CHEEKS OVER 60

In a session dedicated to the unique and specific challenges of treating the mature patient, Dr Helen Marsden’s live demo showed how to improve the condition of cheeks in patients over sixty.

At her clinic in Durham, which Dr Marsden runs with her daughter Kate, more than 80% of the people who come through the door in search of long-lasting, natural-looking results are over the age of 45.

Dr Marsden explained: “Because of my patient demographic I developed a strategy of tackling the mid-face because older patients want an invisible treatment that everybody notices but nobody knows about.”

A former GP who now works solely in the field of medical aesthetics, Dr Marsden is a fan of Kysense products, a range of premium high-quality intelligent HA dermal fillers designed for full face rejuvenation, using advanced patented technology that leads to improvements in injection precision, tissue protection and patient satisfaction.

She said: “What my patients like about these treatments is looking naturalwe can always add more to take away the effects of ageing.”

BOOST VOLUME

Dr Marsden began the live demo by introducing the audience to her 62-year-old patient Debs, who had dermal filler around 10 months ago and was looking for a top-up: “With this filler, we are hoping to restore some of the deep volume loss that the ageing process takes away,” explained Dr Marsden. “Predictably as we age, we get selective atrophy of the fat pads and lose volume below the eye and cheek. The superficial nasolabial fat pad naturally undergoes hypertrophy with ageing, and we start to get pull-down. This shows the importance of treating the mid-face to provide support and scaffolding to lift the lower face.”

To boost volume in the mid face, Dr Marsden would target the medial suborbicularis oculi fat pad (SOOF) primarily using Kysense Extreme dermal filler, but added: “This is a very highly projecting dermal filler so we need very much less to still give projection, I think 20-30% less filler and it still gives comparable resultsless is more.”

After a quick chat with Debs, advising her of what to expect and what not to tolerate if concerned,Dr Marsden began the treatment with 0.6ml of Kysense Extreme, an injectable gel for facial sculpting and contouring.

“There’s no rush with this,” she said. “They key is slow and steady, low pressure injections. This is a firm and projecting filler, it handles well in the syringe and injects nicely and easily. I want to make contact and then maintain contact with the periosteum while injecting slowly and I don’t want to overfill Debs’ face. The injections are into the area of the fat pads that deflate with ageing with optimum results being obtained by augmenting the medial and then the lateral SOOF.

DIFFERENT TOOLS

Dr Marsden then switched to a cannula for the Kysense Volume, an injectable gel intended for the facial reconstruction of congenital or medical defects, and the aesthetic treatment of deep skin depressions and augmentation for volume of facial tissues.

“This works well in a 25-gauge cannula,” she explained. “Debs has got a nice volume replacement with the Extreme, now Volume allows us to do a more contouring and sculpting via a cannula in a more superficial plane.

“Even though a cannula is a blunt tool, we should still know where it is at all points. I am going to contour the area where we need the volume. This filler moves slowly through the cannula. It is unapologetically lidocaine-free – you certainly don’t need it in a cheek filler. An added bonus is the skin quality and glow you get from the pharmaceutical-grade hyaluronic acid.”

Debs clearly felt comfortable throughout the treatment, and Dr Marsden went on: “We want to create that nice curve of the cheek and hopefully Debs will go home from here saying she likes it, it doesn’t look overdone, and it looks natural.

“When massaging afterwards, we do not want to flatten, we just want to shape and contour, you don’t need to squash it flat.”

When she had finished one cheek, Dr Marsden pointed out the marked difference between the treated and untreated sides of Debs’ face, pleased with the results: “You can really tell the difference in terms of projection.

“The untreated side has volume loss and pull-down in the labial fat pads. The treated side has a gentle result, nice and subtle. The area that people call the tear trough has really been enhanced.”

But like many other experts at the event, Dr Marsden warned delegates about the risk of simply following patients’ requests without a thorough consultation first: “Patients actually need to examine what is going on, they can come in with a different complaint and we end up treating the mid-face as it is a way of improving most complaints. And I am quite risk-averse!”