Facial Injections and Blindness

Li, Dan; Zhang, Hengshu

doi:10.1097/sap.0000000000002866

Cited by 6 publications

(4 citation statements)

References 49 publications

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“…Moreover, a visionthreatening complication could occur because the AA is located close to the eye and is connected to an ophthalmic artery in this region. 14 The purpose of the present study was to identify the distribution of the AA in the lateral nasal regions using image superimposition. We also investigated the three-dimensional course of the AA in this region using ultrasonography.…”

Section: Discussionmentioning

confidence: 99%

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Superimposition Study to Determine the Angular Arterial Distribution and its Clinical Application

Shin¹,

Kim²,

Song³

2023

Plastic &Amp; Reconstructive Surgery

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Background:The purpose of this study was to determine the distribution of the angular artery (AA) in the medial canthal area with the aim of defining an arterial course to prevent AA injury during facial surgery in this region. Methods: The authors dissected 36 hemifaces of 18 cadavers. The horizontal distance from the vertical level through the medial canthus to the AAs was measured. The AA course of each specimen was then recorded, and all of them were then superimposed to determine the AA course. The diameter and depth of the AA around the medial canthal area were also investigated using ultrasonography on living subjects. Results:The horizontal distances from the medial canthus level and 2 cm below the medial canthus were 9.0 ± 2.0 mm (mean ± SD) and 1.9 ± 2.4 mm, respectively. The superimposed image demonstrated that most of the AAs were present inside the vertical line through the medial canthus. Ultrasonography indicated that the AA was 2.3 ± 0.9 mm below the skin and 1.7 ± 0.3 mm in diameter. Conclusions:The AA course was relatively constant along the nasojugal fold. The AAs were most often present between the middle of the medial canthus and the facial midline, but were very scarce in both the medial and lateral thirds. Knowledge of the detailed course of the AA may help surgeons to avoid arterial injury and decrease the risk of surgical morbidities around the nasal root and medial canthal area.

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Section: Discussionmentioning

confidence: 99%

“…Moreover, a vision-threatening complication could occur because the AA is located close to the eye and is connected to an ophthalmic artery in this region. 14…”

Section: Discussionmentioning

confidence: 99%

Superimposition Study to Determine the Angular Arterial Distribution and its Clinical Application

Shin¹,

Kim²,

Song³

2023

Plastic &Amp; Reconstructive Surgery

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“…These distal emboli can fully or partially obstruct any component of the arterial tree, including small arterial branches (~400–1000 μm), subcutaneous arterioles (~100–400 μm), terminal (dermal) arterioles (15–100 μm), and capillaries (5–15 μm) [ 148 , 177 , 178 , 179 , 180 , 181 ]. Ultimately, the ischemic insult of FIVO results from the underperfusion of end-organ capillary beds and the amount of filler required to do so depends on the functional configuration of the affected angiosome; specifically, it depends on the presence of true anastomoses and choke vessels [ 182 , 183 ].…”

Section: Pathophysiology Of Ha-mediated Vascular Occlusionmentioning

confidence: 99%

Bridging a Century-Old Problem: The Pathophysiology and Molecular Mechanisms of HA Filler-Induced Vascular Occlusion (FIVO)—Implications for Therapeutic Interventions

Soares

2022

Molecules

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Biocompatible hyaluronic acid (HA, hyaluronan) gel implants have altered the therapeutic landscape of surgery and medicine, fostering an array of innovative products that include viscosurgical aids, synovial supplements, and drug-eluting nanomaterials. However, it is perhaps the explosive growth in the cosmetic applications of injectable dermal fillers that has captured the brightest spotlight, emerging as the dominant modality in plastic surgery and aesthetic medicine. The popularity surge with which injectable HA fillers have risen to in vogue status has also brought a concomitant increase in the incidence of once-rare iatrogenic vaso-occlusive injuries ranging from disfiguring facial skin necrosis to disabling neuro-ophthalmological sequelae. As our understanding of the pathophysiology of these injuries has evolved, supplemented by more than a century of astute observations, the formulation of novel therapeutic and preventative strategies has permitted the amelioration of this burdensome complication. In this special issue article, we review the relevant mechanisms underlying HA filler-induced vascular occlusion (FIVO), with particular emphasis on the rheo-mechanical aspects of vascular blockade; the thromboembolic potential of HA mixtures; and the tissue-specific ischemic susceptibility of microvascular networks, which leads to underperfusion, hypoxia, and ultimate injury. In addition, recent therapeutic advances and novel considerations on the prevention and management of muco-cutaneous and neuro-ophthalmological complications are examined.

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“…Deoxynucleic acid is useful to reduce local fullness in areas of excessive fat accumulation. However, the facial and submental regions are supplied by a complicated neurovascular network; therefore, post-injection complications represent a significant challenge to cosmetologists [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Imaging of Facial Vascular Neural Structures and Relevance to Aesthetic Injections: A Pictorial Essay

Chang

et al. 2022

Diagnostics

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The facial and submental regions are supplied by complicated neurovascular networks; therefore, facial aesthetic injections may be associated with serious adverse events such as skin necrosis and blindness. Pre-injection localization of neurovascular structures using high-resolution ultrasound can theoretically prevent unexpected complications. Therefore, a systematic protocol that focuses on these facial neurovascular structures is warranted. In this pictorial essay, we discuss the sonoanatomy of facial and submental neurovascular structures and its relevance to aesthetic injections. Moreover, we have highlighted the mechanisms underlying potential neurovascular injuries during aesthetic injections.

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Facial Injections and Blindness

Cited by 6 publications

References 49 publications

Superimposition Study to Determine the Angular Arterial Distribution and its Clinical Application

Superimposition Study to Determine the Angular Arterial Distribution and its Clinical Application

Bridging a Century-Old Problem: The Pathophysiology and Molecular Mechanisms of HA Filler-Induced Vascular Occlusion (FIVO)—Implications for Therapeutic Interventions

Ultrasound Imaging of Facial Vascular Neural Structures and Relevance to Aesthetic Injections: A Pictorial Essay

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