A Safe Doppler Ultrasound–Guided Method for Nasolabial Fold Correction With Hyaluronic Acid Filler

2020 ◽  
Author(s):  
Won Lee ◽  
Ji-Soo Kim ◽  
Hyoung-Jin Moon ◽  
Eun-Jung Yang
Keyword(s):  
Hyaluronic Acid ◽  
Doppler Ultrasound ◽  
Rating Scale ◽  
Vascular Complications ◽  
Facial Artery ◽  
Nasolabial Fold ◽  
Filler Injection ◽  
Ultrasound Evaluation ◽  
Filler Injections ◽  
Nasolabial Folds

Abstract Background Injection of hyaluronic acid filler, a common procedure for nasolabial fold correction, poses a risk of vascular compromise, which can result in skin necrosis and blindness. Objectives The aim of this study was to examine the facial arterial pathway in real time by Doppler ultrasound to avoid arterial complications during filler injections. Methods The facial artery pathway of 40 patients (80 nasolabial folds; 2 men and 38 women; mean age, 46.5 years; range, 28-72 years) was examined by Doppler ultrasound before hyaluronic acid filler injection. On the basis of this ultrasound evaluation, the filler injection targeted the subdermal, subcutaneous, and deep to submuscular layers by bypassing the facial artery. The efficacy of the filler injection was evaluated for each patient. Results The facial artery was detected lateral to the nasolabial fold in 31% of patients; it was detected beneath the nasolabial fold in the other patients as follows: subdermal layer, 13%; subcutaneous layer, 29%; muscular layer, 24%; and submuscular layer, 4%. The mean [standard deviation] Wrinkle Severity Rating Scale score was 3.68 [0.76] before injection and 2.28 [0.78] at 3 months after injection. Two patients experienced unilateral bruising of the nasolabial fold, which resolved after 2 weeks without treatment. Conclusions Doppler ultrasound can be considered as pretreatment tool for the prevention of vascular complications during filler injections to correct nasolabial folds. Level of Evidence: 4

Safe Glabellar Wrinkle Correction With Soft Tissue Filler Using Doppler Ultrasound

2020 ◽  
Author(s):  
Won Lee ◽  
Hyoung-Jin Moon ◽  
Ji-Soo Kim ◽  
Eun-Jung Yang
Keyword(s):  
Hyaluronic Acid ◽  
Botulinum Toxin ◽  
Soft Tissue ◽  
Doppler Ultrasound ◽  
Vascular Complications ◽  
Level Of Evidence ◽  
Filler Injection ◽  
Subcutaneous Layer ◽  
Soft Tissue Filler

Abstract Background Glabellar wrinkle corrections are usually performed by injecting botulinum toxin and hyaluronic acid fillers. The glabella is one of the most dangerous locations for filler injection because of possible visual complications. Objectives The aim of this study was to use Doppler ultrasound to determine the anatomic relation between glabellar wrinkles and the supratrochlear artery pathway, perform safe hyaluronic acid filler injection to correct glabellar wrinkles, and determine the efficacy of the procedure. Methods From January 2019 to July 2019, 42 patients (74 glabellar wrinkle lines; 32 bilateral and 10 unilateral wrinkles) were evaluated. Glabellar wrinkle lines were corrected with hyaluronic acid filler. Doppler ultrasound was used to avoid the supratrochlear artery. Results Among the 74 wrinkle lines, the supratrochlear arteries were located either at the glabellar wrinkle lines (30/74, 41%) or lateral to the glabellar wrinkle lines (44/74, 59%). In the latter 44 wrinkles, fillers were injected into the subdermal layer of the glabellar wrinkle lines. In the 30 wrinkles where supratrochlear artery was located at the glabellar wrinkle lines, the artery was located at the deep subcutaneous layer in 24 and at the subdermal layer in 6; thus, filler injection was not performed. Conclusions The supratrochlear artery may be located either at or lateral to the glabellar wrinkle lines. When performing glabellar wrinkle correction, Doppler ultrasound can be used to confirm the location of the supratrochlear artery before filler injection, which helps in avoiding vascular complications. Level of Evidence: 4

scholarly journals Hyaluronic Acid Injections as Nonsurgical Alternative in case of Delayed Diagnosis of Malar Arch Fracture: Case Report and Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Raffaele Rauso ◽  
Giorgio Lo Giudice ◽  
Nicola Zerbinati ◽  
Gianpaolo Tartaro
Keyword(s):  
Hyaluronic Acid ◽  
Case Report ◽  
Functional Impairment ◽  
Delayed Diagnosis ◽  
Facial Trauma ◽  
Facial Fracture ◽  
Filler Injection ◽  
First Case ◽  
Filler Injections ◽  
Fracture Diagnosis

Background. In this article, we describe a nonsurgical approach based on hyaluronic acid filler injection to restore the facial features of a delayed diagnosis of malar fracture. We analyze the differences between surgical and nonsurgical solution: in case of early detection, the surgical approach is the gold standard of treatment. However, in cases of delayed facial fracture diagnosis without functional impairment, nonsurgical procedures could be considered an alternative tool as we show in the present case report. Aims. The aim of this study is to underline the importance of a complete aesthetic restoration in patients treated for noncosmetic purposes. Patients/Methods. We present a case of a 26-year-old male patient with a delayed diagnosis of malar fracture without functional impairment that was treated with hyaluronic acid (HA) filler injections. Results. The patient was followed up for 1 year showing stable results for the first 8 months; at the 12-month follow-up, a touch-up was suggested due to partial resorption of the filler. Conclusion. This is the first case describing a facial fracture treated with HA injections for only recontouring purposes. We assess that nonsurgical cosmetic procedures could be considered a “new” tool in the process of facial rehabilitation but only when functional problems are not associated with facial trauma.

Facial Arterial Variations in Asians: A Study on Computed Tomographic Angiography

2021 ◽  
Author(s):  
Dawei Wang ◽  
Shixuan Xiong ◽  
Ning Zeng ◽  
Yiping Wu
Keyword(s):  
Computed Tomographic Angiography ◽  
Facial Artery ◽  
Nasolabial Fold ◽  
Anatomical Landmarks ◽  
Filler Injection ◽  
Computed Tomographic ◽  
Arterial Variations ◽  
Significant Difference ◽  
Tomographic Angiography

Abstract Background A consensus on facial artery (FA) anatomy has not been established due to the discrepancies in previous studies. Objectives The purpose of this study was to assess the branches, course, and location of the FA in Asians utilizing computed tomographic angiography (CTA). Methods The CTA images of 300 FAs from 150 Asian patients were evaluated. According to the termination branch, the FA was classified as follows: type 1, FA terminates superior labial or inferior labial artery; type 2: FA terminates lateral nasal or inferior alar artery; type 3: FA terminates medial canthal artery; type 4: FA is divided into duplex branches with dominant medial canthal artery laterally. The relationship between nasolabial fold and FA was evaluated, and the distances from anatomical landmarks to FA were measured to position the course. Results 70 arteries (23.3%), 163 arteries (54.3%), 49 arteries (16.3%), and the other 18 arteries (6.0%) were classified as type 1, 2, 3 and 4, respectively. 72.3% of FAs were located medially to the nasolabial fold, and only 14.7% of arteries were lateral to the nasolabial fold. The vertical distance between FA and the inner canthus or the midpoint of inferior orbital rim decreased from type 1 to type 4 FA (P < 0.0001). No significant difference was found among the four types of FA in the distances between the mandibular angle (P = 0.1226) or oral commissure (P = 0.1030) and the FA at inferior of mandible. Conclusions The detailed findings of facial artery will provide a valuable reference for filler injection in cosmetic procedures and flap design in reconstructive surgery.

scholarly journals An Open-Label Uncontrolled, Multicenter Study for the Evaluation of the Efficacy and Safety of the Dermal Filler Princess VOLUME in the Treatment of Nasolabial Folds

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Daisy Kopera ◽  
Michael Palatin ◽  
Rolf Bartsch ◽  
Katrin Bartsch ◽  
Maria O’Rourke ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Adverse Events ◽  
Multicenter Study ◽  
Dermal Filler ◽  
Nasolabial Fold ◽  
Efficacy And Safety ◽  
Open Label ◽  
Moderate Severity ◽  
Injection Site Reactions ◽  
Nasolabial Folds

The dermal filler Princess VOLUME is a highly cross-linked, viscoelastic hyaluronic acid injectable gel implant used for aesthetic treatment. To evaluate the efficacy and safety of Princess VOLUME in the treatment of nasolabial folds, an open-label uncontrolled, multicenter study was conducted. Forty-eight subjects were recruited who had moderate to deep wrinkles, according to the Modified Fitzpatrick Wrinkle Scale (MFWS). Subjects received Princess VOLUME in both nasolabial folds at Day 0. Nasolabial fold severity was evaluated at 30, 90, 180, and 270 days after treatment, using the MFWS and the Global Aesthetic Improvement Scale (GAIS). Adverse events and treatment site reactions were recorded. Among the 48 subjects, 93.8% were female with a median age of 52 years. There were significant improvements(P<0.0001)in the MFWS scores at 30, 180, and 270 days after treatment compared with those at baseline, with a mean decrease of 1.484 (±0.408), 1.309 (±0.373), and 1.223 (±0.401), respectively; hence the primary endpoint was achieved and clinical efficacy demonstrated. Princess VOLUME was well tolerated, and most adverse events were injection site reactions of mild to moderate severity. Subject satisfaction (97.9%), subject recommendation of the treatment (93.6%), and investigators GAIS scores (97.9% improvement) were high.

scholarly journals Perceived naturalness of facial expression after hyaluronic acid filler injection in nasolabial folds and lower face

2019 ◽  
Vol 19 (7) ◽  
pp. 1600-1606
Author(s):  
Wolfgang G. Philipp‐Dormston ◽  
Bernd Schuster ◽  
Maurizio Podda
Keyword(s):  
Hyaluronic Acid ◽  
Facial Expression ◽  
Lower Face ◽  
Filler Injection ◽  
Nasolabial Folds

The Utility of Color Doppler Ultrasound to Explore Vascular Complications After Filler Injection

2017 ◽  
Vol 43 (12) ◽  
pp. 1508-1510 ◽  
Author(s):  
Hyun Jung Kwon ◽  
Beom Joon Kim ◽  
Eun Jung Ko ◽  
Sun Young Choi
Keyword(s):  
Doppler Ultrasound ◽  
Color Doppler ◽  
Vascular Complications ◽  
Color Doppler Ultrasound ◽  
Filler Injection

scholarly journals Vascular Complication in Aesthetic Medicine Treated with Hyperbaric Oxygenation

2018 ◽  
Vol 63 (2) ◽  
pp. 18-21
Author(s):  
Romuald Olszański ◽  
Zbigniew Dąbrowiecki ◽  
Wojciech Marusza ◽  
Irina Netsvyetayeva ◽  
Dorota Niewiedział ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Hyperbaric Oxygenation ◽  
Adverse Reactions ◽  
Subcutaneous Administration ◽  
Vascular Complications ◽  
Vascular Complication ◽  
Nasolabial Fold ◽  
Livedo Racemosa ◽  
Aesthetic Medicine ◽  
Nicolau Syndrome

Abstract The most hazardous adverse reactions following hyaluronic acid injections in aesthetic medicine involve vascular complications, known as the Nicolau Syndrome. This article presents a vascular complication in the area of the upper part of the nasolabial fold following subcutaneous administration of 0.5 ml of hyaluronic acid. At the time of the injection, paling occurred, which was followed by livedo racemosa appearing an hour later. Upon the lapse of a week, an ulceration appeared. It was not until the tenth day after the hyaluronic acid injection that hyaluronidase was administered. After 15 hyperbaric oxygen exposures, the ulcer was completely healed

scholarly journals Nasolabial folds modeling — literature review

2019 ◽  
Vol 2 (1) ◽  
pp. 46-54
Author(s):  
Teresa Matthews‑Brzozowska ◽  
Anna Swatowska ◽  
Magdalena Tuczyńska
Keyword(s):  
Hyaluronic Acid ◽  
Literature Review ◽  
Skin Condition ◽  
Middle Part ◽  
Nasolabial Fold ◽  
Facial Skin ◽  
Aesthetic Medicine ◽  
Medical Databases ◽  
Materials Used ◽  
Nasolabial Folds

Introduction. Nasolabial folds are skin folds that run from both sides of the nose to the corners of the mouth. They are caused by the loss of fat in the dermis, followed by the loss of muscles in the middle part of the face.Aim. The aim of the work is to present contemporary knowledge of materials used for modeling nasolabial folds.Material and Methods. Medical databases PubMed, EBSCO Multiplier, were analyzed by entering the slogans: nasolabial folds, nasolabial folds, hyaluronic acid in nasolabial fold modeling, nasolabial fold correction. Analyzing the literature, data from eleven scientific articles from the last five years (2013–2018) were used.Results. In most articles for modeling nasolabial folds, crosslinked hyaluronic acid was used after prior photographic assessment of skin condition or after anamnesis examination — an interview. From the papers describing the cases, it appears that the applied materials for face aesthetic medicine treatments level the nasolabial folds.Conclusions. The obtained results are ambiguous and studies need to be continued. In the literature, the instrumental evaluation of facial skin was not used before modeling nasolabial folds.

Cadaveric Dissections to Determine Surface Landmarks Locating the Facial Artery for Filler Injections

2020 ◽  
Author(s):  
Tanvaa Tansatit ◽  
Elizabeth Kenny ◽  
Thirawass Phumyoo ◽  
Benrita Jitaree
Keyword(s):  
Turning Point ◽  
Arterial Injury ◽  
Reference Points ◽  
Facial Artery ◽  
Nasolabial Fold ◽  
Bony Landmarks ◽  
Lateral Channel ◽  
Filler Injections ◽  
Mouth Corner ◽  
Oral Commissure

Abstract Background The facial artery is a high-risk structure when performing filler injections at the nasolabial fold, buccal, and mandibular regions. Objectives This study aimed to establish reference landmarks locating the course of the facial artery and its essential branches. Methods Thirty-one embalmed cadavers were enrolled in this study. The course of the facial artery was observed in regard to the following reference points: masseter insertion, oral commissure, and common bony landmarks. The corner of the mouth was utilized as the landmark to measure the turning point of the facial artery. Results Seven points were established to identify the course and turning point of the facial artery. These included the anterior masseteric, lateral mental, infraorbital, medial canthal, basal alar, post-modiolar (PMP), and supra-commissural (SCP) points. The course of the facial artery deviates at least twice at the lateral mental points and at the SCP or PMP. The facial artery appeared more medially when the artery turned at the PMP and SCP. It presented through the lateral channel if the turning point was solely at the PMP. Wherever the facial artery deviates, it can be divided into 3 segments: the mandibular, buccal, and nasolabial segments. The arterial course may deviate laterally from the mouth corner towards PMP. The nasolabial segment may also deviate laterally to the basal alar point at the alar grove for 0.5 to 1 cm. Conclusions The deviation of facial artery closely relates with mandibular, buccal, and nasolabial segments. It is essential in avoiding arterial injury for physicians and surgeons who perform procedures in these areas.

Three-Dimensional Computed Tomography Scanning of Temporal Vessels to Assess the Safety of Filler Injections

2021 ◽  
Author(s):  
Chun-Lin Chen ◽  
Li-Yao Cong ◽  
Xiang-Xue Kong ◽  
Wei-Rui Zhao ◽  
Wei-Jin Hong ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coordinate System ◽  
Superficial Temporal Artery ◽  
Vascular Complications ◽  
Temporal Artery ◽  
External Carotid ◽  
3D Images ◽  
Filler Injection ◽  
Computed Tomography Scanning ◽  
Filler Injections

Abstract Background Temple filler injection is one of the most common minimally invasive cosmetic procedures involving the face; however, vascular complications are not uncommon. Objectives This study aimed to investigate the anatomy of the temporal vessels and provide a more accurate protocol for temple filler injection. Methods Computed tomography (CT) scans of 56 cadaveric heads injected with lead oxide were obtained. We then used Mimics software to construct 3-dimensional (3D) images of the temporal vessels described by a coordinate system based on the bilateral tragus and right lateral canthus. Results In the XOY plane, the superficial temporal artery (STA), middle temporal artery (MTA), zygomatico-orbital artery (ZOA), posterior branch of the deep temporal artery (PDTA), and lateral margin of the orbital rim divide the temple into 4 parts (A, B, C, and D). The probabilities of the STA, MTA, ZOA, and PDTA appearing in parts A, B, C, and D were 30.73%, 37.06%, 39.48%, and 77.18%, respectively. In 3D images, these vessels together compose an arterial network that is anastomosed with other vessels, such as the external carotid, facial, and ocular arteries. Conclusions 3D CT images can digitally elucidate the exact positions of temporal vessels in a coordinate system, improving the safety of temple filler injections in a clinical setting.

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