▶ Previous Artlcle : #2-3. Minimally Invasive Treatment Designing According to Patient Age: Combination of 3DC and 3SC

 

3DC and 3SC combination treatment for different age groups

People in their 20s: Patients in this age group have rich fat and collagen along with strong ligaments that hold them in place. Less aggressive and subtle approaches are suitable for this age group. Minimize LZ and RZ (the so-called V line approach) and add subtle volume in CZ. However, the chin which is the lowest mid-point of CZ, should not be sculpted too sharply as in the letter V. This works against the overall elegant balance of the face. I think a natural U line + V line should be the right approach. Even if excess cheek hollowness or fat protrusion is observed, I recommend using dermal filler or autologous fat transfer rather than thread lift in this age group. If the patient has overdeveloped cheek fat, I recommend using contour/sculpture injection and mini facial fat aspiration for sufficient improvements.

 

People in their 30s and 40s: The key objective of treatment in this age group is regeneration and rejuvenation. A decade long accumulation of aging signs and drastic life changes such as pregnancy and childbirth have taken a toll on the face. Supplementing deficient collagen and promoting collagenesis can easily bring back a youthful appearance. My design concept of 3DC & 3SC is based on facial anatomical base points and allows quick procedures with little downtime in various age groups.

 

As collagen degradation is not yet too serious in this age group, various design approaches are possible (this is based on my experience and individual differences exist). The easiest and most effective wrinkle reduction approaches include localized botulinum toxin injection, facial botulinum toxin injection for overall face tightening, and HIFU, which boasts the smallest downtime of all lifting procedures. For increasing collagen, methods such as injecting collagenesis-promoting substances can be used as well. Vector increasing treatments using injectables may not bring sufficient improvement in this age group compared to younger patients. I recommend performing regeneration and rejuvenation procedures first for better designing.

 

People in their 50s and older: People in their 30s and 40s may not show clear aging signs yet but in this age group aging signs such as wrinkles, grooves, and sagging, etc. are clearly noticeable. It is most important to first reduce the gap between the skull and skin. This can be a part of the designing phase and is comparable to clearing the paper surface before you start drawing on it. It is just as important as laying down good foundation in building construction.

 

For this foundation procedure, I recommend short and long thread lift as it is effective, easy and has a low risk of complications. Depending on patient condition, HIFU can be combined. However, correctly carried out short and long thread lift can bring sufficient tightening. A unique characteristic of this age group, which is both an advantage and disadvantage, is the jowls of the lower face or the droopy and protruding buccal fat. This deposit of excess soft tissues can be used for fat transfer.

 

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I already mentioned that thread lift is the main modality of correction in this age group. I prefer using the long thread in patients with severe soft tissue sagging. The suture material also should differ based on the patient condition. I use various materials including the quickly absorbed PDO (polydioxanone) thread, PLLA thread with collagenesis and longer duration of the lift and non-absorbable thread. Creating a cone or mesh structure using thread can bring excellent fat layer enhancement. This can help bring the desired facial outlines without using additional vector increasing procedures. I highly recommend laying the foundation with thread lift first and observing the outcome in 3-6 months’ time before introducing other modalities. This will help create the desired effects in follow-up 3DC and 3SC procedures more easily.

 

-To be continued