Holistic Facial Design · Hyaluron Concept
Premium hub for structured multi-area treatment. An anatomically individual staged plan across 2–3 sessions instead of a single spot-treated wrinkle. Follows the international 8-point framework (de Maio, Trevidic, MD Codes™) as a framework, not a flat-rate bundle. Transparent cost information at the consultation (GOÄ).
Volume & Fillers · Overall Concept
When Individual Treatments Are No Longer Enough
Some changes can't be corrected in one spot. An overall concept views the face as a whole and plans across several sessions — instead of filling wrinkle by wrinkle.
The Holistic Hyaluron Concept
A face is not a collection of individual wrinkles — it is a connected anatomical structure. Treating "the wrinkle in the mirror" in isolation often changes only the symptom, not the cause. The Holistic Hyaluron Concept is the anatomically structured alternative: a planned, layer-appropriate restoration across several areas that views the face in its overall architecture.
This concept follows the international standard for mid- and lower-face restoration as established in the plastic-surgical and aesthetic-dermatological literature (the 8-point framework by M. de Maio, layer concepts by Trevidic, the anatomy schools of MD Codes™). The underlying anatomical principle — that facial volume is distributed across connected fat compartments, and that one compartment co-determines the appearance of the neighboring region — is documented by anatomical cadaver studies. In the Ackermann practice, this approach is applied factually and individually — no rigid schemes, but medically guided planning across several areas and usually several appointments.
The Structural Logic
Instead of "filling" individual wrinkles, the face is restored according to its anatomical hierarchy. The holistic concept typically covers six to eight treatment axes:
| Anatomical Axis | Function Within the Overall Concept |
|---|---|
| Midface / Cheek Augmentation | Anchor of the concept — supraperiosteal restoration of the cheek contour, lifting the entire midface |
| Tear Trough / Under-Eye Region | Transition cheek–eye — corrects the "tired" impression, often treated with soft hyaluronic acid |
| Nasolabial Fold | Follow-up correction after midface restoration — usually only a sparing supplement is needed |
| Marionette Lines | Transition mid–lower — filler combined with BTX-DAO for a lasting effect |
| Chin Augmentation | Anchor of the lower-face proportion — structural definition of the lower third of the face |
| Jawline Definition | Structural anchor of the contour line — pre-jowl sulcus correction and gonion definition |
| Lips / Perioral Lines | Completion of the mouth region — included where indicated |
| Transition to the Neck (optional) | Where indicated, neck-décolleté treatment with a skinbooster or polynucleotides |
What the Holistic Concept Is Not
Honest Premium Tone Instead of Bundle Hype
Many practices advertise "8-point lifts" or "liquid face lifts" as flat-rate premium packages with fixed prices and fixed ml amounts. The Ackermann practice deliberately works differently:
- No standard schemes — anatomical reality is individual; standard points often lead to disproportionate results
- No maximum-volume packages — anyone offering a flat "6 ml in one session" without knowing the findings is not acting medically
- No influencer aesthetic — apple cheeks, "hamster cheeks," overfilled lips are not an anatomical ideal, but marketing
- No promises of "10 years younger" — the effect is subtle, anatomically sound, and concretely describable — not emotionally charged
- Gender-specific differentiation — masculine and feminine facial ideals differ fundamentally, and that is respected
The concept is premium through professional depth and medical planning — not through wellness staging or bundle marketing.
Why This Practice
Planning Under Direct Vision, Not by Scheme
A facial concept concerns exactly the regions where the relevant vessels run — temple, cheek, nasolabial region, chin. Their location and depth vary considerably from person to person; textbook figures describe an average, not your anatomy.
- Sonographic visualization before injection — vessel course and layer depth are visualized in the region to be treated before injecting (see Ultrasound-Guided Injection). Anatomical studies show strongly variable vessel courses specifically in the midface — with concrete risk zones for the tear-trough and cheek region (Hufschmidt et al. 2018, PMID 30327185)
- Checking existing material — if filler remains in the tissue from previous treatments, its location and amount can be visualized rather than assumed
- Anesthesiological emergency routine — hyaluronidase is kept on hand, and emergency protocols for vascular, circulatory, and allergic reactions are established
- Second opinion, also from elsewhere — the Filler Complications & Second Opinion consultation is also open to patients who were treated elsewhere
Imaging does not replace anatomical knowledge. It replaces the assumption that anatomy looks the same in everyone.
How the Concept Proceeds
Fee Logic
The Holistic Hyaluron Concept is not designed as a fixed bundle package — that would contradict the factual, anatomical tone of the anti-position described above. Instead, billing follows each area according to the fees for the respective individual treatments:
| Typical Constellation | Scope |
|---|---|
| Full midface: cheeks + nasolabial + lip (1st session) + tear trough (2nd session) | 2 sessions |
| Full lower face: cheeks + marionette lines + chin + jawline (2 sessions) | 2 sessions |
| Complete mid- and lower-face restoration (3 sessions, 5–7 ml total) | 3 sessions |
| Initial consultation with concept development (creditable toward treatment) | Aesthetic consultation (GOÄ) |
Who the Concept Suits
| Profile | Recommendation |
|---|---|
| From age 40 with early mid- or lower-face volume loss | Classic indication — preventive, structured restoration |
| From age 50 with more pronounced contour changes | Multi-stage plan, often combining hyaluronic acid + hydroxylapatite |
| After successful individual treatment, wanting an overall concept | Often sensible — the individual areas are brought together into a whole |
| Younger patients with anatomically weak midface projection | Structural definition, smaller volumes than for age-related atrophy |
| Men wanting masculine contouring | Gender-specific planning with focus on chin, jawline, gonion |
What the Concept Is Not
Four Precise Distinctions
- Not a "liquid face lift" as a bundle package. Anyone expecting a flat-rate premium package with fixed ml and a fixed price will, in this practice, be directed toward medical individual planning. Standardized schemes often lead to unsatisfying results.
- No liquid rhinoplasty (nose correction). The Ackermann practice does not offer hyaluronic acid treatment of the nose — because of the documented vascular risk (the dorsal nasal artery, with an anastomosis to the ophthalmic artery; a published case report documents blindness and cerebral infarcts after retrograde embolization via exactly this vascular connection, Ansari et al. 2018, PMID 30376386) and the classification, confirmed by the German Federal Court of Justice (BGH I ZR 170/24, April 2025), as a plastic-surgical procedure.
- No substitute for a plastic-surgical facelift. With pronounced skin laxity, a surgical procedure is anatomically more appropriate. We advise on this honestly.
- No promise of instant rejuvenation. The concept works over weeks — swelling is initially visible, and the final result stabilizes after 4–8 weeks. Anyone wanting "10 years younger in 10 minutes" is not the right patient for this.
"A face does not age wrinkle by wrinkle — it loses volume in connected compartments. Treating only the visible wrinkle corrects the symptom. Understanding the cause means planning across areas — and also knowing when another session is no longer sensible."
- Hufschmidt K, et al. (2018): The infraorbital artery: Clinical relevance in esthetic medicine and identification of danger zones of the midface. J Plast Reconstr Aesthet Surg, PMID 30327185
- Ansari ZA, et al. (2018): Ocular and cerebral infarction from periocular filler injection. Orbit, PMID 30376386
- DeLorenzi C. (2014): Complications of injectable fillers, part 2: vascular complications. Aesthet Surg J, PMID 24692598
This page provides an initial overview. What an overall concept specifically means for you — which areas, which sequence, which time frame is sensible — belongs in a personal conversation at the practice. Unhurried, with findings, with time.
The Next Step
Findings First. Then the Decision.
In the initial consultation, we clarify whether the treatment makes sense for you — and what is realistic to expect. Herzogenaurach, twelve minutes by car from Erlangen.
Frequently Asked Questions About the Holistic Hyaluron Concept
How does the concept differ from individual treatments?
With individual treatments, one specific area is addressed (for example the lips, or the nasolabial fold). The holistic concept analyzes the face as a whole and creates a staged plan across several areas and sessions. The key advantage: the areas reinforce each other (cheek augmentation indirectly reduces the nasolabial fold), and the result looks anatomically coherent rather than "patched" at one spot.
Do I have to have all areas treated at the same time?
No — and that would not be sensible either. Filler distributes in the tissue over several weeks, and a layer-appropriate assessment after each session is part of quality assurance. Typically 2–3 sessions spaced 4–6 weeks apart.
What are the total costs?
Costs depend on findings, the number of sessions, and the chosen axes, and are billed per GOÄ. We discuss the specific cost range transparently at the initial consultation — the practice deliberately does not offer flat-rate packages, because that would be incompatible with medical individual planning.
What materials are used?
Mainly approved hyaluronic acid fillers of varying cross-linking density, and depending on indication, calcium hydroxylapatite for structural axes (cheek, jawline, chin). Brand names are not advertised on the website, as that does not fit the factual tone — we clarify all details transparently in the personal consultation.
How long does the overall result last?
Hyaluronic acid filler lasts 6–18 months depending on area and cross-linking density, hydroxylapatite-based filler 18–24 months. In the holistic concept, materials are used strategically: structural anchors (cheek, jawline, chin) with longer-lasting materials, expression-active areas (lip, marionette) with softer, shorter-lasting materials. Refresher treatments are typically annual for the structural axes, every 9–12 months for the expression-active areas.
Is there downtime between sessions?
Each individual session has typical filler reactions: redness, swelling, occasionally bruising, subsiding over 3–7 days. There is no downtime between sessions — normal daily life is possible. Before important social occasions, plan 1–2 weeks of lead time relative to the respective session.
What sets the concept apart regionally?
In regional comparison, the practice differentiates itself along three axes: anesthesiological complication management for vessel-adjacent filler treatments, a factual, evidence-based tone without marketing promises, and medical individual planning instead of standardized bundle packages. Hyaluronidase (the antidote) is kept on hand — see Hyaluronidase Treatment.
Can I book only parts of the concept?
Yes — the concept is not a "mandatory package." You can have individual axes treated at any time, for example midface restoration without the lower face. The concept is a consultation framework, not a binding booking package. The medical decision about what makes sense is made individually.
Can the concept be combined with other treatments?
Yes — very often sensible. Established synergies: concept + BTX (glabella, forehead, crow's feet, DAO), concept + HIFU (for skin laxity without sufficient volume need), concept + polynucleotides (bioregeneration, skin quality), concept + skinbooster. The sequence is planned at the initial consultation.
What happens at the initial consultation?
A 90-minute detailed consultation, an anatomy analysis of all relevant axes, discussion of pros and cons, a proposed staged plan, and a written cost breakdown. The Aesthetic Consultation is billed per GOÄ and credited toward subsequent treatment.
The Individual Building Blocks of the Concept
Cheek Augmentation
Midface anchor — structural restoration as the foundation of the concept
Nasolabial Folds
Follow-up correction — usually a sparing supplement after midface restoration
Marionette Lines
Bridge mid–lower — filler combined with BTX-DAO for a lasting effect
Chin Augmentation
Lower-face anchor — proportion correction for the lower third of the face
Jawline Definition
Structural anchor — contour line and pre-jowl correction
Lips in Harmony
Mouth region — contouring and harmonization as part of the overall concept
Pleats
Perioral fine lines — completion of the mouth region
Dissolving Hyaluronic Acid
Reversibility anchor — the safety component of the entire concept
Filler Complications
Second opinion for complications following treatments elsewhere
This treatment belongs to the field of hyaluronic acid wrinkle filling. The treatment overview covers the mechanism of action, procedure, safety, and all treatable regions in context.
Wrinkles & Muscle Relaxants
HIFU Lifting
Primary Care Support
Hair Loss
Infusion Therapy
Tension & Pain
Skin Diseases
