Clinical validation of the upper face first principle-A clinical, prospective, interventional split-face study

Area of Science:

• Facial anatomy and biomechanics
• Aesthetic medicine and cosmetic procedures
• Dermatology and plastic surgery

Background:

• Facial biomechanics understanding has led to new principles for aesthetic procedures.
• Established principles include Lateral Face First, Deep Layers First, and Upper Face First.

Purpose of the Study:

• To evaluate the efficacy of the Upper Face First principle in facial aesthetic injections.
• To compare an injection sequence starting in the upper face versus one starting in the lower face.

Main Methods:

• An interventional split-face study design was employed.
• 15 patients received soft tissue fillers in a sequential manner (upper, middle, lower vs. lower, middle, upper face).
• Outcomes were assessed using semiquantitative scores and 3D imaging at D0, D30, and D90.

Main Results:

• The upper face first algorithm showed better ratings for midfacial volume and jawline contouring at all follow-up points.
• The global aesthetic improvement scale was significantly better for the upper face first approach (p < 0.001).

Conclusions:

• The Upper Face First injection algorithm appears to provide superior aesthetic outcomes.
• Clinical effectiveness is supported by both semiquantitative and objective outcome measurements.