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Updated: Mar 22, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
A Multimodal Approach to Rejuvenation of the Lower Face
Jean Carruthers1, Alastair Carruthers
1Departments of *Ophthalmology and Visual Sciences, and †Dermatology and Skin Science, University of British Columbia, Vancouver, Canada.
Background:
Facial aging is multifactorial, including changes in all the anatomical layers of the face including bone, fat, connective tissues and skin.
Methods:
An evaluation of the multifactorial causation of facial aging pointed to the need for a multifactorial approach to restoration and rejuvenation of the aging human face.
Results:
The varied aetiologies of the expressions of facial aging require more interventions than a unipolar approach. Combinations of neuromodulators, three and two-dimensional fillers and energy based devices were discussed. Surgical interventions were also discussed but were not addressed in this paper.
Conclusions:
A multimodal approach to lower facial rejuvenation and restoration is discussed as the most effective and appropriate method to achieve noninvasive aesthetic treatment success.
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