Background The measured intra-arterial volume of cadaveric ophthalmic arteries was used for safety recommendations during facial soft tissue filler injections. However, its clinical practicability and model applicability has become questionable. Objectives To measure the volume of the ophthalmic artery in living individuals by utilizing computed tomography (CT) imaging technology. Methods A total of n = 40 Chinese patients (23 males, 17 females) were included in this study with a mean age of 61.0 (14.2) years and a mean body mass index of 23.7 (3.3) kg/m2. Patients were investigated using CT-imaging technology to evaluate the bilateral length, diameter and volume of the ophthalmic artery as well as the length of the bony orbit resulting in a total of n = 80 investigated ophthalmic arteries and orbits. Results Independent of gender, the average length of the ophthalmic artery was 80.6 (18.7) mm, the calculated volume of the ophthalmic artery was 0.16 (0.05) cc and the minimal and maximal internal diameter of the ophthalmic artery was 0.50 (0.05) mm and 1.06 (0.1) mm, respectively. Conclusions Considering the results obtained from the investigation of n = 80 ophthalmic arteries it needs to be concluded that current safety recommendations must be re-evaluated. The volume of the ophthalmic artery seems to be 0.2 cc rather than 0.1 cc as previously reported. In addition, it seems to be not practical to limit the volume of soft tissue filler bolus injections to 0.1 cc due to the aesthetic requirements of each individual patient and treatment plan.
BACKGROUND Hyaluronic acid (HA) fillers have been studied extensively on the face; however, their safety and efficacy on the neck has not yet been evaluated in a prospective trial in the United States. OBJECTIVE Analyze the efficacy and safety of a HA filler for static horizontal neck rhytides using either a cannula or needle. MATERIALS AND METHODS Twenty-six subjects were randomized to receive up to 1 mL of the HA filler Restylane Refyne (HARR, n = 20) or saline (n = 6) using a cannula on one side and a needle on the other with optional repeat treatment. Subjects were graded using the Transverse Neck Line Scale, Canfield photography, and the Global Aesthetic Improvement Scale. RESULTS A significant improvement 30 days after the last treatment was achieved on the Transverse Neck Line Scale when comparing HARR with saline according to the blind evaluator, subjects, and investigator without any significant side effects. In addition, the blind evaluator, subjects, and investigator rated the side of the neck injected with a needle as having significantly greater improvement than the cannula. CONCLUSION The hyaluronic acid filler, Restylane Refyne, achieved significant improvement in static horizontal neck rhytides using either a cannula or needle without any serious side effects, although the needle was more effective.
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