing in dermatology and aesthetic medicine is not what we put, what is important is where we put it. Aesthetic medicine and dermatologists must lead a revolution in the way we work and change our treatment pattern in rejuvenation.