Racial and ethnic differences in skin aging: implications for treatment with soft tissue fillers

Racial and ethnic differences in the age of onset, severity, and anatomical features of facial aging have been described. In addition, increased melanocyte lability and fibroblast reactivity are functional features that are characteristic of skin of color. These differences should be considered when treating patients with soft tissue fillers in order to achieve optimal results. Signs of facial aging in individuals with skin of color tend to be most pronounced in the periorbital and midface region with less prominent features of skin aging in the upper third of the face and a decreased tendency toward perioral rhytides and radial lip lines. As such, volumization of the midface while preserving individual and ethnic ideals of beauty is a key goal. Important treatment considerations include minimization of inflammation, epidermal injury, and bruising, which can lead to aesthetically displeasing sequelae.