I’m continuing a conversation here that I started in my last post: While plastic surgery has always blended technical expertise and artistry, it’s maybe never been more evident than it is at this very moment with all the innovative ways surgeons are delicately sculpting the human face with precisely placed injections. These are a couple more examples for your consideration.
What you’re not seeing
In high school art classes, it’s one of the first lessons they teach us: What’s not there is every bit as essential as what is. It can seem like plastic surgery is constantly focused on creation, even in the cases of liposuction and breast reduction surgery, where we’re removing something, but also creating a new silhouette. However, much of what we’re able to accomplish through injectables involves the engineering of negative space.
To slenderize blocky jaws, for example, we can administer a neurotoxin to the chewing muscles, which tend to turn bulky after years of clenching and chewing. With the right dose, the muscles will shrink slightly, narrowing the lower third of the face into a softer heart shape.
A neurotoxin can also tighten the neckline when it’s administered in a series of small doses under the jawline and across the platysma muscle that runs up and down the neck. It will enable the face to lift upward, to a degree, and any folds in the neck to lie flat.
Aging produces both positive spaces—folds and fullness—and negative ones, like wrinkles, under-eye depressions, and sunken temples. Hyaluronic acids are commonly used to fill the voids, though it still requires a refined technique and wealth of experience because precise placement is crucial. As is using a gel with an appropriate viscosity. The skin under the eyes, in particular, is extremely delicate. If certain hyaluronic acids are injected in the wrong place, the natural contours can be dramatically upset.
A long-term perspective
Miraculous as much of this sounds (and is), there can be such a thing as too much of a good thing. (Though, much more often, it’s a good thing that’s been poorly administered.) In those instances, we can refresh the canvas by dissolving hyaluronic acid with an enzyme called hyaluronidase. (It doesn’t have the same effect on other types of filler, which generally have to degrade on their own or be surgically removed.)
With many of the treatments I’ve highlighted in this post and the last one, it’s important to consider them as part of an ongoing treatment plan that’s been designed by a board-certified plastic surgeon after an extended and thoughtful discussion about your short- and long-term expectations. Without the right guidance, it can be easy to lose perspective and begin adding volume beyond what’s been naturally lost.
Throughout these posts, I’ve emphasized the surgeon’s expertise in knowing where to place these injections and his or her ability to place them. But just as important is their vast knowledge of the human anatomy and the effect these subtle alterations will have, not only over the next several months, but over the course of a lifetime.