A 10-point plan for avoiding hyaluronic acid dermal filler-related complications during facial aesthetic procedures and algorithms for management

Introduction The facial beauty is not easy to define, yet it is paramount to assess the needs of each patient to propose an appropriate treatment plan that will provide beautification or rejuvenation in a natural-looking fashion.One of the beauty aspects easily recognized is the face shape, which can give a perception of age, gender, and attractiveness, and reflects the facial anatomical structure. Because addressing the structure of the face is the basis for the aesthetic approach with dermal fillers, we find the identification of the patient’s face shape to be a very good starting point in the facial assessment. Objective To discuss important aspects of facial beauty, the characteristics of the different facial shapes (oval, heart, round, and angular), and a method of planning the aesthetic treatment with injectable fillers based on the strengths and weaknesses of each morphology of the face, that is called the AB face technique. Methods In this study, we describe seven clinical cases: two cases each of oval, heart, and round, and one case of angular shape. Results The evaluation of the face shape can help us define the priorities of the aesthetic approach, determining the areas that need to be restored in the aging face, as well as which areas could be enhanced in the younger patient. Conclusion This approach can be helpful in proposing the aesthetic treatment plan with injectable fillers to provide beautification, rejuvenation, and enhancement of the facial structure, which may benefit facial contours through aging.

Section: Methodsmentioning

confidence: 99%

The Facial Shapes in Planning the Treatment with Injectable Fillers

Braz¹,

Eduardo²

2020

“…19 The most severe complication is the vascular compromise. [20][21][22][23] This is why the knowledge of anatomy is very important to apply the adequate technique. 6,14 It is important to inject slowly, with low pressure, in the correct plane.…”

Section: Adverse Eventsmentioning

confidence: 99%

“…6,14 It is important to inject slowly, with low pressure, in the correct plane. 20,23 It is paramount to perform the reflux maneuver aspiration for some seconds before the injection, especially when using a needle. If blood is seen in the syringe, the injection must be interrupted, and the needle withdrawn from the skin, to avoid undesired placement of the product into a vessel, which can lead to embolization and ischemia.…”

Section: Adverse Eventsmentioning

confidence: 99%

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Reshaping the Lower Face Using Injectable Fillers

Braz¹,

Eduardo²

2020

The lower third is very important for the pleasant appearance of the face. A well-contoured jawline is desirable in men and women, giving a perception of beauty and youth. It is also key to sexual dimorphism, defining masculine and feminine characteristics. The nonsurgical rejuvenation and beautification of the lower third of the face is becoming more frequent. Injectable fillers can reshape the jawline, lift soft tissues, and improve facial proportions, effectively improving the appearance of the area.It is paramount to understand the facial anatomy and perform a good facial assessment in order to propose a proper aesthetic treatment plan. The aesthetic goal of the rejuvenation approach is to redefine the mandibular angle and line. In young patients, beautification can be achieved through correction of constitutional deficit or enhancement of the contour of the face, improving the facial shape. It is very important to possess knowledge of facial anatomy and of the aging process in order to deliver effective and safe results.In this article, we discuss the anatomy of the lower third of the face, facial assessment, aging process, and treatments of the chin, prejowls and mandibular line and angle with injectable fillers. The authors’ experience in the approach of this area is discussed.

“…Further treatment with hyaluronic acid (HA) fillers, according to the principles of myomodulation, is instituted one month after BoNTA in patients with suitable selection criteria for the use of HA fillers. 25 In the author's practice, fillers are performed in patients with stable FNP at least 1 year after the acute event. Zygomaticus function and balance may be strengthened by insightful placement of HA fillers, with the functionality of the orbicularis oculi muscle enhanced by HA placement in the underlying medial and lateral suborbicularis oculi fat pad (SOOF).…”

Section: Practical Guidelinesmentioning

confidence: 99%

The Treatment of Facial Asymmetry with Botulinum Toxin: Current Concepts, Guidelines, and Future Trends

Heydenrych

2020

This article will describe facial asymmetry secondary to facial nerve paralysis (FNP), and review current concepts, guidelines, and future trends. Despite the increasing use of botulinum toxin (BoNTA) in treating FNP, ideal dosage, timing, and additional therapies are not unequivocally established. Facial asymmetry significantly impacts quality of life (QOL) by strongly affecting self-perception and social interactions; injectables may mediate great clinical improvement. This article provides practical guidelines for the use of BoNTA and provides schemes for accurate assessment and documentation. A systematic, stepwise approach is recommended with methodical assessment, meticulous placement, conservative dosage, and careful follow-up. Future trends include the potential use of newly developed toxins, muscle modification with fillers, improved imaging techniques, and targeted QOL studies. Hopefully, a growing number of aesthetic injectors may become technically proficient and join multidisciplinary teams for managing FNP.