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Assessing Asian preferences in aesthetic injections
Varying beauty standards lead to different requests for fillers, neuromodulators in Asian patients (1,300 words, 6 minutes)
Because of differences in skeletal structure and beauty standards, Asian patients may seek cosmetic injections in different areas than non-Asian patients, Dr. Monica K. Li said in her presentation at the 8th annual Skin Spectrum Summit on Sept. 17, 2022
Dr. Li is a clinical instructor in the Department of Dermatology and Skin Science at the University of British Columbia.
Cosmetic injectables treat patients of all backgrounds, but there are unique uses for Asian patients, she said.
Older patients often seek treatment with neuromodulators for traditional indications such as platysmal bands. Micro-injections of neural modulators may also be used in Asian patients to reduce the appearance of larger pores, said Dr. Li.
Younger Asian patients may seek neuromodulator injections to shape and recontour muscles they perceive as having unwanted bulk. Dr. Li said patients understand these injections can cause muscle weakness but seek them out for aesthetic reasons.
Dr. Li said the masseter muscle along the jaw is a frequent target, as well as the trapezius in the upper back and the gastrocnemius in the calf.
Dermal fillers are used to volumize across the skin spectrum, but in Asian patients who tend to have more flatness of the central face, they can be used to correct and improve those proportions, she said.
Dr. Li said standards of beauty could be different for Asian patients. She noted some of her patients wish to create a ridge underneath the lower eyelash margin because it is perceived as youthful. This contrasts with non-Asian patients who often feel that “bags under their eyes” make them look tired. Other Asian patients are seeking more anterior projection of the forehead, said Dr. Li. She cautioned that using filler in that area requires a more advanced injector.
Dr. Li talked about some general trends she had observed and emphasized there are substantial facial differences between patients of various Asian backgrounds. She said that even among people who share a national background, there could be differing concepts of beauty.
Bottom Line: For Asian patients, pore size, skin texture and acne scarring are particular concerns. Because of differing concerns, Asian patients may seek different applications of injectable treatments than a physician typically sees. Older Asian patients may want to volumize the medial cheeks and augment their nose, forehead, or chin. Younger patients may wish to slim bulkier muscles such as the masseter, trapezius, or calves.
From the literature on aesthetic dermatology in skin of colour
Aesthetic concerns of chin augmentation with hyaluronic acid soft tissue filler in Chinese: A prospective, observational study
This article includes a discussion of cosmetic concepts for the chin area in Asian patients and findings from a small study verifying the effectiveness of chin augmentation techniques in this population.
Chin volume injections were performed on 23 Asian female subjects and 15 Asian male subjects. The researchers collected demographic and imaging data and calculated facial aesthetic length. They also measured the length of “beautiful chins,” as evaluated by two plastic surgeons, and the ratios of chins from “The 100 Most Beautiful/Handsome Faces in China,” published in 2020.
Overall, the mean volume of chin filling was 1.89±0.74 mL in female subjects and 2.68±1.28 mL in male subjects. The authors concluded the ideal length of the chin was equal to the nasal dorsum in male subjects, and the ideal chin-to-nasal dorsum ratio was 0.9 in female subjects.
Repairing small facial soft tissue defects by tissue regeneration in Asians
This retrospective study evaluated 33 patients with minor facial defects repaired by tissue regeneration healing in situ from Jan. 2019 to Jan. 2022. The soft tissue defects were treated with wound moist theory to promote wound regeneration.
All patients underwent follow-ups between one and six months after the initial visit. The authors write that 100% of the patients were satisfied with their cosmetic outcome. Some patients developed small depression scars after surgery, similar in appearance to acne scars. The researchers write that re-resection and laser treatment could be used as complementary procedures in these cases.
Prospective comparison study of a 550 picosecond 755 nm laser vs. a 50 ns 755 nm laser in the treatment of nevus of Ota
Ten Asian patients with nevus of Ota were enrolled in this study. The researchers treated each half of each lesion with either a 755 nm picosecond laser (PSL) or a 755 nm nanosecond laser (NSL). The clinical endpoint for fluence choice was immediate whitening (PSL: 2.33 ~ 3.36 J/cm2, NSL: 5.5 ~ 7 J/cm2) of the treated area. Investigators used fixed pulse durations of 550 picoseconds (PSL) and 50 ns (NSL). The spot size of each laser was 2.5-3 mm. Physicians continued laser treatments until excellent clinical improvement was observed. Patients were examined one week after the first treatment, at each follow-up visit, and six months after the last laser treatment.
On average, 4.2 treatment sessions were needed to achieve excellent clinical improvement using PSL, and 5.4 treatments were needed with NSL. One case of hyperpigmentation and one of hypopigmentation were observed in the NSL treatment group. There were no complications in the PSL treatment group. Overall, the PSL approach was more effective and had minimum side effects.
Nonsurgical lower eyelid rejuvenation using injectable poly-d,l-lactic acid in Asian patients
The authors of this paper describe a filler injection method they use in their clinic for the lower eyelids in Asian patients.
They suggest this approach is suitable for patients with tear trough deformities, infra-orbital hollows, nasojugal grooves, dark eye circles, or mild eyebags.
The authors write that they have treated more than 100 patients with this approach since 2019, with high patient satisfaction. Post-injection complications were mild and transient and included edema, erythema, and ecchymosis.
VIDEO: Asian female facial sculpting with fillers on the cheek, temples, jawline, chin, and lips|Dr. Jason Emer
At the intersection of skin and society
The Toronto District School Board (TDSB) has voted to replace its compulsory Grade 11 English course, which focuses on traditional English authors such as William Shakespeare and Charles Dickens, with a course centred on the works of Indigenous writers in Canada, reports The Toronto Star.
Trustees with the Toronto District School Board voted at a Feb. 1 board meeting.
“I’m excited that the TDSB passed this motion. This is a historic change and will affect youth for generations to come,” Indigenous student trustee Isaiah Shafqat, who was the driving force behind the motion, told the Star. “Today was a win for the Indigenous community.”
The new course is “Understanding Contemporary First Nations, Métis, and Inuit Voices.” TDSB plans to implement the course gradually across all 110 of the board’s high schools. Currently, 29 TDSB schools offer the course, which the Ministry of Education says may be used to meet the Grade 11 English compulsory credit requirement.
“It is so important that we continue to take meaningful steps such as this one to implement the Truth and Reconciliation Commission of Canada: Calls to Action,” said TDSB chair Rachel Chernos Lin in a media statement.
February is LGBT+ History Month in the U.K.
Feb. 14 is Frederick Douglass Day in the U.S.
Feb. 17 is National Caregivers Day in the U.S.
Something to think about in the week ahead…
George Savile, English politician, 1726-1784
Teledermatology is a valuable tool for supporting health in remote communities. During a presentation during the 8th annual Skin Spectrum Summit on Sept. 17, 2022, Dr. Jaggi Rao explained how the technology is being used to improve outcomes for Indigenous people in Canada.
If you like Skin Spectrum Weekly, why not check out Chronicle’s other publications, podcasts, and portal?
Established in 1995, The Chronicle of Skin & Allergy is a scientific newspaper in print providing news and information on practical therapeutics and clinical progress in dermatologic medicine. The latest issue features:
Dr. Kim Papp (Waterloo, Ont.) discusses recent research on the TYK2 inhibitor deucravacitinib as a treatment for psoriasis
A review of 2022’s new dermatology treatments, featuring interviews with Dr. Ben Barankin (Toronto), Dr. Kerri Purdy (Halifax), and Dr. Marlene Dytoc (Edmonton)
Plus regular features, including the popular column “Vender on Psoriasis” by Hamilton dermatologist Dr. Ron Vender
The Women in Dermatology e-newsletter updates new findings concerning dermatologic issues that affect women and the female dermatologists who care for them. Read the current issue here.
Season two of the Shear Listening Pleasure podcast with Dr. Neil Shear has launched. Listen to the fourth episode here, where Dr. Shear speaks with Dr. Trevor Champagne about switching from computer science to medicine, how the experience of treating patients varies between provinces and the benefits of using A.I. and big data in dermatology.
And if you’re looking for a web destination for all things derm, please visit derm.city, “Where Dermatology Lives.” Please like it, rate it, review it, and share it with your colleagues.