Dermal Fillers Restore Youthful Facial Movement, Don't Just Fill Wrinkles

American Society of Plastic Surgeons (ASPS)

January 28, 2019

Injectable dermal fillers do more than just fill in wrinkles. According to a new study in the February issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS), dermal fillers also restore a more youthful pattern of facial movement and expressiveness.

Dermal fillers provide a minimally-invasive approach to reducing facial lines and wrinkles while restoring volume and fullness in the face. Almost 2.7 million dermal filler injection procedures were performed in 2018, according to the most recent ASPS statistics.

To be truly effective, filler treatments must do more than just fill out facial lines and sagging. They must also produce a more youthful-appearing pattern of facial movements. "Facial expressions convey emotions as well as signal characteristics such as age and quality of life," said ASPS member Ivona Percec, MD, PhD, of University of Pennsylvania, Philadelphia, who led the study.

Researchers Study Face in Motion

A technique called 3D digital stereophotogrammetry is used to study how dermal fillers affect the face in motion. Precise measurements were obtained of facial stretch and compression in 30 women aged 41 to 65 years. All patients were to undergo HA dermal filler treatment for facial lines and wrinkles in the lower face.

The women were treated for moderate to severe nasolabial folds (the lines running from the corners of the nose to the corners of the mouth) and marionette lines (which run from the mouth to the chin). The scans were performed prior to HA filler treatment and repeated 6 weeks later.

The facial dynamic strain results were compared with those in a group of 20 untreated women ages 25 to 35. In scans performed before dermal filler treatment, heat maps showed significantly higher "stretch profiles" in the treatments areas in the older women compared to the younger women.

Reduction Seen in Stretch Levels

The older women had significant reductions in stretch and strain across the full range of facial expressions in the follow-up scans. "That finding provides objective evidence that HA dermal filler treatment of facial lines in middle-aged women results in stretch levels more like those of younger women," said Dr. Percec.

Facial movement reflects the complex interplay of the skin and underlying soft tissue, skeletal volume and muscle activity. "Facial dynamics should be central to the evaluation of rejuvenation treatments to produce natural-looking results," the authors said. Assessment of facial movement is especially important in the area around the mouth, which is especially mobile and prone to facial lines and volume loss.