Mid Face



Treatment of mid face with Botox®, Bocouture® and/or a Filler

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Crow's feet (1)

Wrinkles on the exterior of both eye sockets can best be reduced by softening the strength of the eye muscle (M. orbicularis Oculi lateralis) using a botulinum-A-Neuromodulator ( Botox® , Bocouture® ). As a result, the activity of this muscle decreases, thereby causing fewer wrinkles to appear in the skin around the eye sockets. Any wrinkles that still remain visible, can be restored using a thin hyaluronic acid filler. This filler allows for skin hydration and helps restore the connective tissue just below the skin.


Loss of volume at the cheekbones (2)

Near the area of the cheekbones almost anyone pushes the skin up just to see just how tight the skin once was. The cheekbones are an essential part of facial attractiveness. Recovery of volume in this part of the face is the basis for a good cosmetic effect and immediately gives a very crisp result. To achieve this both deep and superficial layers of the face are treated with an injectable filler. The choice of a particular type of filler is based on your specific skin and anatomical characteristics. We can determine this during consultation with you. No Botulinum-A-neuromodulators are to be used at the cheekbones for cosmetic medicine purposes.


Puffiness, dark circles and Tear Trough (3)

Puffiness and dark circles under the eyes give a tired and old look. The cause is a deep wrinkle under the eyes, also called the tear trough. Puffiness and dark circles are caused by volume loss, lack of sleep, stress, chronic fatigue, poor nutrition and fluid retention. In some cases, a genetic predisposition plays an important role herein. During aging, in particular the puffiness and dark circles become worse because your skin loses its elasticity and the underlying anatomy changes. The tired appearance of sunken eyes have a big impact how people look at you and form their impression of you. Your appearance may not correspond to how you feel inside. The treatment of the tear trough is precision work. In this area, different structures have important functional significance. Intraocular fluid must be able to clear through this structure. Through the use of the correct filler and by applying the correct technique, tear duct walls can be treated so your face regains a fit and healthy appearance.


The cheeks (4)

There are roughly three types of cheeks: wrinkled cheeks, hanging cheeks and sunken cheeks. They all look different but have the same cause; the jaw bone shrinks as we age. Essentially the skin becomes too large for its content. The subcutaneous fat in the face decreases, leaving more space under the skin. Both processes lead to wrinkles and / or sunken cheeks. Furthermore, the cheek contain two connective tissue partitions, just below the cheekbone to jaw line and the second just off the chin to the mouth. These both pull the skin increasingly inwards and upwards. Together with the force of gravity this causes the creation of lobules and dents in the cheeks.


Wrinkles, Dents or lobules? Do the 'centenbak test'.

Stand in front of a mirror and look through a hand mirror to the side of your face.


Keep your head straight and push your lower jaw forward so that you create a "centenbak'. If the wrinkles, dents and lobules in your jaw in your jawline disappear a treatment with a filler is your solution.


Do you have hanging cheeks with ripples or dents?

Take a picture of the side of your face. Do you see a small "wave" like shape on the jawline? You then have problems with the jaw bone loss with sagging skin as a result. The solution: A treatment with a good filler....


Do you have sunken cheeks? Try the "ruler test"

Take a picture where you can see the tip of your nose and a bit of cheek, just like the picture below. Draw a line from your cheekbone to chin. Is there space between the line and your cheeks? You would benefit from a filler treatment.



Nasolabial fold (5)

These skin folds run from both sides of the nose to the corners of the mouth and provide a separation between the cheeks and the upper lip. The folds are part of a system of connective tissue-divisions which keep the fat pads in the cheeks in place. From birth, the fat pads in the cheeks are prominent and the nasolabial fold is an attractive dynamic structure. From the age of 20, however, the fold grows steadily in depth and length. From the thirty-fifth year, the fold becomes more static and the face starts to age more rapidly. During subsequent aging the facial muscles weaken, reducing the content of the fat pads. We lose collagen and hyaluronic acid in the skin and in particular, the force of gravity ensures a downward traction on this system. The result: sagging cheeks with increasingly visible nasolabial-folds. The shadows, that due to the increasing nasolabial-folds, become more apparent in your face, can thus become a cosmetic problem.

Correction of the nasal-labial-folding can be carried out by injecting a dermal filler in the cheeks to re-fill the void and move the cheeks back to the correct position. The filler is also injected into the region of the nose-labial-fold in order to support and further mitigate the growth of the fold from below. Your face gets its youthful appearance back quickly.


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