Facial shaping: beyond lines and folds with fillers

Facial attractiveness is the most important determinant of physical attractiveness, and an important factor in social and interpersonal interactions. The field of facial rejuvenation using minimally invasive procedures has expanded exponentially over the last decade. Historically, aging and the resulting changes were primarily attributed to changes in the skin and the underlying musculoskeletal system. However, more recent understanding of the changes associated with facial aging has shifted the focus to changes in the distribution of subcutaneous fat. With the introduction of seemingly endless varieties of fillers over the last decade, restoration of volume loss by subcutaneous fat, and to some extent bone, has never been easier. Here, the authors review the basic principles that govern facial beauty, facial anatomy, the aging process, and the wide variety of fillers available on the market today that enable a dermatologic surgeon to revitalize the face.