Face analysis

Analysis of a face showing signs of fatigue, aging or a pejorative expression requires specific training.

Evaluation can be top-down, bottom-up, right-to-left or left-to-right, but must always arrive at the same conclusions: treating causes and consequences.

The causes

Until proven otherwise, the face is subject to one constant: gravity, the primary cause of facial aging. The second: reduced production of collagen, elastin and hyaluronic acid, leading to sagging tissues. To combat gravity, there is little that is reasonable to suggest. On the other hand, to combat loss of tone, there are quite a few options.

The consequences

Tissue ptosis, particularly of deep fat compartments. Added to this is the progressive degeneration of skin quality, leading to spots, superficial wrinkles and expression lines, dilated pores and other redness.

“Knowing how to analyze a face and give precise indications while mastering your technique is the art of aesthetic medicine.

Setting indications

Injections

Hyaluronic acid injections

“Master your diapers!”

Hyaluronic acid injections are a formidable tool for effectively and naturally combating the signs of aging. But to do so, you need to master anatomy, master the different types of hyaluronic acid, master your tools (cannula, needle), master depth and quantity. For a long time, aesthetic medicine was not taught, because the contours and recommendations of good practice were not known. Today, thanks to major advances such as the periosteal injections developed by Dr Di Maio, we can offer hyaluronic acid injections with tangible, natural effects.

But for that to happen, it has to be properly taught.

Bleaching techniques for superficial wrinkles, subcutaneous injections for furrows in the lower face, periosteal injections using a needle or cannula to reposition deep fat compartments: these are the techniques you absolutely must master if you want to practice aesthetic medicine in 2024.

Numerous laboratories (Galderma, Merz, Allergan, Ibsa) offer a complete range of different hyaluronic acids to address the different layers of the face.

Botulinum toxin injections

“Less varied than hyaluronic acid, but equally effective, botulinum toxin must be used with delicacy and precision, like salt and pepper in a chef’s recipe “.

Neither too much, nor too little – this is undoubtedly the difficult cocktail that needs to be found to open up a look, smooth out the marks of time, while preserving the patient’s expression and uniqueness with botulinum toxin.

We need to understand how they work and how to dilute them.

Botox, Vistabel, Azzalure, Dysport, Bocouture, Alluzience, they all have their little secrets.

You need to know the bony and cutaneous insertions of the facial skin muscles, understand their dynamics, and inject at the right depth.

For this, a perfect mastery of anatomy and a theoretical and fundamental understanding of how botulinum toxins work are essential. A practical application on a model enables you to quickly understand the subtleties of this formidable molecule in aesthetic medicine.

Bio-stimulants

They are a perfect complement to hyaluronic acid and botulinum toxin.

The most widely used are calcium hydroxyapatite (Radiesse) and L-polylactic acid (Scupltra).

When applied subcutaneously, you need to have a good command of injections into the various layers, particularly subcutaneous cannula injections and the fanning technique. Easy to apply, they do present a few pitfalls, particularly if distribution is not perfect. If dilution is not mastered, or if the indication is poorly defined, they can dull or sublimate the result of a full-face treatment with toxin and hyaluronic acid.

Deep stimulation treatments

Radio frequencies (thermage, excilis, endymed) and HIFU (ultherapy) will focus on treating the cause of facial signs of aging, i.e. reduced elastin and collagen production. This reduction in the tone of the collagen bands between the skin and the SMAS leads to ptosis of the deep fat compartments, giving way to hollow circles, a valley of tears, nasolabial folds, bitterness creases and jowls.

By stimulating fibroblasts and boosting collagen and elastin production, Energy Based Devices (EBD) are the perfect complement to the injections mentioned above. Here again, a good grasp of the fundamentals of these devices is essential for the right indications and satisfactory results for your patients.

Surface treatments

Epidermal or dermal surface treatments consist in treating the homogeneity of the skin and complexion.

These include: peels, platelet-rich plasma (PRP, sometimes erroneously called plasma lift, as it does not lift the skin but restores its radiance and vigor), photorejuvenation by IPL or laser, resurfacing lasers, mesotherapy, prophilo and microneedling.

All these treatments will restore the skin’s radiance, luminosity and homogeneity, giving the face a more luminous appearance that will enhance the deeper treatments.

Conclusion

As you can see, aesthetic medicine is all about comprehensive, synergistic care. To achieve this, it is absolutely essential to go through a solid theoretical training, then into the hands of experts who will teach you the best techniques and indications, while respecting the safety, natural appearance, difference and physical integrity of your patients.

To learn these techniques, there’s nothing like a dedicated day with several models in a small group with students who share the same level of knowledge. This is what the SAMBA full diploma offers, with its online theory courses and its day of practice with 3 to 4 models in a restricted group, where the patient’s face is approached in its entirety.