Sculpt Your Face
Posted: Tuesday 30 November 2010 06:00am
The art of looking rejuvenated these days is no longer the “fill ‘er up” approach of plugging wrinkles and furrows as if Spakfilla in damaged walls.Rather, looking at the face as a whole and restoring it to more youthful symmetry.
What lies beneath is often the bigger issue than the “cobwebs” on top. The signs of facial ageing are normally the result of decreased volume (fat) in the face, which can exaggerate wrinkles because there is less surface area for the skin to sit across.
Facial revolumisation has been the buzz term in cosmetic medicine over the past two years. A new generation of more sophisticated hyaluronic acid dermal fillers (with names like Juvederm, Restalyne and Esthelis; Voluma, Sub Q and Fortelis) have allowed doctors to re-plump larger areas that tend to hollow with age, such as the mid face and under the eyes, with results than can last for around nine months.
But it’s not necessarily the pursuit of youth that is drawing people to the needle. A recent survey of 1007 men and women aged 30+, conducted by global pharmaceutical giant Sanofi Aventis, revealed that Australians want to feel better rather than look younger.
To that end, 51 per cent of those women surveyed, and one third of the men, were considering the so-called “liquid facelift”.
However, fears remain about unnatural results (and some celebrity “pillow faces”, such as French First Lady Carla Bruni’s unfortunate encounter with a dermal filler earlier this year, would do nothing to assuage those – see our photo gallery, Pumped!). The survey and also found the immediate effects offered by some products are not always desirable. Sixty per cent surveyed were more likely to undergo a procedure that delivered a gradual improvement and natural appearance.
Carla Bruni
Sculptra, a dermal stimulation agent that has not enjoyed the higher profile of its hyaluronic acid cousins, may be the answer.
“It is Poly-L-lactic acid [synthesised from lactic acid, which is present in the human body], a naturally biodegradable substance that has been used in dissolvable stitches for well over 30 years,” explains Sydney cosmetic physician Dr Jeremy Cumpston.
“Sculptra works by stimulating the deep dermal layers to produce more collagen, which then reduces loss of elastin and hyaluronic acid [which helps draw more moisture back into the dermis, making it plumper still].”
It differs from dermal fillers in that it is not placed in a “spot” injection but used in a pattern to evenly fill out the face in the problem area. The treated area is massaged to evenly distribute the product.
Improvement in contour occurs gradually over two to six months, an advantage for those people wishing to avoid the obvious tell-tale overnight change in appearance of cosmetic surgery.
“Sculptra is excellent for patients who have volume loss in malar (cheek) region, nasolabial fold region and in temples,” says Dr Cumpston.
“It can really help in cases of severe lipo-atrophy (loss of skin fat) and the effects are significantly longer lasting than standard dermal fillers [up to two years].”
Patients interested in the procedure are urged to have a preliminary consultation as to their suitability for Sculptra, at least a week before treatment. Unlike hyaluronic acid fillers, the solution must be prepared in advance.
It is approved in the US for the treatment of HIV-associated lipo-atrophy and treatment for cosmetic purposes is considered “off-label” use.
“Sculptra is more relevant to a patient’s needs when there is `global’ volume depletion,” says Brisbane cosmetic physician Dr Alison Jamieson.
“It’s common for both Sculptra and dermal fillers to be used on one patient as they are both suited to different areas of the face. “Collagen stimulators [such as Sculptra] are used largely for pan-facial volumisation whereas dermal fillers are often used in more targeted areas of the face to fill lines or create contour changes.”
Melbourne plastic surgeon Dr Brett Archer explains that a typical treatment with Scupltra takes about 30 minutes, under local anaesthetic, and “usually happens over two or three visits approximately six weeks apart, to achieve desired correction.
“Depending on the amount of product required, it can cost anywhere from $1000-$3000 in total. “The effects generally last 18 months to more than 3 years – they last longer the younger you are.”
As with any cosmedical procedure there are risks, however minimal. Apart from temporary redness, bruising and swelling, “in a small percentage of cases, hard lumps may form in the dermal layer of the skin,” concludes Dr Cumpston.
“To prevent this happening, patients are urged to apply deep tissue massage to the injection sites following the 5:5:5 rule – five minutes of deep massage to injection sites, five times a day for five days. Most lumps resolve with simple repetitive massage. There are cases of lumps becoming very large and requiring surgical removal, but fortunately this is a very rare situation.”