Background Hyaluronic acid filler injection is commonly administered to correct temple hollowness, typically through deep temporal injection. Since the vascular distribution at the injection site can be diverse, studies on avoiding damage to the corresponding blood vessels are needed. Aims To assess the commonly used hyaluronic acid filler injection site in the temple region, 1cm lateral and 1 cm above from the end of eyebrow, using a Doppler ultrasound to detect any anatomic variations in the blood vessels. Patients/Methods Thirty patients (60 temples, right and left) were examined using Doppler ultrasonography. An 8‐17 MHz ultrasound probe was used to discriminate between the anatomic layers of the temple. Blood vessels found in each anatomical layer were subsequently investigated. Results Among the 30 patients included in this study, we found temporal region arteries 1 cm above and 1 cm lateral to the distal end of the eyebrow in 9 patients; However, no arteries were detected in the temples of 21 patients. The presence or absence of arteries was bilateral in all patients. Conclusions The anatomical layers with blood vessels varied among patients. The variability could give rise to complications. Possible anatomic variations at the temple should be carefully identified using pre‐injection ultrasonography, and harming blood vessels should be avoided while injecting hyaluronic acid filler for temple augmentation.

Background Deviated noses and asymmetric nostrils can be corrected using corrective rhinoplasty. However, after proper correction, adjacent facial mimetic muscles can cause recurrence of asymmetry because of preoperative habits. Objectives We performed this study to investigate the effects on botulinum toxin on the prevention of recurrence of asymmetry after corrective rhinoplasty. Methods From January 2016 to December 2019, 60 patients underwent corrective rhinoplasty and 30 received botulinum toxin type A injection (Botulax; Hugel Co.) at the depressor septi nasi and levator labii superioris alaeque nasi muscles, bilaterally. Vertical and horizontal deviations were compared preoperatively and postoperatively. Results Postoperative vertical deviation was 0.20° ± 0.65° in the botulinum toxin–injected group and 1.20° ± 0.53° in the control group (P < 0.0001). Horizontal deviation was 0.80° ± 0.52° in the botulinum toxin–injected group and 2.18° ± 0.42° in the control group (P < 0.005). Differences between preoperative and postoperative vertical deviations at 6 months were 2.30° ± 0.03° in patients who received botulinum toxin injection and 1.10° ± 0.22° in controls (P < 0.005). Conclusions Botulinum toxin effectively restricted the paranasal muscles without any significant adverse events. We recommend injecting botulinum toxin after corrective rhinoplasty to prevent recurrence of deviation by facial mimetic muscles.

Background and ObjectivesSurgery for harvesting costal cartilage is often required for revision septorhinoplasty due to a lack of septal cartilage in patients with a severely contracted nose, and postoperative scarring on the anterolateral rib cage commonly requires additional treatment. This study aimed to evaluate the therapeutic efficacy and safety of combined polydeoxyribonucleotide (PDRN) and microlens array (MLA)-type nanoseconddomain neodymium (Nd):yttrium-aluminum-garnet (YAG) laser treatment for postoperative scars after costal cartilage harvest surgery. Materials and MethodsNine Korean patients with scars after costal cartilage harvest surgery treated with PDRN injections and MLA-type Nd:YAG laser treatments were retrospectively reviewed. ResultsMost of the scar lesions exhibited clinical improvement at 2 weeks after PDRN and MLA-type nanosecond-domain laser treatments, and the lesions further improved after adding more treatment sessions. The median Vancouver Scar Scale (VSS) score decreased from 6 (interquartile range [IQR]: 6-7) before combined intralesional PDRN injection and MLA-type, nanosecond-domain Nd:YAG laser treatments to 3 (IQR: 2-4) thereafter. Patient satisfaction after the combination treatments was rated as satisfactory. None of our patients reported major adverse events. ConclusionThis case series study demonstrated that combined PDRN and MLAtype, nanosecond-domain Nd:YAG laser treatments are effective and safe for treating scars from costal cartilage harvest surgery.

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