Journal of Clinical and Aesthetic Dermatology

AUG 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

Issue link: http://jcadonline.epubxp.com/i/870497

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Treatment suggestions for patients with square face shape. due to the magnitude of c orrections required, square faces need the most interventions (figure 5). discussion the experts agreed that cultural and country- specific preferences determine aesthetic goals and must be included as part of aesthetic treatment strategies. east asians do not generally find square, thin faces attractive but prefer softer, more oval- shaped faces for both sexes. 15–17 While similarities do exist and can be applied to all asian nationalities, some critical differences in preferences are apparent, especially in what is considered congenital and what is considered aesthetically appealing. Korean faces, for example, have fuller, chubbier cheeks with shorter faces, 17 while chinese faces have relatively narrow, slim faces with longer jaws, fuller lips, and narrower noses. 1 8,19 In the treatment of Korean women for forehead volume deficiencies with brow ptosis, overly arched or lifted brows and lateral orbital rims must be avoided, as these are perceived as exaggerated and aggressive. 20,21 physicians, therefore, use MfU-V treatments for brow ptosis in these patients. chinese patients often request filler augmentation in the temporal area, regardless of whether they have significant temporal hollowing and temporalis hypertrophy, as the area is thought to represent fortune in chinese culture. treatment recommendations for the nlf vary among asian countries. some physicians consider the upper nlf to be a natural curve rather than a flaw and will avoid overtreatment here, whereas others use MfU-V and inverse contraction of the nasolabial fat pad to lift the midface area. to treat masseter hypertrophy, taiwanese physicians address the entire face rather than just the affected area, while thai physicians use a lower dose of Bont-a for masseter restoration alongside other interventions for excessive sagging. some aesthetic preference commonalities exist. for example, due to unattractive or extreme images in the media, asian patients refrain from lip plumping interventions. asian chins tend to be smaller and recessed, 22,23 resulting in age-related and congenital deficiencies. therefore, unlike caucasians, asians seek treatment for chin volume loss, rather than for chin projection. 24 Most Korean patients find longer faces unappealing. 25 thus, while small- chin volumization requires fillers, Korean physicians do not usually perform chin volume augmentation. 23 JCAD journAl oF clinicAl And Aesthetic derMAtologY august 2017 • Volume 10 • number 8 c o n s e n s U s Figure 2. Treatment recommendations for the already ideal oval/heart shape a) ha fillers can be applied for forehead augmentation and in the temples to increase the convexity of the curvature and create fullness and contouring here, as well as in the cheeks, to improve contours. hairstyling can be used to narrow transverse widths over the cheekbones (photo courtesy of dr. yates chao); B) patient 1 received Bont-a for the masseter several months prior to the photo being taken (left), which shows an exaggerated subzygomatic depression, aggravated zygomatic prominence, and a blunt chin. for oval shaping and face slimming, 1ml of filler was used per side for volumization of the subzygomatic depression and the anterior chin (right) (photos courtesy of dr. Kyle seo).

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