In this article, I present my unique method of injecting dermal fillers in the hairline to create a lifting effect that is concealed from view and does not distort the patient’s natural appearance. As a portrait artist and sculptor with an expertise in the natural human face, my objective as an injector has been to reverse the laxity and accordion effects of age due to osteoporosis, loss of subcutaneous support tissues, and loss of elasticity without changing the natural contours and appearance of my subject. My method entails placing hyaluronic acid dermal fillers in the scalpline and hairline so as to provide a lifting effect without the product being in any way apparent on the face. Akin to surgical facelifting, I place the filler in the areas where a surgeon would routinely cut and sew to obtain a lift to the lower, mid-face, and upper face, including the posterior and pre-auricular areas, and the temporal and frontal scalpline. Instead of incising and excising skin, I employ the tension caused by the deposition of filler to create the lift in vectors depicted to achieve the lift required to elevate jowels, nasolabial folds, periorbital folds, and the brow (see Figure). In placing the hyaluronic acid fillers intradermally, my method has achieved long-term improvements beyond the duration of the filler, likely due to the neocollagenesis that has been observed with intradermal placement of hyaluronic acid fillers. To date, I have treated over one thousand cases, and have not observed any incidence of hair loss or occlusion due to intradermal placement.
References
- Carruthers, J, D., Carruthers, J. A., Humphrey, S. Fillers and neocollagenesis. Derm Surg. 2014; 40:S134-S136.
- Ho, D and Jadeo J. Biological properties of a new volumizing hyaluronic acid filler: a systematic review. J Drugs Dermatol. 2015; 14(1):5.
AUTHOR CORRESPONDENCE
Macrene Alexiades MD PhD dralexiades@nyderm.org