Superior outcomes in comprehensive facial rejuvenation generally require addressing the aging face with a variety of approaches:  lifting sagging tissues, restoring volumetric relationships with injectable fillers or placement of facial implants as well as skin renewal via its own multifaceted approach (topical therapies and peels or light based treatments).

Practitioners face a variety of limitations with lifting procedures including inability to effectively overcome the effects of gravity in the midface and jawline. Rhytidectomy procedures often provide limited and temporary improvement of the midface – persistent ptosis of the melolabial fold is a common post-rhytidectomy patient concern.  Improvement of the jawline also tends to diminish over time with gradual return of gravitational jowling.

The concept of “restoration of facial volume” does not accurately address underlying age-related idiosyncratic volumetric changes of the mid- and lower face. Are we restoring “lost” tissue volume by injecting filler substances or transferring fat into deep melolabial folds or deep pre-jowl sulci? Perhaps we are merely attempting to CAMOUFLAGE the anatomical correlates of descended fat in the midface and along the jawline. We are all very familiar with the potential aesthetically inferior results of this endeavor – an unnatural appearance with excessive central facial fullness and/or further squaring of the jawline. 

Laser-assisted volumetric contouring (LAVC) presents a new paradigm for facial rejuvenation that enables selective REMOVAL of descended fat in the face (and submentum and neck) with a relatively simple, quick and effective procedure that only requires local anesthesia. Treatment areas and conditions include:

Midface and Melolabial Fold – LAVC reduces and softens the “break” or hollow area in the midface between the malar eminence and the melolabial fold while also reducing the anterior projection of malar fat and restoring aesthetic relationships of the submalar triangle. LAVC reduces melolabial fold ptosis and depth while also improving additional aesthetics of the midface (see above). We are selectively REMOVING some of the displaced tissue (descended malar fat). Case studies.

Jawline and Jowl – LAVC reduces bulky soft tissue volume at, below and above the jawline as needed to sharpen the contour of the jawline while also helping to restore the characteristic youthful aesthetic facial triangle. Isolated contouring of the jowl, an excellent indication for LAVC, provides dramatic improvement of the jawline and overall aesthetics of the lower face. We are again selectively REMOVING some of the displaced tissue (descended jowl fat). Case studies.

Melomental Fold – LAVC of bulky soft tissue proximal to the marionette line.  Case study.

Submentum & Neck – LAVC of the submentum is often completed at the time of facial contouring. LAVC of the neck typically also includes the submentum. Case studies.

Orbital Fat Pseudoherniation – Investigational – LAVC is an intriguing new horizon for eyelid rejuvenation that appears quite promising as a minimally invasive option for reducing fullness associated with orbital fat pseudoherniation as well as eliciting substantial tightening of the overlying skin. Case study.

Pentagonal Jaw following Chemodenervation Treatment – Pentagonal jaw after is a recognized anatomical sequela of chemodenervation (eg, Botox Cosmetic) treatment for masseter muscle hypertrophy. LAVC offers a unique and effective method for improving jawline contour in these patients. Case study.

Round Face - LAVC is the only effective minimally invasive option for reversal of the dependent features that accompany the round face. The procedure involves contouring of the midface and jawline to create a more sculpted oval or heart shaped facial outline. Case study.

Scarring – Investigational – Utilization of the fiber laser to release deep, tethered acne and other scars has met early success. Case study.

Skin Laxity - Investigational – The potential for eliciting modest to significant skin tightening with subcutaneous fiber laser energy delivery is in early stages of investigation.

Disclaimer Statement – None of the above should be construed as a formal clinical recommendation. Formal clinical recommendations should be obtained from a qualified medical provider. Laser assisted volumetric contouring may be recommended as a standalone procedure or as part of a more comprehensive plan that may also involve surgical lifting, skin resurfacing and/or volume replacement procedures.