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. 2019 Oct 19;2(1):ojz029. doi: 10.1093/asjof/ojz029

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© 2019 The American Society for Aesthetic Plastic Surgery, Inc.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

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Figure 2. — A 48-year-old female with moderate midfacial volume deficit with ptosis, moderate jowling, and submental laxity underwent placement of 2 sets of 8-cone sutures per side; one placed along the midface (nasolabial fold to temporal sideburn) in a vertical vector and the other placed along the jawline (marionette line to temporal sideburn) in a vertical vector. Follow-up photographs were taken at 6, 18, and 24 months (before second Silhouette procedure). (A) Preprocedure frontal view illustrating midfacial volume deficit and loss of inverted triangle of youth. (B) 6-month follow-up frontal view illustrating improved midfacial volume, improvement in midface ptosis, and reduction in submental laxity. (C) 18-month follow-up showing sustained improvement in midfacial volume, midface ptosis, and submental laxity compared to baseline. (D) 24-month follow-up prior to second Silhouette procedure displaying a continued improvement in overall facial appearance; second procedure performed with two sets of 8-cone sutures on each side, same location as first procedure, to augment results. (E) Preprocedure right three-quarter view illustrating moderate jowling. (F) 6-month follow-up right three-quarter view illustrating improved streamline of the jaw with jowl reduction. (G)18- and (H) 24-month follow-up right three-quarter view demonstrating continued improved streamline of the jaw with jowl reduction as compared to baseline. (I) Preprocedure right profile view illustrating moderate submental laxity with suture placement indicated. (J) 6-month follow-up right profile view displaying improved submental laxity and tighter cervical-mental angle. (K) 18- and (L) 24-month follow-up right profile views demonstrating sustained improvement in submental laxity and tighter cervical-mental angle. The patient was also treated with neuromodulators in the glabella, crow’s feet, upper forehead, and anterior hairline.

Figure 2. — A 48-year-old female with moderate midfacial volume deficit with ptosis, moderate jowling, and submental laxity underwent placement of 2 sets of 8-cone sutures per side; one placed along the midface (nasolabial fold to temporal sideburn) in a vertical vector and the other placed along the jawline (marionette line to temporal sideburn) in a vertical vector. Follow-up photographs were taken at 6, 18, and 24 months (before second Silhouette procedure). (A) Preprocedure frontal view illustrating midfacial volume deficit and loss of inverted triangle of youth. (B) 6-month follow-up frontal view illustrating improved midfacial volume, improvement in midface ptosis, and reduction in submental laxity. (C) 18-month follow-up showing sustained improvement in midfacial volume, midface ptosis, and submental laxity compared to baseline. (D) 24-month follow-up prior to second Silhouette procedure displaying a continued improvement in overall facial appearance; second procedure performed with two sets of 8-cone sutures on each side, same location as first procedure, to augment results. (E) Preprocedure right three-quarter view illustrating moderate jowling. (F) 6-month follow-up right three-quarter view illustrating improved streamline of the jaw with jowl reduction. (G)18- and (H) 24-month follow-up right three-quarter view demonstrating continued improved streamline of the jaw with jowl reduction as compared to baseline. (I) Preprocedure right profile view illustrating moderate submental laxity with suture placement indicated. (J) 6-month follow-up right profile view displaying improved submental laxity and tighter cervical-mental angle. (K) 18- and (L) 24-month follow-up right profile views demonstrating sustained improvement in submental laxity and tighter cervical-mental angle. The patient was also treated with neuromodulators in the glabella, crow’s feet, upper forehead, and anterior hairline.