Volume rejuvenation of the face

Patient's desires for an un-operated look and shorter recovery times have lead to a blending of surgical and nonsurgical techniques to effect facial rejuvenation. Anatomical changes within the skeleton and soft tissue compartments are discussed. A brief review of adjunctive techniques to replace volume lost in aging is presented. These techniques (autologous fat grafting and injectable fillers) are contrasted with more involved surgical procedures (rhytidectomy and sub-periosteal mid-face lifting). In patients with mild jowling, the "liquid facelift" can approach the results seen in surgical face-lifting. In patients with significant jowling, the addition of volume replacement at the time of rhytidectomy enhances the rejuvenation. The addition of volume replacement at the time of rhytidectomy has the potential to allow less aggressive surgical dissections to accomplish a harmonious result.