Search

Background The perception of an attractive face is largely subjective. The purpose of this paper is to provide an insight and a practical approach to facial contouring management with hyaluronic acid (HA) implants and botulinum toxin A. Methods This study is presenting the clinical experience of the authors regarding facial contouring. After a careful medical history, patients underwent an exhaustive aesthetic assessment that includes photographs and videos. Realistic treatment goals were discussed and agreed with the patient. Comprehensive treatment strategies for facial contouring, including HA implants and/or botulinum toxin A injections, were selected according to the patient needs. Results Based on the MD codes®, developed by Mauricio de Maio, these treatment strategies have been adapted to six different basic categories of facial shapes, namely round, square, triangular, inverted triangle, rectangle, oval and oblong faces. The incidence of complications was low and, in all the cases, was mild (edema, erythema and local ecchymosis), of limited duration, and was resolved without sequela. Conclusions The current article presented the personal experiences of the authors on a specific subject, and this fact should be considered when interpreting data from this paper. As other aesthetic treatments, facial contouring should be focused on the patient needs and to select a specific aesthetic approach according to different facial shapes. Finally, it is essential to have a good understanding of the potential associated complications, because it will help the specialist to take the necessary precautions to prevent them, and if they ever arise, to be able to deal with them effectively. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Background Patients often seek guidance from the aesthetic practitioners regarding treatments to enhance their ‘beauty’. Is there a science behind the art of assessment and if so is it measurable? Through the centuries, this question has challenged scholars, artists and surgeons. Aims and Objectives This study aims to undertake a review of the evidence behind quantitative facial measurements in assessing beauty to help the practitioner in everyday aesthetic practice. Methods A Medline, Embase search for beauty, facial features and quantitative analysis was undertaken. Selection Criteria Inclusion criteria were studies on adults, and exclusions included studies undertaken for dental, cleft lip, oncology, burns or reconstructive surgeries. The abstracts and papers were appraised, and further studies excluded that were considered inappropriate. The data were extracted using a standardised table. The final dataset was appraised in accordance with the PRISMA checklist and Holland and Rees’ critique tools. Results Of the 1253 studies screened, 1139 were excluded from abstracts and a further 70 excluded from full text articles. The remaining 44 were assessed qualitatively and quantitatively. It became evident that the datasets were not comparable. Nevertheless, common themes were obvious, and these were summarised. Conclusion Despite measures of the beauty of individual components to the sum of all the parts, such as symmetry and the golden ratio, we are yet far from establishing what truly constitutes quantitative beauty. Perhaps beauty is truly in the ‘eyes of the beholder’ (and perhaps in the eyes of the subject too). Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.