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Analysis of Filler Spread: Facial Retinacula Play a Prominent Role
Leonie Schelke1, Steve Harris2, Jair M Cerón Bohórquez3
1Department of Dermatology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Summary
Facial filler spread is predictable, guided by anatomical structures like the retinacula superficialis and profundus. Filler rheology influences injected length but not directional spread in healthy tissue.
Area of Science:
- Dermatology and Aesthetic Medicine
- Facial Anatomy
- Injectable Fillers
Background:
- Previous ultrasound studies indicated unpredictable filler spread during injections.
- Understanding filler behavior is crucial for safe and effective aesthetic treatments.
Purpose of the Study:
- To investigate facial filler spread in common anatomical locations.
- To determine the predictability of filler spread based on specific facial layers.
- To analyze filler spread direction influenced by the retinacula superficialis (RS) and retinacula profundus (RP).
Main Methods:
- Observational study analyzing 440 filler treatments across 107 patients.
- Evaluation of two hyaluronic acid fillers and three biostimulating fillers.
- Assessment of filler behavior in relation to RS and RP fibrous structures.
Main Results:
- Filler spread patterns were site-specific and predictable, influenced by RS and RP.
- Directional filler spread remained consistent across different injectors and filler types.
- Significant variations in injected bolus length were observed between different filler rheologies.
Conclusions:
- Filler spread is confined to the injected tissue layer in healthy tissue.
- The direction of filler spread is dictated by the RS and RP fiber orientation.
- Filler rheology impacts injected length but not the overall direction of spread.
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