Safe Planes for Injection Rhinoplasty: A Histological Analysis of Midline Longitudinal Sections of the Asian Nose

Tansatit, Tanvaa; Moon, Hyoung-Jin; Rungsawang, Chalermquan; Jitaree, Benrita; Uruwan, Sukanya; Apinuntrum, Prawit; Phetudom, Thavorn

doi:10.1007/s00266-016-0621-1

Cited by 43 publications

(39 citation statements)

References 15 publications

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“…They also found that in 14% of their cadaveric specimens, the dorsal nasal artery crossed the midline at the middle third portion of the nose. This study demonstrated that an injection perpendicular to the midline would puncture the artery in cases where the artery travels across the midline . Choi et al indicated that the dorsal nasal artery was superficial to the muscular layer at the upper (bony) portion of the nose, but beneath the fibromuscular layer at the middle (cartilaginous) portion.…”

Section: Discussionmentioning

confidence: 80%

“…Smaller syringes are preferred to larger ones as a small needle necessitates slower injection and is less likely to occlude vessel . Recent studies suggest that fillers should be injected into the preperiosteal deep fatty layer, between the perichondrium/periosteum and the muscle layer, where major blood vessels are not known to be located, to avoid vascular compromise . Although many techniques have been attempted, vascular complications related to filler injection have been reported and no proven safe method has been established.…”

Section: Introductionmentioning

confidence: 99%

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Nasal dorsum augmentation using soft tissue filler injection

Lee¹,

Kim

et al. 2019

J of Cosmetic Dermatology

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Background: Soft tissue filler injection is a common procedure for augmentation rhinoplasty. Various techniques for augmenting the nasal dorsum using a soft tissue filler have been attempted considering the size of the needle, the anatomical layer where the filler is injected, and the vascular distribution. The purpose of this paper was to evaluate the course of the dorsal nasal artery in patients scheduled for nasal augmentation using a soft tissue filler and to propose a method of nasal augmentation that minimizes vessel damage during soft tissue filler injection by confirming the distribution pattern of blood vessels through ultrasound.Methods: Patients underwent augmentation rhinoplasty using a soft tissue filler. All patients underwent ultrasound examination before the filler injections.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Nasal dorsum augmentation using soft tissue filler injection

Lee¹,

Kim

et al. 2019

J of Cosmetic Dermatology

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“…The dorsal nasal artery supplies the nose after perforating above the medial palpebral ligament at the orbit and then creates an anastomosis with the contralateral dorsal and lateral nasal arteries. Anatomical studies have shown that the dorsal nasal arteries course above the deep fatty layer and beneath the fibromuscular layer of the nose . This vessel also runs through the subcutaneous layer; thus, a superficial injection may cause vascular compromise.…”

Section: Discussionmentioning

confidence: 99%

Ocular complications of soft tissue filler injections: A review of literature

Lee¹,

Koh

et al. 2019

J of Cosmetic Dermatology

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Background Soft tissue filler is commonly used for facial contouring. However, incorrect use can lead to severe ocular complications. Even though filler injections are quite different from fat grafts, they are considered similar procedures. However, to date, there are no proven preventive measures or treatments for blindness secondary to soft tissue filler injections. Objectives This literature review aimed to investigate visual compromise secondary to soft tissue filler injection and discuss the related vascular anatomy, pathophysiology, and prevention of ocular complications of soft tissue filler injections. Methods A literature search until July 2018 was performed for reports on visual compromise after filler injections. We evaluated the previous literature and eliminated cases using fat grafts and unknown fillers. Results A total of 50 reports of filler‐induced visual compromise were identified. Analysis of these cases showed that the procedure with greatest risk was nasal augmentation, followed by glabellar wrinkle treatment. Within the last 3 years searched, 35% of reported cases involved treatment of the nose. There were no reports of blindness from injections into the temple or chin and relatively few case reports involving forehead injections. Conclusion The most common injection site associated with blindness in a previous report was the glabella; however, the most common site currently associated with blindness due to filler injections was the nose. Extreme caution is necessary when performing nasal augmentation or glabellar wrinkle correction using soft tissue fillers to avoid the branches of the internal carotid artery.

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“…20 The needle or cannula is inserted obliquely over the mid-dorsum and directed epiperiosteally in a cranial and then caudal direction, delivering 0.5 to 1.0 mL Artecoll in each direction. 21 Alternately, a 1-inch cannula is inserted parallel through a nostril, and the space of the missing bridge is filled during withdrawal. The implant is then molded with slight pressure and the patient is advised to continue using slight pressure for molding for another week if indicated.…”

Section: Underdeveloped Nasal Bridgementioning

confidence: 99%

Facial Volume Restoration with Permanent Dermal Filler (Artecoll-4) in Chinese Women

Luo

Wang

et al. 2017

Facial plast Surg

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Artecoll is the only permanent dermal filler to be approved by the European Union and China Food and Drug Administration, and has been used worldwide since 1994 in approximately 400,000 patients. Since 2002, Artecoll-4 has also been injected in China in more than 42,000 patients in more than 100 hospitals, primarily for beauty refinement in younger patients and for rejuvenation of the aging face. Artecoll-4 consists of polymethylmethacrylate (PMMA) microspheres (20% by volume) 40 µm in diameter, suspended in 3.5% bovine collagen solution and 0.3% lidocaine. The collagen carrier is absorbed rather early after injection and is completely replaced by the patient's own connective tissue within the first 3 months. Thus, in contrast to all other fillers, Artecoll-4 becomes the patient's own tissue, and it is a “living implant.” In this study, a total of 10,725 patients were treated in 25 Chinese cosmetic hospitals between 2007 and 2012. Optimal injection techniques, efficiency and lasting duration, complications, safety, outcome, and statistical results are discussed. The data support the safety and efficiency of large volumes of Artecoll-4 (5–10 mL) injected deep into the faces of Chinese women, who seek to have a smooth oval face without indentations. No foreign body granulomas have been reported since the recommendation for strict epiperiosteal injections. Level of evidence is Level IV, multiple center study.

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Safe Planes for Injection Rhinoplasty: A Histological Analysis of Midline Longitudinal Sections of the Asian Nose

Abstract: This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Cited by 43 publications

References 15 publications

Nasal dorsum augmentation using soft tissue filler injection

Nasal dorsum augmentation using soft tissue filler injection

Ocular complications of soft tissue filler injections: A review of literature

Facial Volume Restoration with Permanent Dermal Filler (Artecoll-4) in Chinese Women

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