Midface

Cotofana, Sebastian; Schenck, Thilo L.; Trévidic, Patrick; Sykes, Jonathan M.; Massry, Guy G.; Liew, Steven; Graivier, Miles; Dayan, Steve; Maio, Maurício de; Fitzgerald, Rebecca; Andrews, J. Todd; Remington, B. Kent

doi:10.1097/prs.0000000000001837

Cited by 151 publications

(55 citation statements)

References 25 publications

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“…The infraorbital zone is a high-risk zone for the use of hyaluronic acid fillings and is susceptible to the appearance of irregularities, hematomas, blue discoloration, hydrophilic reactions, and potential vascular compromise by compression or direct injection of the filler inside the artery [19]; therefore, indiscriminate filling of this region is not advised.…”

Section: Discussionmentioning

confidence: 99%

Influence of the Topographic Vascular Distribution of the Face on Dermal Filler Accidents

et al. 2019

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Objective: Dermal fillers are an important tool in the field of aesthetic dermatology. Fillers are relatively noninvasive and easy to use but are not free of secondary complications. The main complications are vascular and are due to either the compression of an artery or the direct introduction of the product into the arterial lumen. The aim of this study is to provide an overview of the vascular territories of the face to avoid many possible complications when using facial fillings. Anatomical localization of the main arterial supply to the face has been described to assess the risk of vascular injury. Methods: The authors dissected 17 hemifaces of embalmed adult cadavers that had previously been injected, through the common carotid artery, with latex containing a red dye. Results: A topographic distribution was generated by facial regions following a clinical approach from where the facial fillings were placed and related to the pathways of the arteries. Following these criteria, we established 8 topographic regions (I–VIII) that indicate the main vascular problems of each of these regions. Detailed anatomical localizations of the main arteries in these topographic regions of the face and their relationships are described. Conclusions: The highest index of vascular lesions and especially visual alterations occurred for fillings of the upper third of the face. To prevent and avoid this type of lesion, it is advisable to avoid, as much as possible, treatments with filling materials in the upper third of the face, mainly including the glabellar and nasal region (III) and supraorbital region (VIII).

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Section: Discussionmentioning

confidence: 99%

Influence of the Topographic Vascular Distribution of the Face on Dermal Filler Accidents

et al. 2019

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“…According to the latest study examining the dilution effect of pure HA filler via electron microscopy, there was no change in the ultrastructure after the dilution of 3 commonly used HA fillers [ 24 ]. Next, when injecting the filler, a cannula or needle can be chosen depending on various conditions; a needle is better for making fine contours for injection into a subdermal area above the OOM in a relatively safe plane, but a cannula is recommended to avoid vascular compromise when injecting filler into a deep fat layer under the OOM to compensate for the volume and to release the fibrotic ligamentous structure [ 25 ]. Using a cannula reduces the potential for serious bleeding and vascular compromise in the deep plane of the infraorbital region [ 1 ].…”

Section: Treatment Using Soft-tissue Fillermentioning

confidence: 99%

Definitions of groove and hollowness of the infraorbital region and clinical treatment using soft-tissue filler

Lee

Hong²

2018

Arch Plast Surg

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Clarification is needed regarding the definitions and classification of groove and hollowness of the infraorbital region depending on the cause, anatomical characteristics, and appearance. Grooves in the infraorbital region can be classified as nasojugal grooves (or folds), tear trough deformities, and palpebromalar grooves; these can be differentiated based on anatomical characteristics. They are caused by the herniation of intraorbital fat, atrophy of the skin and subcutaneous fat, contraction of the orbital part of the orbicularis oculi muscle or squinting, and malar bone resorption. Safe and successful treatment requires an optimal choice of filler and treatment method. The choice between a cannula and needle depends on various factors; a needle is better for injections into a subdermal area in a relatively safe plane, while a cannula is recommended for avoiding vascular compromise when injecting filler into a deep fat layer and releasing fibrotic ligamentous structures. The injection of a soft-tissue filler into the subcutaneous fat tissue is recommended for treating mild indentations around the orbital rim and nasojugal region. Reducing the tethering effect of ligamentous structures by undermining using a cannula prior to the filler injection is recommended for treating relatively deep and fine indentations. The treatment of mild prolapse of the intraorbital septal fat or broad flattening of the infraorbital region can be improved by restoring the volume deficiency using a relatively firm filler.

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“…In some parts of the face, another deeper fat pad compartment can be found. The most prominent are the buccal fat pad localised in the Bucco temporal space and serve a metabolic function [ 11 ].…”

Section: Anatomy Of Facial Fat Padsmentioning

confidence: 99%

“…By detailed investigations – both with imaging techniques and cadaveric studies – of deep midfacial fat pads, it became evident that for volumizing one should specifically target these structures. Deep medial cheek fat pads and sup-orbicularis oculi fat pads of layer 4 of soft facial tissue are crucial in midfacial rejuvenation and are used to correct the cheek sagging which is a major aggravating factor for deep nasolabial folds [ 11 , 24 ].…”

Section: Facial Fat Pads and Filler Placementmentioning

confidence: 99%

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Fillers and Facial Fat Pads

Wollina¹,

Goldman²,

Tchernev³

2017

Open Access Maced J Med Sci

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Fillers are used for facial sculpturing and anti-ageing treatments with increasing popularity. The optimal outcome of any filler treatment depends upon different factors: exact indication, known limitations, filler product, and filler placement. For volumizing effect and longevity of procedures, however, the interaction of fillers and facial fat pads seems to be crucial. Here, we will review the optimum filler injections for facial applications in relationship to new data and concepts concerning facial fat pads anatomy and physiology. Such a view will us enable to provide optimum results in aesthetic procedures.

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Midface

Cited by 151 publications

References 25 publications

Influence of the Topographic Vascular Distribution of the Face on Dermal Filler Accidents

Influence of the Topographic Vascular Distribution of the Face on Dermal Filler Accidents

Definitions of groove and hollowness of the infraorbital region and clinical treatment using soft-tissue filler

Fillers and Facial Fat Pads

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