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LVL7 revision > Lower Third - Dermal Filler > Flashcards

Lower Third - Dermal Filler Flashcards

(66 cards)

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1
Q

Juvederm

A

Volift (body)
Volbella (border)

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2
Q

Teoxane

A

RHA 3 or RHA kiss (volume)
RHA 2 (Hydration)

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3
Q

Filler longevity

A

3-8 months

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4
Q

Rickett’s line

A

Lateral profile

Nasal tip to chin

Upper lip 4mm from line
Lower lip 2mm from line

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5
Q

Natural lip symmetry

A

Upper lip 70-80% of lower lip volume

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6
Q

GK point

A

Peaks of the cupids bow

The Glogau-Klein points, coincide with the philtral columns

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7
Q

White lip

A

Philtral dimple
Philtrum columns/ridges
Melolabial/nasolabial folds, Cupid’s bow
Vermilion border

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8
Q

Da Vinci’s golden ratio

A

1:1.618

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9
Q

White roll

A

White roll is the white line that borders the top of the upper lip - caucasian

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10
Q

Arterial supply

A

Superior labial artery - First 1-2cm run superficially before penetrating deep

inferior labial artery

Layer 4 deep to muscle

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11
Q

Lip tubercules

A

Subcutaneous fat pads within the lip

3 top
2 bottom

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12
Q

Layer 3 in the lip

A

Orbicularis oris

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13
Q

Prognathic mandible

A

jaw protusion

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14
Q

Retrognathic jaw

A

jaw recession

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15
Q

Layer of labial arteries

A

78% submucosal - layer 4
17.5% intramuscular
2% subcutaneous

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16
Q

Vermillion border treatment

A

Generally avoid in young patients

Risk of migration and ledge formation

Superficial retrograde linear threads 0.025ml with needle

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17
Q

Body of lip treatment

A

Width of nose - medial

Tubercule treatment

Layer 2

Bolus, fan and linear threads

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18
Q

Post procedure swelling

A

up to 10 days

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19
Q

Anatomy of the nasolabial fold

A

Begins at nose ala

extends through inferior cheek and the upper lip

straight, convex or concave shape

ends below lateral corner of the mouth

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20
Q

How to assess the nasolabial fold

A

Upright position

assess for volume loss in the midface

is skin fibrosed in the crease

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21
Q

Technique for nasolabial fold filler

A

Linear threads along fold

Fanning in alar-facial groove

Medial fanning with significant volume lost

As much as 0.8-1ml filler

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22
Q

Type of filler for nasolabial fold

A

Mid- to high viscosity

Juvederm Vollure or Voluma

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23
Q

Features that are inappropriate for NF filler alone

A

thick fibrosed skin

severe deficit in the mid midface

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24
Q

Relation of facial artery to nasolabial fold

A

43% of cases within 5mm of NLF

34% of cases artery crosses NLF

then transitions into angular artery

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25
Which layer is the facial artery found in the lower face
subcutaneous layer
26
How does filler cause blindness
central retinal artery occlusion embolisation of filler through arterial anastamosis
27
Areas for filler in the lower face
Nasolabial folds Piriform fossa Lips Marionette lines Prejowl sulcus
28
What are marionette lines
downturning of the angle of the mouth crease from oral commisure extending to mandible
29
Cannula entry point for nasolabial fold
Base of nasolabial fold
30
Lip and peri-oral targets of treatment
Smokers lines Vermillion Border Philtrum Lip volume
31
Lip differences between men and women
Women - fullness concentrated within width of nose Men - within width of chin
32
Cannula technique for lip
entry point .5cm lateral to oral commisure Cannula remains in layer 2
33
Natural lip symmetry
upper lip 70-80% volume of lower lip
34
Nerve supply to lips
maxillary and mandibular branches of trigeminal nerve
35
Muscle which contributes towards marionette lines
Depressor anguli oris
36
Aging in the lower third
atrophy of the submandibular fat compartments, dehiscence of the mandibular septum leads to descent of the fat compartments toward the neck.
37
Treatment of marionette lines
oral comissure bolus to support lip corners Cannula in subcutaneous layer Fanning and retrograde linear threads
38
Volume of filler for marionette folds
0.5-1ml per side
39
Mental crease filler
Medium g prime, soft filler Corrects volume loss in depression beteen body of mentalis and lower lip Needle
40
Layers of the gonial angle
1. Skin 2. Subcutaneous fat 3. SMAS 4. Parotidomasseteric fascia 5. Parotid gland 6. Masseter 7. Mandible
41
Jowl fat pad framing ligaments
mandibular ligament anteriorly masseteri ligament posteriorly
42
gonial angle
wider in females
43
Order of treatment in lower third
chin - supraperiosteal bolus gonial angle - supraperiosteal bolus pre jowl sulcus - supraperiosteal bolus then subcutaneous treatments
44
gonial angle volume & injection point
0.2 - 0.5ml - 1cm into angle
45
chin volume and injection
0.2 - 0.3ml either side of midline
46
pre jowl sulcus volume
0.1-0.3 ml
47
labiomental crease cannule entry point
tail of crease
48
Where to avoid adding volume in the lower face
subcutaneous layer jowl fat pad - buccal area of the mandible
49
Mental zone - How to treat belnd chin and jowl
Chin to mandibular ligament subcutaneous cannula insertion point at chin cannula reaches resistance at mandibular ligament retrograde linear threads
50
Masseteric zone - Masseteric ligament to gonial angle treatment
subcutaneous insertion at masseteric ligament - posterior border of the jowl cannula passes across mandibular line to mandible
51
Masseteric zone - Ascending ramus of mandible treatment
subcutaneous insert cannula at gonial angle injecting upwards avoiding parotid gland
52
Treatments to define jaw 3 - bone 3 - subcutaneous
Chin, pre jowl sulcus , gonial angle mental zone, masseteric zone (ascending ramus and masseter to gonial angle)
53
How does mental crease form
loss of bondy support to mentalis causing upwards rotation
54
Causes of temple howllowing
HIV lipoatrophy Skeletonisation of the orbital rim
55
Temple needle technique
8mm needle supraperiosteal 45 degree angle, entry behind fronto-zygomatic process do not aim for full correction to avoid venous congestion soft filler
56
Temple important structures
Superficial temporal artery and vein in the superficial fascia temporal branch of facial nerve
57
Facial muscles affected my temporal nerve
frontalis orbicularis oculi corrugator supercilli
58
Temple cannula technique
superficial fascia medium G prime product hand palpates lateral orbital rim and superior temporal crest to avoid spread of product massage
58
temple injection after care
expect jaw pain - muscle of mastication temporalis exits beneath SMAS periosteal is an intramuscular injection
59
Dangers of treating galeal area
Should be done with cannula risk to supraorbital and supratrochlear arteries supraorbital foramen - inject atleast 1.5cm away
60
Tear trough product selection
Teosyal puresense redensity mixed crosslinked and noncrosslinked
61
Tear trough treatment technique (deep)
infraorbital sulcus and area medial to nasojugal groove treated together 25G cannula, entry point 1cm away from end of tear trough zygomatic space deepto SOOF to restore volume
62
The tear trough ligament (TTL)
a osteocutaneous ligament from the maxilla and inserting into the skin, along the location of tear trough
63
Infraoribital fat anatomy
Seperated by oribularis oculi superficial malar fat pad deep suborbicularis oculi fat (SOOF)
64
Tear trough treatment technique superficial
27G cannula subcutaneous entry point - intersection of verticle lateral canthus line to horizontal nasal ala line
65
Filler brow lift
Restore volume to retroorbicularis fat pad and sub brow fat pads inject deep to orbicular occuli avoiding structures exiting supraorbital foramen linear thread deposots

LVL7 revision (18 decks)

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