Non-surgical Facial Sagging Treatments

Central and lateral shaping separation

Hyaluronic acid is a type of mucopolysaccharide that is also found in the body's skin and other tissues. Hyaluronic acid injections are used to replenish volume, lift, support retention ligaments, and contour. Injection methods include Allergan's MD Codes™ and Galderama's Truelift^Ⓡ. In our opinion, the best injection method is to assess the center of the face (forehead, nose, lips, mandible, etc.) and the sides of the face. 

As we age, the face appears flatter from the front. Injecting hyaluronic acid or other material into the central part of the face can give the face a three-dimensional appearance and give it a youthful look. The central part of the face is the forehead, nose, lips and chin. Injection of hyaluronic acid into the nose has been considered dangerous but the risk of blood clots can be reduced by injecting into the membranous nasal septum. Also injecting into the forehead and mandible and/or the lowered nose due to aging (nose tip, nasal bridge and nasal wing base) can give an even more youthful appearance.

From the front view, the side of the face shows a decrease in ridge due to bone atrophy and other factors, giving the impression of aging due to drooping. Injecting hyaluronic acid mainly into the elevated cheek area will give the cheeks a heightened and rejuvenated appearance. We believe that it is important in the treatment of sagging cheeks to inject hyaluronic acid not only into the cheeks and temples, but also into the cheeks to increase the height of the cheeks. Hyaluronic acid is injected into the nose to create a three-dimensional effect and also injected into the chin to restore a beautiful side profile, the E-line. Depending on the case, it is also important to create a mandibular angle and pull the facial line forward and backward to remove sagging of the lower face to restore youthfulness.

Botulinum toxin is a neurotoxin produced by the botulinum bacteria and contains a very small amount of botulinum toxin. Injection can relieve and relax muscles. Injections into the muscles that pull the face downward (e.g., the broad cervical muscles and the submandibular muscles of the angle of the mouth) can help to improve facial contours. Adjustment of the muscles in the chin and mandibular angle areas is also important for facial alignment. In the treatment of facial sagging, Botox can be combined with hyaluronic acid injections and other combination treatments for better results.

Thread lift is very effective in shaping the face lines. The thread lift we use is absorbable. The threads have cogs (spines) and are inserted under the skin of the face to hook and lift tissue. Harder tissues (mandible area) are inevitably easier to hook than softer tissues (such as laugh lines) and the lifting effect is stronger.
We believe that the most effective way to lift the face line is to insert the tissue in a diagonal direction from the hairline area to the mandible. However, even soft tissues have a traction effect so by devising the angle and direction of thread insertion, we can lift sagging facial contours and improve leanness. After insertion of the threads, the tissues are tightened in the process of thread breakdown. From our experience, when thread lifts are performed on a regular basis, long-term effects are achievable.

Super HIFU

HIFU, or High Intensity Focused Ultrasound, is a laser-based "sagging treatment". Our clinic is equipped with KO.Tech's "Super HIFU", a HIFU instrument developed in Japan. The HIFU can lift the face from its foundation by approaching the SMAS layer in the face. SMAS is the deep layer where the incisional facelift surgery approaches. The HIFU is characterized by the fact that it irradiates thermal energy to the targeted areas of the face in a linear, rather than a point-like pattern, which is less painful than conventional HIFU and provides sufficient results while reducing irradiation time.

Thermagen

RF is an instrument to improve facial sagging by irradiating radiofrequency waves and causing the dermis and subcutaneous tissue of the face to contract with heat. Our clinic uses "Thermagen" by KO. Tech, a RF instrument developed in Japan. While the HIFU mentioned above works on a deeper layer, Thermagen works on a shallower layer and applies heat to a wider area. Since it irradiates the shallower layers, it is highly effective in tightening the skin. Combination with the HIFU, it can improve the sagging and lift-up effect of the entire face layers.

In the treatment of facial sagging, skin treatment is very important to give elasticity to the skin on the top surface of the face and keep it firm. At our clinic, we use Dermapen4, Quanta's Q-SW Ruby Laser Q-PLUS R, Hydrabooster and other equipment, as well as peelings, to treat sagging skin.
Dermapen4 is a micro-needling machine that uses a needle to make fine holes in the skin to improve the quality of the skin from the skin's wound-healing point (its own power to heal). This treatment is expected to be effective for acne, acne scars, pores, strawberry nose, fine lines and wrinkles, pigmentation and scars. The skin becomes more elastic during the wound healing process. Q-PLUS R is a laser instrument used to treat spots and birthmarks with a wavelength of 694nm and high absorption rate to melanin. This instrument's ruby fractional treatment is a method of treating spots by irradiating Q-switched ruby in a point-like pattern with a segmented laser beam. Full-face irradiation is possible, and heat is applied to the entire dermis, which reduces pores and gives the skin a firmer appearance.

All treatments have their strengths and weaknesses and we aim for further improvement by complementing each other to treat "sagging facial skin". We combine not only hyaluronic acid and Botox injections, but also thread lift, HIFU, radiofrequency and other instrumental treatments to suit the patient's facial condition. It is also very useful as a maintenance treatment after incisional surgery such as Deep Plane Facelift.