Considering the Line of Ligaments with Aesthetic Treatments

As we mature, our anatomy changes and accounts for what we see when we look in the mirror. In fact, facial aging is an entangled process that involves all the tissues of the face to include bone, muscles, ligaments, fat, and skin. Fresh aesthetic treatment strategies have been developed that address the line of ligaments and facial fat compartments to achieve the most natural and beautiful outcomes. My most recent training with one of my favorite injectors, Nicola Lowry, PA really brought this approach to light. Her results are so beautifully enhancing and natural and she relies heavily on this line of ligaments in her approach. This week I talk about integrating the line of ligaments into treatment so that we get optimal outcomes. 

What is the line of ligaments?

A ligament is a band of tissue that connects bones, joints, or organs. A true ligament, AKA osteo-cutaneous ligament, connects bone to skin. The line of ligaments in the face includes the ‘true ligaments’ and extends from the temporal ligament (TLA), lateral orbital ligament (LOL), zygomatic ligament (ZL), and the mandibular ligament (ML). This line of ligaments separates compartments of the face, and particularly holds the anterior face in place. By replacing the lost volume lateral to the line of ligaments, the anterior compartments of the face should shift, giving the appearance of a lifting effect (1). 

There are several advantages to using the line of ligaments to guide treatment with dermal fillers. First off, treating lateral to the line of ligaments as a first step, reduces the amount of product required for correction in the medial face (2). Minimizing the amount of filler in the middle face keeps the results looking more natural. And keeping results natural is a priority. 

As mentioned above, these ligaments help support the compartments of the face. Some compartments of the face include the nasolabial compartment and the jowl compartments, both of which can be quite bothersome. When we use products in the lateral aspect to the line of ligament, we can add support and tension to the ligaments, shifting the tissue upwards and giving a ‘lifting’ appearance (3). Injecting lateral to this line, actually stretches the middle face up and out (4).

All in all, when we consider the line of ligaments when injecting dermal fillers, we optimize the potential ‘lifting’ appearance to the face while using the least amount of product. Understanding where these ligaments reside, allows us to use the anatomy to support and provide tension so that we shift the middle compartments of the face. This superficial fat shifting will also aid in rounding out the cheeks, a common place for volume loss and flattening. 

The moral of the story is to know our anatomy so that we can carefully and strategically support and volumize for natural and enhancing outcomes.

Thanks for reading, and schedule a consultation to see if supporting the line of ligaments can benefit you.

xo
h.