“Wan Zhang Gao Lou Cong Di Qi” is a metaphor that everything starts with a foundation. Building a skyscraper begins with flat ground, and the principle of injecting fillers is the same.
The principle of fillers and injections may seem simple, but it is essentially filling in lines and grooves. For example, deep wrinkles, like tiger stripes, can be filled with fillers as instruments cannot significantly improve them. Similarly, tear troughs, which appear sunken in the lower eyelids, can be filled with fillers. In addition to filling wrinkles and grooves, fillers can also improve unsatisfactory contours, such as the nose and chin, by making them more prominent.
The old injection technique used to involve injecting hyaluronic acid into the desired areas, which seemed simple. However, this injection method could not solve stubborn problems and could even worsen them. Why is this so? If a large amount is injected in the same spot, it cannot blend thoroughly with the skin, giving it the opportunity to shift to adjacent areas. For example, at the site of tiger stripes, when muscle movement causes the filler to shift to the outside of the stripes, the downward pull can make the stripes even deeper. Similarly, if too much is injected at the site of marionette lines, muscle activity in the chin and lips can cause it to shift to the sides, deepening the lines.
Problems that once required surgery, such as severe skin sagging and significant volume loss, can now be improved through injection of fillers. Patients who may not be suitable for surgical treatment due to personal wishes and physical conditions can now opt for filler injections to improve their skin conditions more widely than before. However, these patients usually require larger amounts of injections than younger patients, and special techniques and plans are required during the injection process.
For these patients, the injection method needs to have a thorough plan, just like building a skyscraper. For example, to improve severe sagging, we need to start from the cheekbones, filling them slowly and increasing the support of facial tissues. “Wan Zhang Gao Lou Cong Di Qi” applies to medical aesthetics too – to improve sagging below the face, we don’t start from the bottom but from the upper part of the face. When injecting, we also need to start at different levels, not just injecting large amounts. If we can slowly rebuild the lost fat and collagen in the face, we can improve severe problems and avoid undergoing surgery prematurely.