Pinch Anatomy of Forehead: An Injection Guide for Forehead Filler Treatment

2022 ◽  
Author(s):  
Krishan Mohan Kapoor ◽  
Vandana Chatrath ◽  
Chris Qiong Li ◽  
Dario Bertossi
Keyword(s):  
Detailed Knowledge ◽  
Dominant Hand ◽  
Anatomical Changes ◽  
Relative Safety ◽  
The Face ◽  
Filler Injections ◽  
Tissue Space ◽  
Facial Anatomy

With the popularity of filler injections globally, more and more injectors are using them for facial shaping and reversing the aging changes of the face. Detailed knowledge of facial anatomy, especially of important vessels and tissue planes is essential for injectors. While performing filler injections, injectors tend to pinch the tissue layers with their non-dominant hand for ease of doing the procedure. Such deformational forces cause some changes in the anatomy of tissue layers held in a pinch. During a deep pinch, the important arteries in that area can get pulled up in the pinch's tissue layers, or they can stay in their position being unaffected by pinching. The ‘pinch and pull’ can also improve the tissue space for injections, by pulling away the mobile tissue layers from the fixed ones. Knowledge of the ‘pinch anatomy’ in the forehead can be used to the injector's advantage to avoid important arteries and place filler in the correct plane. By knowing the anatomical changes during the pinched state of tissue layers, filler injections in the forehead can be performed with relative safety in the correct tissue plane.

Primary Repair of Soft Tissue Facial Trauma

2020 ◽  
Author(s):  
Michelle Seu ◽  
Amir H. Dorafshar ◽  
Fan Liang
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Primary Repair ◽  
Soft Tissue Injury ◽  
Facial Trauma ◽  
Facial Soft Tissue ◽  
The Face ◽  
Craniofacial Trauma ◽  
Facial Anatomy ◽  
Tissue Defects

Craniofacial trauma can result in a wide variety of injuries that cause soft tissue injury of face. However, despite the enormous diversity in presentation of these injuries, they tend to follow certain patterns. Most facial injuries are either contusions, abrasions, lacerations, or avulsions. The extent of injury and approach to repair can be further assessed by the size, depth, and number of facial subunits involved. A plastic surgeon in the setting of acute craniofacial trauma, armed with certain principles of facial anatomy and primary repair methods, can drastically restore function and cosmesis to the face, while also mitigating the chance of future deformity and functional deficit. This review contains 3 figures and 26 references Keywords: facial trauma, craniofacial surgery, primary repair, facial soft tissue defects, soft tissue, facial injury, plastic surgery, facial lacerations, facial avulsions

Reliability of the conditioned pain modulation paradigm across three anatomical sites

2020 ◽  
Vol 20 (2) ◽  
pp. 283-296
Author(s):  
Rania Nuwailati ◽  
Michele Curatolo ◽  
Linda LeResche ◽  
Douglas S. Ramsay ◽  
Charles Spiekerman ◽  
...  
Keyword(s):  
Cold Pressor Test ◽  
Pressure Pain Threshold ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Dominant Hand ◽  
Pain Mechanisms ◽  
Relative Reliability ◽  
Contralateral Hand ◽  
The Face ◽  
Absolute Reliability

AbstractBackground and aimsConditioned Pain Modulation (CPM) is a measure of pain inhibition-facilitation in humans that may elucidate pain mechanisms and potentially serve as a diagnostic test. In laboratory settings, the difference between two pain measures [painful test stimulus (TS) without and with the conditioning stimulus (CS) application] reflects the CPM magnitude. Before the CPM test can be used as a diagnostic tool, its reliability on the same day (intra-session) and across multiple days (inter-session) needs to be known. Furthermore, it is important to determine the most reliable anatomical sites for both the TS and the CS. This study aimed to measure the intra-session and inter-session reliability of the CPM test paradigm in healthy subjects with the TS (pressure pain threshold-PPT) applied to three test sites: the face, hand, and dorsum of the foot, and the CS (cold pressor test-CPT) applied to the contralateral hand.MethodsSixty healthy participants aged 18–65 were tested by the same examiner on 3 separate days, with an interval of 2–7 days. On each day, testing was comprised of two identical experimental sessions in which the PPT test was performed on each of the three dominant anatomical sites in randomized order followed by the CPM test (repeating the PPT with CPT on the non-dominant hand). CPM magnitude was calculated as the percent change in PPT. The Intraclass Correlation Coefficient (ICC), Coefficient of Variation (CV), and Bland-Altman analyses were used to assess reliability.ResultsPPT relative reliability ranged from good to excellent at all three sites; the hand showed an intra-session ICC of 0.90 (0.84, 0.94) before CPT and ICC of 0.89 (0.83, 0.92) during CPT. The PPT absolute reliability was also high, showing a low bias and small variability when performed on all three sites; for example, CV of the hand intra-session was 8.0 before CPT and 8.1 during CPT. The relative reliability of the CPM test, although only fair, was most reliable when performed during the intra-session visits on the hand; ICC of 0.57 (0.37, 0.71) vs. 0.20 (0.03, 0.39) for the face, and 0.22 (0.01, 0.46) for the foot. The inter-session reliability was lower in all three anatomical sites, with the best reliability on the hand with an ICC of 0.40 (0.23, 0.55). The pattern of absolute reliability of CPM was similar to the relative reliability findings, with the reliability best on the hand, showing lower intra-session and inter-session variability (CV% = 43.5 and 51.5, vs. 70.1 and 73.1 for the face, and 75.9 and 78.9 for the foot). The CPM test was more reliable in women than in men, and in older vs. younger participants.DiscussionThe CPM test was most reliable when the TS was applied to the dominant hand and CS performed on the contralateral hand. These data indicate that using the CS and TS in the same but contralateral dermatome in CPM testing may create the most reliable results.

Understanding facial anatomy in aesthetic practice

2020 ◽  
Vol 9 (4) ◽  
pp. 156-161
Author(s):  
Natalie Haswell
Keyword(s):  
Botulinum Toxin A ◽  
Duty Of Care ◽  
Medical Procedure ◽  
Aesthetic Medicine ◽  
Anatomy And Physiology ◽  
Aesthetic Practice ◽  
Poor Treatment ◽  
Filler Injections ◽  
Soft Tissue Filler ◽  
Facial Anatomy

In this article the author will explore the relevance and importance of knowing and understanding the facial anatomy, including what benefits this has to the patient and the injector. This article will detail why an in-depth knowledge of anatomy is important, specifically in relation to aesthetic medicine, botulinum toxin A and soft tissue filler injections. First and foremost, it is the medical injector's duty of care to have a deep knowledge and understanding of anatomy and physiology with regard to any medical procedure. Unfortunately, as well-known, cosmetic injectables are largely unregulated. The number of reports of ‘botched’ cosmetic procedures or even poor treatment and poor consumer service just keeps on rising ( Save Face, 2019 ). This raises the question of why this is and why the complications becoming what seems to be more frequent and increasing in severity.

scholarly journals HA Filler Injection and Skin Quality–Literature Minireview and Injection Techniques

2020 ◽  
Vol 53 (02) ◽  
pp. 198-206
Author(s):  
Jui-Hui Peng ◽  
Peter Hsien-Li Peng
Keyword(s):  
Volume Loss ◽  
Quality Change ◽  
Facial Aging ◽  
Filler Injection ◽  
Quality Literature ◽  
The Face ◽  
Filler Injections ◽  
Injection Techniques ◽  
Injection Protocol ◽  
Skin Quality

AbstractAging of the face produces many changes in the structure and integrity of the skin and other anatomical aspects, the three major signs of which are volume loss, sagginess, and skin quality change. Through surgical or nonsurgical procedures, it is possible to slow or even reverse these mechanisms through artificial means, including thread lifting, radiofrequency, or filler injection. Filler injections are particularly popular in recent years, owing to their convenience, efficacy, and long-lasting results. In this minireview, the author outlines the basic mechanisms behind facial aging, discusses current literature on each aspect of facial aging, and offers injection protocol recommendations based on past literature and clinical experience.

scholarly journals Assessment of Hand Function Through the Coordination of Contact Forces in Manipulation Tasks

2013 ◽  
Vol 36 (1) ◽  
pp. 5-160 ◽  
Author(s):  
Slobodan Jaric ◽  
Mehmet Uygur
Keyword(s):  
Hand Function ◽  
Safety Margin ◽  
Tangential Component ◽  
Contact Forces ◽  
Load Force ◽  
Dominant Hand ◽  
Factors Affecting ◽  
Relative Safety ◽  
Safety Margins ◽  
Mechanical Factors

Exploration of force coordination has been one of the most often used approaches in studies of hand function. When holding and manipulating a hand-held object healthy individuals are typically able to highly coordinate the perpendicular (grip force; GF) with the tangential component of the contact force (load force; LF). The purpose of this review is to present the findings of our recent studies of GF-LF coordination. Regarding the mechanical factors affecting GF-LF coordination, our data suggest that both different hand segments and their particular skin areas could have markedly different friction properties. It also appears that the absolute, rather than relative safety margin (i.e., how much the actual GF exceeds the minimum value that prevents slipping) should be a variable of choice when assessing the applied magnitude of GF. The safety margin could also be lower in static than in free holding tasks. Regarding the involved neural factors, the data suggest that the increased frequency, rather than an increased range of a cyclic LF could have a prominent detrimental effect on the GF-LF coordination. Finally, it appears that the given instructions (e.g., 'to hold' vs. 'to pull') can prominently alter GF-LF coordination in otherwise identical manipulation tasks. Conversely, the effects of handedness could be relatively week showing only slight lagging of GF in the non-dominant, but not in the dominant hand. The presented findings reveal important aspects of hand function as seen through GF-LF coordination. Specifically, the use of specific hand areas for grasping, calculation of particular safety margins, the role of LF frequency (but not of LF range) and the effects of given instructions should be all taken into account when conducting future studies of manipulation tasks, standardizing their procedures and designing routine clinical tests of hand function.

scholarly journals Threshold-Dependent Gene Drives in the Wild: Spread, Controllability, and Ecological Uncertainty

BioScience ◽  
2019 ◽  
Vol 69 (11) ◽  
pp. 900-907 ◽  
Author(s):  
Gregory A Backus ◽  
Jason A Delborne
Keyword(s):  
Critical Frequency ◽  
Wild Population ◽  
Detailed Knowledge ◽  
Gene Drive ◽  
Potential Solution ◽  
Spreading Behavior ◽  
The Face ◽  
In The Wild ◽  
Ecological Uncertainty ◽  
Gene Drives

Abstract Gene drive technology could allow the intentional spread of a desired gene throughout an entire wild population in relatively few generations. However, there are major concerns that gene drives could either fail to spread or spread without restraint beyond the targeted population. One potential solution is to use more localized threshold-dependent drives, which only spread when they are released in a population above a critical frequency. However, under certain conditions, small changes in gene drive fitness could lead to divergent outcomes in spreading behavior. In the face of ecological uncertainty, the inability to estimate gene drive fitness in a real-world context could prove problematic because gene drives designed to be localized could spread to fixation in neighboring populations if ecological conditions unexpectedly favor the gene drive. This perspective offers guidance to developers and managers because navigating gene drive spread and controllability could be risky without detailed knowledge of ecological contexts.

scholarly journals Facial Feminization Surgery: A Review of 220 Consecutive Patients

2020 ◽  
Vol 53 (02) ◽  
pp. 244-253
Author(s):  
Parag Shashank Telang
Keyword(s):  
Soft Tissue ◽  
Plastic Surgeon ◽  
High Patient Satisfaction ◽  
Satisfaction Rate ◽  
Proper Training ◽  
The Face ◽  
Staged Approach ◽  
Facial Anatomy ◽  
Two Stages ◽  
Soft Tissue Surgery

Abstract Background Facial feminization surgery (FFS) is a combination of facial bony and soft tissue surgeries designed to modify and convert a masculine face to feminine. One’s face plays a very central role in gender incongruence and FFS helps patients overcome this. There are prominent differences between the male and the female facial anatomy (bony and soft tissue) which can be surgically altered to change the visual perception of the face. Methods The author presents the method used at his center for treating 220 patients of gender incongruence requesting FFS from June 2016 to June 2019. The alterations to known methods of forehead contouring, hairline lowering, and jaw shave adopted by his team are discussed. He also presents the logic of performing the entire FFS in two stages at an interval of 7 to 10 days. Results A total of 220 cases of FFS are presented, along with surgical details of techniques used, the sequence and staging of procedures performed, and the results obtained. A two-staged approach to FFS is proposed to maximize the recovery and minimize complications and promote faster healing. Different methods of forehead contouring are also explained in detail. Conclusions FFS is a very rewarding surgery for the plastic surgeon and has high patient satisfaction rate. With proper training in craniomaxillofacial and soft tissue surgery, it is possible for the plastic surgeon to be the main team leader for this procedure. A two-stage approach is highly recommended.

Pathological and anatomical changes in the cerebral cortex in two cases of premature dementia (Dementia praecox)

1903 ◽  
Vol 3 (3-4) ◽  
pp. 149-150
Author(s):  
A. L. Lyubushin
Keyword(s):  
Cerebral Cortex ◽  
Microscopic Examination ◽  
Cortical Layer ◽  
Dementia Praecox ◽  
Pathological Anatomy ◽  
Anatomical Changes ◽  
Early Dementia ◽  
The Face ◽  
History Of ◽  
The Brain

Journal of neuropathology and psychiatry named after S. S. Korsakov, book. 1 and 2 1902The study of the literature on this issue (Kahlbaum, Kiernan, Chizh, Alzheimer) leads to the conclusion that the evidence on the pathological anatomy of early dementia is extremely inadequate and unclear. The author introduces the history of illness to two patients who suffered from early dementia. Both cases ended in death; at autopsy with microscopic examination, they appeared on the face: in one case, the brain was full-blooded, slightly swollen, atrophy of the gyrus of the brain and atrophy of the cortical layer, expressed equally in all lobes of the brain. The lateral ventricles are slightly distended and contain a significant amount of fluid; in another - leptomeningitis sclerotica, Atrophia

Lower face and lifting treatments

2021 ◽  
Vol 10 (8) ◽  
pp. 336-343
Author(s):  
Jemma Gewargis ◽  
Vikram Swaminathan
Keyword(s):  
Treatment Plan ◽  
Facial Rejuvenation ◽  
Dermal Filler ◽  
Comprehensive Treatment ◽  
Age Changes ◽  
Lower Face ◽  
The Face ◽  
Facial Anatomy

Lower face age changes are hugely impactful on the overall ageing concerns presented by patients, and lower face-lifting treatments form an integral part of the rejuvenation and beautification of the face, as part of a comprehensive treatment plan. It is essential that the clinician possesses a deeper understanding of facial anatomy in this region, to allow a more holistic, rather than isolated, approach to rejuvenation and reduce complication risks and downtime. A combination of dermal filler and neuromodulators can be used in the lower face to produce effective, long-lasting and natural facial rejuvenation results.

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