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Dermal fillers guide: injection techniques and complication management
- 2. Dermal fillers are gel-like substances injected beneath the skin for the restoration of lost volume, smooth lines, and softening the creases, or enhancement of the facial contours Three O's of Beauty • Angle Of Beauty 6-9 degrees • Oval Face Shape • O G Curve
- 7. • SKIN • SUPERFICIAL FAT • SMAS • RETAINING LIGAMENTS • DEEP FAT • DEEP FASCIA • BONES
- 8. • THE UPPER THIRD ( TRICHION ) which runs from your hairlines to your brows. • THE MIDDLE THIRD (GLABELLA ) which extends from the brow to you nose tip. • THE BOTTOM THIRD (MENTON) which runs from the nose tip to the narrowest part of your chin.
- 9. • The first and last fifths that cover the ear up to the outer corner of the eye. • The second and fourth fifths that represent the distance between the inner and outer corners of the eye. • The middle fifth is the distance between the inner corners of your two eyes. Horizontal Fifths
- 10. • FOREHEAD • GLABELLA • NASOBIAL FOLD • MARIONETTE LINE • MANDIBULAR & CHIN RESHAPING • NOSE RESHAPING • CHEEK • TEAR TOUGH • LIPS, HAND, TEMPLE
- 13. Assessing a Suspected Vascular Occlusion
- 15. SKIN STAGES OF A VASCULAR OCCLUSION
- 17. SWELLING & ERYTHEMA of lower eyelids and upper malar areas following filler injections TYNDALL EFFECT cause by hyaluronic acid injection into the tear troughst *tyndall : cairan filler yg disuntikan terlalu dekat dengan permukaan kulit, dpt menyebabkan kebiruan. Early Complications
- 18. ERYTHEMATOUS NODULE on the left nasolabial fold with 2 additional superiorly placed 4-mm nodules. BLANCHING over the nasal dorsum and midline forehead area. The blanching indicates likely intravascular cannulation of the angular artery with resulting filling of the dorsal nasal artery and retrograde flow into the ophthalmic artery and one of its branches (the supratrochlear artery)
- 19. NECROSIS Necrosis or darkening of the skin means the loss of living tissue, the amount of which depends on the size of the tissue. When, for any reason, the blood does not reach the tissues of the body and does not receive oxygen, it disappears and turns black.
- 20. AA : Angular artery DNA : Dorsal nasal artery FA : Facial artery LNA : Lateral nasal artery SLA : Superior labial artery
- 21. BIOFILM
- 22. GRANULOMA cystic in nasolabial fold 8 months after injections Late Complications
- 23. MIGRATIONS Filler Migration is defined as the process of dermal filler spreading or “migrating” to another area beyond the site of injection. Whilst migration is mainly spoken about in terms of lip fillers, migration can also happen anywhere that filler is injected. This includes the tear-trough, jawline and also the cheeks.
- 24. HYPERTROPHY SCAR Superficial placement of fillers may be associated with hypertrophic scarring. Superficial placement of fillers rarely resolves with permanent scar, consisting mainly of extracellular matrix components such as collagen, fibroblasts, and small vessels
- 25. TELANGIECTASIA Erythema and, occasionally, permanent telangiectasia may occur at the injection site. In cases with erythema, prolonged intralesional or topical steroid therapy should be avoided because they can induce telangiectasia. And, in patients with telangiectasia, injection of the filler could worsen their appearance and size. Treatment with intense pulsed light therapy or pulsed dye laser can be helpful.