The author outlines the anatomical changes of the lower face in meticulous detail, supported by current literature, and accurately describes the senescent skeletal and deep fat compartment changes of the mid face and how these can impact on the presentation of the ageing lower face. Clear diagrams illustrating the relationship of the superficial and deep fat compartments are provided, as well as the author’s before and after photographs, throughout the text. Whilst the author proposes that the resorption that occurs at the mandible is due to mastication, this has not been definitively proven within the literature. The author discusses poly-l-lactic acid (PLLA) and calcium hydroxylapatite (CaHA) as preferred choices for augmenting the jawline and lower face, and it may have been useful for the reader to have discussed other types of dermal filler suitable for this region which have been described in the literature. The off-label lower face uses of Botulinum toxin (BoNTA) are conveyed and patient suitability briefly discussed, along with dermatological approaches to resurface and refine ageing skin. Principally laser, chemical peels, micro needling and radio-frequency are explored, with rationale. This a very comprehensive and well referenced overview of a number of evidence-based and established approaches for redefining and correcting many of the age-related changes of the lower face.

Lower facial rejuvenation: age related changes and treatment options.
Miller A.
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Anna Baker

BJN Aesthetic Nurse of the Year 2016.

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