A New Image for a Facelift

By Jane Farrell

Complications from facelifts can be painful and embarrassing, but a new 3-D technique may change that.

The technique deals with liquid facelifts, in which people remove wrinkles and soften creases by the injection of a gel-like material. Hundreds of patients suffer redness and swelling after the procedure.

Millions of people each year remove wrinkles, soften creases and plump up their lips by injecting a gel-like material into their facial tissue. These cosmetic procedures are sometimes called “liquid facelifts” and are said to be minimally invasive.

Researchers from Washington University in St. Louis worked on a mouse ear to test their new technique. The mouse had a seemingly successful cosmetic filler injection. But the filler merely rested on the tissue and could lead to “filler-induced death” of the cells.

 “Filler-induced tissue death can be a really devastating complication for the patient and provider,” said Shu-Hong (Holly) Chang, a UW assistant professor of ophthalmology specializing in plastic and reconstructive surgery. “This noninvasive imaging technique provides far better detail than I’ve ever seen before and helped us figure out why this is happening.”

Using this technology, Chang and her team saw that complications arose when filler was inadvertently injected into the bloodstream rather than in the intended soft tissues of the face. The gel builds up in a vessel, blocking blood movement and oxygen exchange and leading to swelling and rednesss.

Ruikang Wang, a UW professor of bioengineering, and his lab pioneered this fine-resolution imaging, called optical microangiography. “We can visualize how blood responds to the cosmetic filler gel, even looking at the responses of each individual vessel. No other technique can provide this level of scrutiny,” Wang said.

Cosmetic filler procedures have surged worldwide in recent years, particularly in Europe and Asia. In 2012 in the U.S. about 2 million procedures were performed. Up to 800 patients reportedly suffered serious complications, including potentially permanent disfigurement.

The findings were presented at the annual meeting of the American Society of Ophthalmic Plastic and Reconstructive Surgery.