Soft tissue fillers are flexible substances that can be injected into the skin to improve the appearance of fine lines and wrinkles, plump lips, fill hollow cheeks, repair various facial imperfections, improve scars, and elevate deep folds. Perhaps nothing is more gratifying for cosmetic patients than having an immediate correction of rhytides or scars as a result of the injection of a dermal filler The result is a smoother, more youthful appearance with minimal "downtime" and maximum safety. Prof. Moawad uses a variety of soft tissue fillers, including, hyaluronic acid, and autologous fat (one's own fat) among others. Since filler substances do not involve major surgery and are generally cost-effective, men and women are using these youth-enhancing techniques more than ever. With the increasing desire for people to achieve a more youthful appearance, the aging baby boomer population, and the increased demand for "lunch-time procedures," the pharmaceutical market has responded by providing the cosmetic surgeon with an increasing number of options to meet the demands of the cosmetic patient.

4. What to Inject?
FDA Approved Fillers
Prof. Moawad uses a variety of soft tissue
fillers, including, hyaluronic acid, and
autologous fat (one's own fat) among other FDA
approved fillers.

5. 12/18/2009
MSI Rejuvenation
5
Where to Inject?

6. Is My Results
Permanent/Temporary
Temporary
6-M
Semi-
permanent
6m-2years
Permanent
2-5years

7. Prof. Moawad believe
that volume
restoration of the
mid face is the first
essential step in the
global approach

8. Malar volume anchors the
structure of the midface
that will lessen the
appearance of the
nasolabial and the
nasojugal folds
Secondly, treatment of the
nasolabial folds and
periorbital area with HA
should be performed when
needed

10. Brow/Upper Eyelid / Temple Complex
Temple
Lateral eye brow Over time, loss
of subcutaneous
fat, gravitational
changes due to
loss of elasticity,
and remodeling
of bony and
cartilaginous
structures lead
to visible signs
of aging.

12. Upper Eyebrow
Under eyes
Nasolabial
Lips
Brow/Upper Eyelid / Temple Complex
AB Temple

13. Brow/Upper Eyelid/Temple Complex
Upper Eyebrow
Under eyes
Nasolabial
Lips
The youthful brow/upper eyelid complex is
characterized by soft tissue fullness.
AB

14. emple
Under eyes
Middle
cheek
Temple, eyebrow and upper eye lid volume
restoration is an emerging therapeutic area for
esthetic physicians
AB
Upper Eyebrow
Upper Eyelids

15. Hypertrophy
is a visual,
relative
phenomenon.
It is only in
relationship
to the
flattened,
inferior cheek
mass that the
suborbital
area appears
to protrude
forward
Under Eyes Bags

16. Eye Bags
Nasolabial groove
B AA

17. AB
Infra-orbital and ant
cheek fat Loss

18. AB
Infra-orbital and ant
cheek fat Loss

19. AB

20. Reconstitution of the malar fat pads to re-establishes an
aesthetic convex shape to the face that will lessen eye bags
Under eye bags
Middle Cheeks
Augmentation
AB

21. Reconstitution of the malar fat pads to re-establishes an
aesthetic convex shape to the face that will lessen eye bags
AB

22. Reconstitution of the malar fat pads to re-establishes an
aesthetic convex shape to the face that will lessen eye
bags
AB

23. AB

24. Reconstitution of the malar fat pads to re-
establishes an aesthetic convex shape to the face
that will lessen eye bags
AB

25. Loss of under eyes
fat with hollow and
sunken appearance
together with
unmasking skin
blood vessels in
addition to the
shadowing effect of
concavity forces
patients often seek
treatment for under
eyes circles
Under Eyes Circles

26. Dark Circles
Reconstitution of the malar fat pads to re-establishes an
aesthetic convex shape to the face that will lessen dark circles
AB

27. Dark Circles
Middle Cheek
AB
Reconstitution of the malar fat pads to re-establishes an
aesthetic convex shape to the face that will lessen dark circles

28. Middle Cheek
Dark Circles
AB
Reconstitution of the malar fat pads to re-establishes an
aesthetic convex shape to the face that will lessen dark circles

29. Volume restoration of infraorbital
will lessen dark circles
Atrophy of infraorbital pad of fat
AB

30. Under eyes dark circle
AB

31. AB

32. Dark Circles Infra orbital filling
AB

33. Eye Bags Infra orbital filling
AB

34. With senescence comes loss of the anterior projection of
the cheek/ brow/forehead area, loss of the arcs, and a
downward displacement of tissue
AB
Under Eyes Bags

35. Reconstitution of the malar fat pads to re-establishes an aesthetic convex
shape to the face that will lessen eye bags
AB

36. Reconstitution of the malar fat pads to re-establishes an
aesthetic convex shape to the face that will lessen eye bags
AB

37. Removal of skin and
fat around the eye
alone during
blepharoplasty can
actually hollow the
eye and thereby age
the patient even
more dramatically
rather than serve to
rejuvenate
Post Blepharoplasty
A
Sunken Eyes

38. In both the
atrophic and
hypertrophic
variants of
suborbital
aging, filling is
an excellent tool
to restore the
normal arced
contour of the
eye/cheek
complex
B

39. Patient who ages by a diffuse loss of facial fat without any
apparent residual skin is an ideal candidate
AB

40. The primary patient who ages by a diffuse loss of
facial fat without any apparent residual skin is an
ideal candidate.
AB

41. Dermal Fillers are being used in Lieu of Structural fat
grafts to add volume to the aging face
AB

42. B A

44. Nasolabial
B

45. A

46. Nasolabial
Marionette line
B

47. A

48. B
Prejowl sulcus

50. AB
Chin Augmentation

51. B
Nasolabial
A

52. AB

53. B AA

54. B A

55. B A

56. B A

57. B
Prejowl sulcus
A

58. B A

59. B A
Reconstitution of the malar fat pads to re-
establishes an aesthetic convex shape to the face
that will lessen nasolabial and marionette lines

60. AB

61. B A

62. AB

63. Marionette line
B

65. AB

66. AB

67. B A

68. Loss of ant, lat and buccal fat
AB

69. Buccal Recess
B

70. A

71. Buccal Recess
B

72. A

73. B A

74. A

75. Buccal Recess
B

76. AB

77. B A
Submalar Hollow
AB

78. Submalar Hollow
AB

79. Nonsurgical rhinoplasty (NSR) using an injectable dermal
filler has gained popularity for both primary and revision
nose enhancement procedures

80. Soft tissue filler
injections can provide an
immediately visible
result in the convenience
of the office setting
Despite its temporary
longevity, it is popular
because it is simple,
effective, and
economical
Non Surgical
Nose Job

81. Nasal Tip
Small Defects
Saddle dorsum
Nasion
Nasal deviation
Where to Inject in the Nose?

82. Non Surgical Nose Job
AB

83. Non Surgical Nose Job
AB

84. B
Non Surgical Nose Job
A

85. B A
Non Surgical Nose Job

86. B A
Non Surgical Nose Job

87. AB
Non Surgical Nose Job

88. B A
Non Surgical Nose Job

89. B A
Non Surgical Nose Job

90. B A
Non Surgical Nose Job

91. A
Non Surgical Nose Job
B

92. B A
Non Surgical Nose Job

94. AB

95. Acne Scars

96. B

97. AB

98. AB

99. AB

101. B

102. A

103. B

104. A

105. B

106. A

107. B

108. A

111. A

112. B A

113. B

114. A
Shaping the lips, not just adding volume

115. B

116. Shaping the lips, not just adding volume
A

117. B

118. Shaping the lips, not just adding volume
A

120. A
Shaping the lips, not just adding volume

121. B

122. Shaping the lips, not just adding volume
A

123. B

124. Shaping the lips, not just adding volume
A

125. B

126. Shaping the lips, not just adding volume
A

127. B

128. Shaping the lips, not just adding volume
A

129. AB
Shaping the lips, not just adding volume

130. AB
Shaping the lips, not just adding volume

131. B

132. A
Shaping the lips, not just adding volume

133. B A
Shaping the lips, not just adding volume

134. AB
Shaping the lips, not just adding volume

135. Soft tissue fillers are
often considered the
first line in the
treatment of aging
skin and are
frequently used in
combinations or
with other
techniques for facial
rejuvenation
Complementary Procedures

136. Complementary Procedures
Subcision is done before filling
A.Subcision Surgery
AB

137. Botox injection before dermal filler will
improve the results of both and keep it longer
B. Botox

138. B. Botox
Botox injection before dermal filler will
improve the results of both and keep it longer

139. Pitfalls of Fillers
Discomfort
Bruising
Swelling
Bluish Discoloration
Asymmetry
Beading
Infection

140. What Do I
Expect
Immediately
after
Injections?
Early and expected side
effects include swelling,
bruising, and redness at
the injection
Redness
Swelling
Bruising

141. when an undesirable outcome occurs with hyaluronic
acid, correction is possible with the injection of
commercially available hyaluronidase, which breaks down
the unwanted hyaluronic acid dermal filler
What If Something Goes Wrong?
A.Resorable Fillers

142. What If Something Goes Wrong?
B. Permanent Fillers
Complications secondary to
biodegradable or resorbable
fillers will disappear
spontaneously in a few months,
but non-resorbable fillers may
give rise to severe permanent
reactions. Patient are left
helpless. These permanent
products should be reserved to
reconstructive surgery

143. Immediate Icing and Massage to
decrease swelling and bruising

144. fillers can be injected
into the skin to
improve the
appearance of fine
lines and wrinkles,
plump lips, fill hollow
cheeks, repair various
facial imperfections,
improve scars, and
elevate deep folds
Since filler substances
do not involve major
surgery and are
generally cost-
effective, men and
women are using
these youth-enhancing
techniques more than
ever.

145. The use of
injectable
products for
cosmetic
enhancement is
increasing rapidly.
This is due in large
part to the wide
range of effective
options, decrease
in social stigma,
and the excellent
safety profile.