HA fillers have an impressive safety record. Despite this impressive safety record, adverse events occur when injecting HA fillers. It is important to be familiar with potential complications and management. Complication can be divided into early and delayed in time of occurrence, and minor and major in severity. Early minor complications include bruising, pain, edema […]
Injection Insert the needle into the middle to deep dermis. You may stretch the skin to aid insertion. The contour of the needle should be BARELY or NOT visible depending on the type of filler and the type of wrinkle being injected. If you are injecting using the threading technique, then remember to apply even […]
PRECAUTIONS Restylane is packaged for single patient use. Do not resterilize. Do not use if package is opened or damaged. Based on U.S. clinical studies, patients should be limited to 6.0 mL per patient per treatment in wrinkles and folds such as nasolabial folds and to 1.5 mL per lip per treatment. The safety of […]
The results of the blinded evaluator assessment of NLF wrinkle severity for Restylane and control (Perlane) are presented in Table 15. In the primary effectiveness assessment at 12 weeks, 77% of the Restylane and 87% of the control patients had maintained at least a 1-point improvement over baseline.
In 1893, the first fat auto-grafting was performed by Dr. Neuber, who successfully auto-grafted fat into the infraorbital margin in a man with tuberculous ostitis. In 1980’s Dr. Fournier injected fat from liposuction surgery. Average fat survival rate was around 25%. Bovine collagen was developed in the 1970’s and Zyderm implant was FDA approved in 1983.
Eyelid skin is thin and elastic, with no underlying subcutaneous fat. Orbicularis oculi, is an elliptical muscle that closes the eyelids and acts as the sphincter of the eye. Orbicularis oculi has three parts: orbital, palpebral and lacrimal. The lacrimal part connects to the lacrimal sac and inserts on the upper and lower eyelids at the tarsal plate.
The vertical frontalis muscle is responsible for the formation of the horizontal forehead lines (HFL). Dysport can be used off-label to smooth these wrinkles. The frontalis muscle inserts into the periocular muscles such as the procerus, corrugator supercilii, orbicularis oculi, and depressor supercilii.
The glabellar complex consists of the two corrugator supercilii muscles and the procerus muscle. These muscles pull depresses and medially contract the eyebrows. The corrugator supercilii typically lie horizontally from medial eyebrow to near the mid-pupillary position.
Patients treated concomitantly with botulinum toxins and aminoglycosides or other agents interfering with neuromuscular transmission (e.g., curare-like agents) should be observed closely because the effect of the botulinum toxin may be potentiated.
Three double-blind, randomized, placebo-controlled, clinical studies evaluated the efficacy of Dysport® for use in the temporary improvement of the appearance of moderate to severe glabellar lines. These 3 studies enrolled healthy adults (ages 19—75) with glabellar lines of at least moderate severity at maximum frown.