The Art and Science of Filler Procedures for a More Attractive Face

  • Giwoong HongEmail author
  • Seungmin Oh
  • Bongcheol Kim
  • Yongwoo Lee


The current trend and prevailing issue in aesthetic medicine are creating natural beauty. In addition to enhancing natural beauty with cosmetics, hair products, and fashion items, more and more people are fervently striving for healthier lifestyles and well-being. Such social and cultural changes have not only impacted the field of aesthetic medicine but have also changed how people react to facial changes related to aging. People seek to age beautifully but focus has shifted. From deliberately reverting and masking the signs of aging and inadvertently looking awkward, more and more people are pursuing beauty that is natural, graceful, and effortless.


  1. 1.
    Bray D, et al. A review of dermal fillers in facial plastic surgery. Curr Opin Otolaryngol Head Neck Surg. 2010;18:295–302.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Edsman K, et al. Gel properties of hyaluronic acid dermal fillers. Dermatol Surg. 2012;38:1170–9.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Kablik J, et al. Comparative physical properties of hyaluronic acid dermal fillers. Dermatol Surg. 2009;35:302–12.PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Matarasso SL, et al. Consensus recommendations for soft-tissue augmentation with nonanimal stabilized hyaluronic acid (Restylane). Plast Reconstr Surg. 2006;117(3):3S–34S;discussion 35S.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Cohen SR, et al. Facial Rejuvenation with Fillers by Elsevier Limited, 2009.Google Scholar
  6. 6.
    Kim P, et al. Structured nonsurgical asian rhinoplasty. Aesthetic Plast Surg. 2012;36:698.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Liew S. Ethnic and gender considerations in the use of facial injectables: Asian patients. Plast Reconstr Surg. 2015;136(5):22S–7S.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Pierre S, et al. Basics of dermal filler rheology. Dermatol Surg. 2015;41(1):120S–6S.CrossRefGoogle Scholar
  9. 9.
    Tezel A, et al. The science of hyaluronic acid dermal fillers. J Cosmet Laser Ther. 2008;10:35–42.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Gold MH. Use of hyaluronic acid fillers for the treatment of the aging face. Clin Interv Aging. 2007;2(3):369–76.PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Sundaram H, et al. Comparison of the rheological properties of viscosity and elasticity in two categories of soft tissue fillers: calcium hydroxylapatite and hyaluronic acid. Dermatol Surg. 2010;36:1859–65.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Casabona G, et al. Microfocused ultrasound with visualization and fillers for increased neocollagenesis: Clinical and histological evaluation. Dermatol Surg. 2014;40:194S–8S.CrossRefGoogle Scholar
  13. 13.
    Kenner JR. Hyaluronic acid filler and botulinum Neurotoxin delivered simultaneously in the same syringe for effective and convenient combination aesthetic therapy. J Drugs Dermatol. 2010;9:1135–8.PubMedGoogle Scholar
  14. 14.
    Lee, et al. Rejuvenating effects of facial hydrofilling using Restylane Vital. Arch Plast Surg. 2015;42(3):232–87.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Kim, et al. Development of facial rejuvenation procedures: thirty years of clinical experience with face lifts. Arch Plast Surg. 2015;42:521–31.PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Flynn TC, et al. Ultrastructural analysis of 3 hyaluronic acid soft-tissue fillers using scanning electron microscopy. Dermatol Surg. 2015;41:143S–52S.CrossRefGoogle Scholar
  17. 17.
    Narurkar V, et al. Facial treatment preferences in aesthetically aware women. Dermatol Surg. 2015;41:153S–60S.CrossRefGoogle Scholar
  18. 18.
    Kim J. Effects of injection depth and volume of stabilized hyaluronic acid in human dermis on skin texture, hydration, and thickness. Arch Aesthetic Plast Surg. 2014;20:97–103.CrossRefGoogle Scholar
  19. 19.
    Carruthers J, et al. Introduction to fillers. Plast Reconstr Surg. 2015;136:120S–31S.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Friedman PM, et al. Safety data of injectable nonanimal stabilized hyaluronic acid gel for soft tissue augmentation. Dermatol Surg. 2002;28:491–4.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Ablon Glynis. Understanding how to prevent and treat adverse events of fillers and neuromodulators. Plast Reconstr Surg Glob Open. 2016;4(12S):e1154.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    Perrett D. In your face: the new science of human attraction; 2012.Google Scholar
  23. 23.
    Ioi H, et al. Influence of facial convexity on facial attractiveness in Japanese. Orthod Craniofac Res. 2007;10(4):181–6.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Pessa JE, Rohrich RJ. Facial topography: clinical anatomy of the face. St. Louis: Quality Medical Publishing; 2012.CrossRefGoogle Scholar
  25. 25.
    Farkas LG, et al. Is photogrammetry of the face reliable? Plast Reconstr Surg. 1980;66:346.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Park HS, et al. Harmonized profiloplasty using balanced angular profile analysis. Aesthetic Plast Surg. 2004;28:89–97.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Mendelson B. In your face: the hidden history of plastic surgery and why looks matter. Hardie Grant Books; 2013.Google Scholar
  28. 28.
    Pearson DC, et al. The ideal nasal profile: rhinoplasty patients vs the general public. Arch Facial Plast Surg. 2004;6(4):257–62.PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Jones BC, et al. When facial attractiveness is only skin deep. Perception. 2004;33(5):569–76.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Kaipainen Anu E, et al. Regional facial asymmetries and attractiveness of the face. Eur J Orthodont. 2015;13:1–7.Google Scholar
  31. 31.
    Berneburg M, et al. Changes in esthetic standards since 1940. Am J Orthod Dentofacial Orthop. 2010;137(4):450.PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    Lee HB, et al. Evaluation of influence of individual facial aesthetic subunits on the cognition of facial attractiveness in public. J Korean Soc Plast Reconstr Surg. 2010;37(4):361–8.Google Scholar
  33. 33.
    Meneghini, et al. Clinical facial analysis: elements, principles, and techniques.Berlin: Springer; 2012.Google Scholar
  34. 34.
    Rhee SC, et al. Balanced angular profile analysis. Plast Reconstr Surg. 2004;114(2):535–44.PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Liew S, et al. Consensus on changing trends, attitudes, and concepts of Asian beauty. Aesthetic Plast Surg. 2016;40:193–201.PubMedCrossRefGoogle Scholar
  36. 36.
    Zhuang Z, et al. Facial anthropometric differences among gender, ethnicity, and age groups. Ann Occup Hyg. 2010;54(4):391–402.PubMedGoogle Scholar
  37. 37.
    Swift A, et al. Beautiphication: a global approach to facial beauty. Clin Plast Surg. 2011;38:347–77.PubMedCrossRefGoogle Scholar
  38. 38.
    Farkas LG, et al. International anthropometric study of facial morphology in various ethnic groups/races. J Craniofac Surg. 2005;16(4):615–46.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Narins RS, et al. Validated assessment scales for the lower face. Dermatol Surg. 2012;38:333–42.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Soh J, et al. Professional assessment of facial profile attractiveness. Am J Orthod Dentofacial Orthop. 2005;128(6):690–6.CrossRefGoogle Scholar
  41. 41.
    Choe KS, et al. The Korean American woman’s face: anthropometric measurements and quantitative analysis of facial aesthetics. Arch Facial Plast Surg. 2004; 6(4):244–52.PubMedCrossRefPubMedCentralGoogle Scholar
  42. 42.
    Farkas JP, et al. The science and theory behind facial aging. Plast Reconstr Surg Global Open. 2013;1:e8–15.Google Scholar
  43. 43.
    Ek Chan, et al. Esthetic evaluation of Asian-Chinese profiles from a white perspective. Am J Orthod Dentofacial Orthop. 2008;133(4):532–8.CrossRefGoogle Scholar
  44. 44.
    Sadick NS, et al. A novel approach to structural facial volume replacement. Aesthetic Plast Surg. 2013;37:266–76.PubMedCrossRefPubMedCentralGoogle Scholar
  45. 45.
    Fitzgerald R, et al. Update on facial aging. Aesthet Surg J. 2010;30(Suppl):11S–24S.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Farkas LG, et al. Anthropometric measurements of the facial framework in adulthood: age-related changes in eight age categories in 600 healthy white North Americans of European ancestry from 16 to 90 years of age. J Craniofac Surg. 2004;15:288–98.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Oh HS, et al. Correlations between cepharometic and photographic measurements of facial attractiveness in Chinese and US patients after orthodontic treatment. Am J orthod Dentofacial Orthop. 2009; 136(6):762.e1–14:discussion 762–3.Google Scholar
  48. 48.
    Kahn DM, et al. Overview of current thoughts on facial volume and aging. Facial Plast Surg. 2010;26:350–5.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Radlanski RJ, et al. The face: pictorial atlas of clinical anatomy. Quintessence Publishing; 2012.Google Scholar
  50. 50.
    Ekman P, et al. Facial signs of emotional experience. J Pers Soc Psychol. 1980;39:1125–34.CrossRefGoogle Scholar
  51. 51.
    Krumhuber EG, et al. Can Duchenne smiles be feigned? New evidence on felt and false smiles. Emotion. 2009; 807–20.PubMedCrossRefPubMedCentralGoogle Scholar
  52. 52.
    Surakka V, et al. Facial and emotional reactions to Duchenne and non-Duchenne smiles. Int J Psychophysiol. 1998;29:23–33.PubMedCrossRefPubMedCentralGoogle Scholar
  53. 53.
    Talarico S, et al. High patient satisfaction of a hyaluronic acid filler producing enduring full-facial volume restoration: An 18-month open multicenter study. Dermatol Surg. 2015;41(12):1361–9.PubMedCrossRefPubMedCentralGoogle Scholar
  54. 54.
    Budai M, et al. Relation between anthropometric and cepharometric measurements and proportions of the face of healthy young white adult men and women. J Craniofac Surg. 2003;14(2):154–61.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Giwoong Hong
    • 1
    Email author
  • Seungmin Oh
    • 2
  • Bongcheol Kim
    • 3
  • Yongwoo Lee
    • 4
  1. 1.SAMSKIN Plastic SurgerySeoulKorea (Republic of)
  2. 2.ON ClinicSeoulKorea (Republic of)
  3. 3.Lamar Clinic Isu BranchSeoulKorea (Republic of)
  4. 4.LIKE Plastic SurgerySeoulKorea (Republic of)

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