The lower third face rejuvenation: our experience

Abstract

The lower third of the face is supported by the basal border of the mandible and centred by the oral and perioral region (smile). The aging of this region is mostly due to change in its environment (skin, muscle and bone). Chronodermie: the programmed aging, interested melting of the various components of this environment with age (bone loss related to the evolution of the dental condition, muscle atrophy, sagging skin, etc). Heliodermatitis: aggravated aging, especially interesting the superficial dermis with variable intensity elastolysis giving vertical wrinkles above the upper lip. We report our experience about therapeutic methods of rejuvenation lower third of the face which must fight against the forces of gravity in 50 aged patients consulting the maxillofacial and dental department for aging of the lower face during past five years. The cervicofacial lift remains the “gold standard” in some cases (three cases). Genioplasty was indicated in five patients to improve facial contour. Preimplantary surgery was needed in eight patients when edentation is ancient. Alternatives to these surgical procedures are sometimes necessary (time ± long recovery, morbidity, the financial implications, etc.) and are done in most cases even after surgery. As volume restoration methods we used: the lipofilling (five cases), hyaluronic acid fillers (42 patients). Regeneration procedures are up-to-date methods such as platelet-rich plasma injections (four cases), mesotherapy, etc. Botulinum toxin that are normally less indicated in the lower third of the face especially with the technique of mesobotox in jaws wrinkles were used in (25 cases).