Temple filler volumization can significantly improve facial balance and appearance, but has significant risks, including contour irregularities, vascular occlusion, skin necrosis, hair loss, blindness, stroke, and nonthrombotic pulmonary embolism. To improve the safety and precision of temple volumization, we have introduced ultrasound-guided injections of hyaluronic acid filler.
Filler injections in the upper face pose significant challenges due to its complex anatomy and proximity to vascular structures. High-frequency Doppler ultrasound offers real-time visualization of facial anatomy, improving both safety and aesthetic outcomes. This paper presents a detailed overview of the ultrasonographic anatomy of the temples, forehead, and glabella, along with reproducible, ultrasound-guided filler injection techniques for these areas.
The midface is a key area in facial aesthetics, highly susceptible to age-related changes such as fat pad absorption, bone resorption, and loss of skin elasticity. These changes lead to the formation of prominent folds, such as the nasolabial fold. In addition, critical vascular structures and non-vascular components, such as the facial artery, angular artery, and parotid gland, make this region prone to complications during filler injections.
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.
Nonsurgical rhinoplasty using filler injections is a popular procedure; however, it carries risks of significant complications, including vascular occlusion, skin necrosis, blindness, and cerebral ischemia. We present a case of septal necrosis after nonsurgical rhinoplasty and describe management using ultrasound guidance. Awareness of this complication and high clinical index of suspicion are necessary for early diagnosis and treatment, crucial to minimizing permanent sequelae. We show that high-definition ultrasound can help to guide the management and improve the treatment outcomes.
The aim of this study was to investigate the 2- and 3-dimensional location of the change of plane of the deep branch of the supratrochlear and supraorbital artery, respectively.
The purpose of this article is to update the changes to the author's protocols used to manage acute filler related vascular events from those previously published in this journal. For lack of a better term, this new protocol has been called the High Dose Pulsed Hyaluronidase (HDPH) protocol for vascular embolic events with hyaluronic acid (HA) fillers. The initial protocol used involved many different modalities of treatment.
Hyaluronic acid (HA) fillers are used to treat an array of aesthetic indications. Proper filler selection is paramount for successful patient outcomes. However, many important physiochemical and physical properties that impact HA gel behavior remain undefined.
The Restylane portfolio of soft tissue fillers spans a wide range of indications, due in part to their complementary manufacturing technologies [non-animal stabilized hyaluronic acid (NASHA) and Optimal Balance Technology (OBT/XpresHAn)]. Using an array of products, injectors can achieve a holistic, natural looking effect for their patients. However, with a wide range of products it may be difficult to choose an optimal combination.
ULTRASOUND IS USED UBIQUITOUSLY throughout the field of medicine. Almost all specialties have embraced ultrasound as a quick, painless, and relatively inexpensive diagnostic tool to assist the clinician in determining pathology, anatomy, and assisting in diagnostic or therapeutic procedures. The field of aesthetics has been late to embrace the power of ultrasound, but it is slowly happening now.
Filler-related vascular occlusion (VO) treatment remains challenging despite established protocols, including high-dose pulsed hyaluronidase injections and ultrasound-guided targeted injections. Managing patients’ pain and anxiety during treatment presents additional difficulties.
Wrinkles, sagging, pigmented spots and other signs of
aging that result from accumulating damage, signify
failure of skin’s defensive and regenerative mechanisms.
Moreover, as recent studies point out the progressive
decline in skin regenerative function may have dire
consequences well beyond wrinkles, causing diverse skin
diseases such as cancer (1). Hence, substances that
promote skin regeneration may offer much more than “a
wrinkle cure”.
Cutaneous ageing, as a result of combined chronological and photo-ageing in sun-exposed areas, is accompanied by major modifications of the elastic fibres. We aimed to investigate qualitative and quantitative changes of dermal elastin fibres during cutaneous chronological and photo-ageing and the involvement of lysozyme in these processes.
Reduced synthesis of collagen types I and III is characteristic of chronologically aged skin. The present report provides evidence that both cellular fibroblast aging and defective mechanical stimulation in the aged tissue contribute to reduced collagen synthesis.
The extracellular matrix (ECM) is the non-cellular component present within all tissues and organs, and provides not only essential physical scaffolding for the cellular constituents but also initiates crucial biochemical and biomechanical cues that are required for tissue morphogenesis, differentiation and homeostasis.
Mammalian skin comprises a multi-layered epithelium, the epidermis, and an underlying connective tissue, the dermis. The epidermal extracellular matrix is a basement membrane, whereas the dermal ECM comprises fibrillar collagens and associated proteins.
Skin aging is a complex biological process influenced by a combination of endogenous or intrinsic and exogenous or extrinsic factors. Because of the fact that skin health and beauty is considered one of the principal factors representing overall "well-being" and the perception of "health" in humans, several anti-aging strategies have been developed during the last years.
Biochemical and ultrastructural approaches were used to assess collagen changes in photodamaged skin. Extensive collagen fragmentation, clumping of the fragmented collagen, and interaction of fibroblasts with the damaged matrix were observed.
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