215: Soft Tissue Augmentation Flashcards
What are the primary uses of soft tissue fillers?
Soft tissue fillers are used for multiple cosmetic and therapeutic indications.
What are some examples of biodegradable products used as soft tissue fillers?
Examples of biodegradable products include hyaluronic acid, collagen, calcium hydroxylapatite, and poly-L-lactic acid.
What are superficial rhytides and what causes them?
Superficial rhytides are wrinkles caused by solar damage, characterized by loss of collagen at the dermal-epidermal junction (DEJ) and increased elastosis in the reticular dermis.
What is the threading technique in soft tissue augmentation?
The threading technique involves the deposition of filler in a linear fashion along the track of the needle as it is being withdrawn.
What is a significant complication associated with soft tissue fillers?
A significant complication is vascular occlusion, which can lead to local necrosis, CNS infarction, or blindness, especially with collagen and hyaluronic acid fillers.
What is the advantage of the push-ahead technique in injection?
The push-ahead technique allows injectable material to flow from the tip of the needle, hydrodissecting the tissues as it flows, which is advantageous in areas prone to bruising (e.g., upper lid, brow).
What are some other complications that can arise from soft tissue augmentation?
Other complications include ecchymosis, edema, extrusion, foreign body reactions, pigmentary alterations, injection site scarring, overcorrection, undercorrection, misplacement, and infection.
What technique would you use to inject a filler in an area prone to bruising, such as the upper lid or brow?
The push-ahead technique is ideal for areas prone to bruising. It involves anterograde injection, where the material flows from the needle tip and hydrodissects tissues as it flows.
What is the most devastating complication of soft tissue filler injections, and how can it be minimized?
Vascular occlusion is the most devastating complication, potentially causing local necrosis, CNS infarction, or blindness. It can be minimized by exerting minimal pressure, using blunt cannulas, and keeping the needle or cannula moving.
What is the recommended technique for diffuse coverage of a large area during filler injection?
The crosshatching technique is recommended. It involves layering linear threads in succession, followed by a second series of rows at right angles to the first.
What is the recommended technique for injecting fillers in areas with deep folds or near the bone?
The depot technique is recommended, where small ‘pearls’ of filler are deposited serially along a fold or deep by the bone.
What is the purpose of using a blunt cannula for fat transfer during filler procedures?
A blunt cannula minimizes the risk of vascular occlusion and tissue trauma during fat transfer.
What is the recommended technique for injecting fillers in areas with bruising?
The push-ahead technique is recommended for areas with bruising, as it hydrodissects tissues and minimizes trauma.
A patient experiences ecchymosis after filler injection. What is the likely cause, and how can it be minimized?
Ecchymosis is likely due to vascular trauma during injection. It can be minimized by using a blunt cannula and applying gentle pressure.
What are the primary uses of soft tissue fillers in cosmetic and therapeutic applications?
Soft tissue fillers are used for multiple cosmetic and therapeutic indications, including facial rejuvenation and correction of superficial rhytides.
What is the advantage of using subcutaneous volumizers in facial rejuvenation?
Subcutaneous volumizers provide long-lasting results, making them effective for facial rejuvenation.
Describe the threading technique in soft tissue augmentation.
Threading involves the deposition of filler in a linear fashion along the track of the needle as it is being withdrawn, allowing for controlled placement of the filler.
What is the fanning technique in soft tissue filler injection?
Fanning is a type of threading where the needle is withdrawn to create a new track radially adjacent to the last, rather than inserting the needle into a new area each time.
How does the push-ahead technique work in soft tissue augmentation?
In the push-ahead technique, injection is made in an anterograde fashion, allowing the injectable material to flow from the tip of the needle and hydrodissect the tissues as it flows.
What is the depot technique in soft tissue filler application?
The depot technique involves depositing small ‘pearls’ of filler serially along a fold or deep by bone, allowing for targeted augmentation.
What is crosshatching in the context of soft tissue fillers?
Crosshatching is a technique where linear threads are lined up in succession, with a second series of rows layered at right angles to the first, allowing for diffuse coverage of an area.
What is the proposed mechanism behind central occlusive events during filler injections?
Central occlusive events are theorized to occur due to high pressure injections that cause retrograde flow into arterioles connecting with the internal carotid system.
What are some strategies to minimize the risk of vascular occlusion during filler injections?
To minimize the risk of vascular occlusion, it is recommended to exert as little pressure as possible, use blunt cannulas for fat transfer, and keep the needle or cannula moving during injection.
List some common complications associated with soft tissue filler injections.
Common complications include ecchymosis, edema, extrusion or drifting of the filling substance, foreign body reactions, pigmentary alterations, injection site scarring, overcorrection, undercorrection, misplacement, and infection.