Cosmetic Treatments

Facesculpture® : global facial rejuvenation

3D global face rejuvenation using only Botulinum toxin and hyaluronic acid

As early as age 30, the skin begins to lose density and firmness and the first wrinkles show up. By the age of 50, our skin loses more than 50% of its hyaluronic acid capital, which is one of the natural elements of the dermis and responsible for its hydration. Signs of aging consist of dynamic wrinkles and folds in the upper face area, but in reality, this is mostly due to volume changes in the mid- and and lower parts of the face.

The use of dermal fillers (such as hyaluronic acid) and botulinum toxin has made it possible to develop minimally invasive procedures and a 3-dimensional approach to facial rejuvenation [2]: this is a faster, less painful and less expensive alternative to face lift; it can also be a perfect complement to surgery, if the latter is needed. [4].

Today, the aesthetic facial care takes a global approach and no longer focuses on wrinkle removal alone. The goal is to reshape the volumes and recreate a harmonious face, meeting the following criteria: soft and oval contours, smooth transition between the different face areas, convex cheekbones and well-shaped mandibular contour. With the help of innovative products, this can result in a new, ideally heart-shaped face : the heart base is the upper face area [5], while its tip points downwards (this shape is usually reversed with age [3]).

Dr. Hervé Raspaldo, a facial aesthetics specialist, described the procedure called FACESCULPTURE®. Based on a natural approach to facial rejuvenation, this procedure is designed to act on three dimensions: the face dynamic (expression lines, mimicry), the heart-shaped volumes and the skin texture. The injections aim to reduce hyperdynamic wrinkles using Botulinum toxin, restore harmonious volumes, fill wrinkles and lines, but also rehydrate the skin tissues.


There are two types of injectable products:

•  The Botulinum toxin works by relaxing muscles, restoring the face’s dynamic and preventing the expression lines to progress. For the upper face care, botulinum toxin is injected into the hyperdynamic muscles specially for the glabellar area and the crow’s feet ; it can also be used to reposition sagging eyebrows and improve their overall shape.

• Dermal fillers restore volumes. There are several types of temporary effective, resorbable products: hyaluronic acid, collagen, calcium hydroxyapatite and polylactic acid.
The hyaluronic acid (HA) is the most frequently used filler, with a high filling quality, natural resorption and a perfectly safe use. Injections compensate for the age-related volume loss. There are different ranges of hyaluronic acids with different viscosity levels:

– The low viscosity products are particularly adapted to a technique called ”topping”, used for the treatment of fine lines, dark circles or hollow eyes.

– The medium viscosity products can reduce face wrinkles (perioral wrinkles, lip contour, nasolabial folds, mouth lines, forehead wrinkles).

– High-viscosity products restore volumes in the cheekbones, cheeks, temples, nose and chin.

The ranges of products used in Switzerland are: Restylan®, Stylage®, Juvederm®, Teosyal®, Belloterro®, Princess®

The Botulinum toxin and the different hyaluronic acids each have a specific and complementary effect. Therefore, they are often used together, which leads to better results than those obtained with each product separately. This is especially true for cheekbones or glabella [6].

There are other advantages in using these products combined : the results last longer [2, 4, 7], the HA is resorbed slower due to a prior injection of botulinum toxin [6], and the facial natural expression is preserved, because the procedure uses lower doses of toxin, supplemented by HA in residual wrinkles [8].

This global therapeutical approach takes into consideration the epidermis (superficial peel, mesotherapy) and the dermis (pulsed light and photodynamic therapy).

It is recommended to start with botulinum toxin injections, in order to relax the muscles and restore their natural balance. The eyes look more open and the face more relaxed.

Then, the volumizing hyaluronic acids result in a 3D (heart-shaped) volume restore and a more harmonious face contour. A month later, classic hyaluronic acid injections will fill the residual lines.

Watch our video on Facesculpture® used to correct face asymmetry
Watch our video on Facesculpture® used for global face rejuvenation

Technical information on  Facesculpture ®

About MD Codes:
Dr Raspaldo, friend since 2004 with Dr Mauricio Di Maio, has participated to the beginning of the embellissement concepts with hyaluronic acide and botulinum toxine injections, and to their teaching. Dr Mauricio Di Maio has finalized these teaching techniques by creating the concept of MD Codes®, whose aim is to treat strategically the face with a precise definition of the entry points, regarding the anatomical data of each face. The historical and scientifical partnership between Dr Raspaldo et le Dr Mauricio Di Maio has grown up with their long-lasting friendship and deep respect.


1- H.RASPALDO – Consensus français sur l’usage de la toxine botulique BTX pour le haut
2- et le bas du visage – Journal Cosmetic Dermatology JCD 2009
3- H.RASPALDO et coll. How to use Juvéderm + Voluma in facial rejuvenation (consensus français) – JCD 2010
4- RASPALDO, HOFMAN, SEBBAN – Consensus international about how to use Voluma – PRIME Aesthetic Anti Ageing Journal 2011.
5- H.RASPALDO – New Era Facial 3D Rejuvenation – Monduzzi Editore (2006)
6- Belahouari, Gassia – L’art de la toxine botulique- edition Arnette.

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