The face recurve concept: medical and surgical applications.

The application of the Face Recurve theory gives rise to new technical opportunities in the fields of both aesthetic medicine and aesthetic surgery to block the action of the age marker fascicules largely responsible for aging of the paramedian folds. With respect to aesthetic medicine, the combination of botulinum toxin and soft tissue fillers has proven effective. On the basis of the authors' theory, however, two new technical refinements become pertinent.

Structural aging: the facial recurve concept.

Cutaneous facial aging is responsible for the increasingly wrinkled and blotchy appearance of the skin, whereas aging of the facial structures is attributed primarily to gravity. This article purports to show, however, that the primary etiology of structural facial aging relates instead to repeated contractions of certain facial mimetic muscles, the age marker fascicules, whereas gravity only secondarily abets an aging process begun by these muscle contractions. Magnetic resonance imaging (MRI) has allowed us to study the contrasts in the contour of the facial mimetic muscles and their associated deep and superficial fat pads in patients of different ages.

Treatment of depressor anguli oris weakening with the face recurve concept.

The authors have created a strategy for rejuvenation of the peribuccal region based on the concept that the repeated contraction of certain fascicles of the mimetic muscles, and not gravity, is the primary cause of structural aging. Treatment is based on a 4-stage strategy, with interventions including botulinum toxin, hyaluronic acid, autologous fat transfer, and surgery of the depressor anguli oris.