A Combined Treatment Proposal for the Empty Deep Pyriform Space

Area of Science:

• Aesthetic Medicine
• Facial Anatomy
• Dermatology

Background:

• Nasolabial folds (NLF), nasal tip ptosis, and angry facial expressions are common aesthetic concerns.
• Anatomical causes for this combination of signs are not well-established.
• This study reviews relevant anatomy and proposes a combined treatment approach.

Purpose of the Study:

• To evaluate a combined treatment modality for specific facial aging concerns.
• To correlate anatomical findings with aesthetic outcomes.
• To improve static and dynamic facial expressions.

Main Methods:

• Retrospective analysis of patients treated with hyaluronic acid (HA) fillers and abobotulinumtoxinA.
• Injections targeted the deep pyriform space (HA) and nasal muscles (abobotulinumtoxinA).
• Photographic documentation at rest and during motion, pre- and post-treatment.

Main Results:

• Significant effacement of the nasolabial fold (NLF) was observed.
• Improved nasal tip positioning during smiling.
• More favorable overall facial expressions in static and dynamic views.

Conclusions:

• Combined HA fillers in the deep pyriform space and abobotulinumtoxinA in nasal muscles effectively address aging stigma.
• This treatment improves angry expressions and associated facial features.
• The modality is effective for both resting and dynamic facial conditions.