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LVL7 revision > The Midface - Dermal filler > Flashcards

The Midface - Dermal filler Flashcards

1
Q

Borders

A

Glabella to subnasale

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2
Q

Type of filler used

A

High G prime

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3
Q

Juvederm

A

Voluma deep fat
Volift superficial fat

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4
Q

Teoxane

A

Teosyal Deep/RHA4

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5
Q

Belotero

A

Volume

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6
Q

Injection technique

A

Supreperiosteal bolus
Cannula

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7
Q

Compartments

A

Zygomatic Arch
Lateral cheek
Apex
Medial cheek

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8
Q

Hinderers lines

A

Intersecton of lines for the cheek apex

  1. Horizonal line nose ala to tragus
  2. Diagonal line lateral canthus to oral commissure
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9
Q

Midface superficial fat pads - layer 2

A

Infraorbital
Nasolabial medial - increases with age
Middle cheek
Lateral cheek - reduces with age
Temporolateral

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10
Q

Midface deep fat pads - layer 4

A

Medial + Lateral portions of SOOF (suborbicularis oculi fat) - divded by lateral canthus

Deep medial
Deep lateral

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11
Q

Vasculature

A

Facial (angular branch)

infraorbital arteries (branch of maxillary artery)

Transverse facial artery (branch of superficial temporal artery)

Facial vein more lateral to artery

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12
Q

Sensory innervation

A

Maxillary branch of trigeminal nerve - emerges from the infraorbital nerve

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13
Q

Motor innervation

A

Zygomatic and buccal branch of facial nerve - arrises deep to parotid gland

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14
Q

Bone aging process

A

Maxilla recession
Maxillary angle reduces
Orbits widen

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15
Q

SMAS

A

Superficial Musculoaponeurotic System

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16
Q

Lymphatics

A

Medial and lateral channels

Submandibular and parotid nodes respectively

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17
Q

Wilkinsons’ line

A

Vertical line from Lateral canthus to mandible - apex is 1/3 of line from lateral canthus

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18
Q

Ogee curve

A

enhance the contours of the face along the Ogee Curve to create a more youthful and balanced appearance

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19
Q

Men vs women mid face

A

Cheek bone is flatter in men

Apex is more medial and lower in men

Women have more medial SC fat

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20
Q

Supraperiosteal technique for cheek filler

A

0.2ml at apex, followed by 3 x 0.1ml injections along zygoma

21
Q

Piriform fossa

A

Treat maxillary recession

Improving nasolabial fold appearance

22
Q

Piriform fossa technique

A

Supraperiosteal bolus

Pull lateral tisses away to move facial artery laterally in layer 2

Aim needle towards contralateral oral commisure - 45 degress onto bone

Aspirate for 5-10 seconds

0.3ml filler

23
Q

Order of treatment in mid face

A

Apex

Zygomatic arch

Piriform fossa

24
Q

Cannular entry point for deep cheek filler

A

Medial cheek fat apex

Insert pilot needle in vertical line with lateral orbit

Pass through SMAS into deep planes

25
Q

Cannular entry point for nasiolabial fold

A

Base of nasolabial fold

Cannula passes through layer 2

26
Q

Ligament of the midface

A

Orbicularis retaining ligament

Zygomatic cutaneous ligament

27
Q

Aging process in the midface

A

resorption of maxilla bone

maxillary angle reduces

pyriform apeture of nose widens

orbit widens

28
Q

Layer 4 components

A

SOOF - suborbicularis oculi fat (medial and lateral)
DLCF - deep lateral cheek fat
DMCF - deep medial cheek fat

29
Q

Location of SOOF

A

inferior to orbicularis retaining ligament

superior to zygomatic cutaneous ligament

30
Q

What is the SMAS

A

Layer 3

Superficial musculoaponeurotic system

Fibrous continuation of facial muscles

Tightens with layer 4 expansion

31
Q

Superficial fat pads which hypertrophy with age

A

Nasolabial

32
Q

Superficial fat pads which atrophy with age

A

Lateral cheek fat pad

33
Q

Transient piriform fossa filler side effect

A

Temporary upper lip anaesthesia from lidocaine infiltration to trigeminal nerve

34
Q

Terminal branch of the facial artery

A

Angular artery

becomes the angular artery after the lateral nasal artery branch

35
Q

Artierial supply in the midface

A

Transverse facial artery
Infraorbital artery
Facial artery

36
Q

Aspiration length

A

5-10 seconds

37
Q

What divides the medial and lateral SOOF

A

Lateral canthus of the eye

38
Q

Glide planes of the midface

A

Pre-septal space
Pre-zygomatic space
Buccal space

39
Q

What technique addresses maxillary recession

A

Deep piriform space filler

40
Q

Technique of piriform fossa injection

A

pull tissues laterally

needle aimed towards contralteral oral commissure at 45 degree angle

Supraperiosteal bolus up to 0.3ml filler

41
Q

Supraperiosteal treatments of midface

A

Cheek apex - zygomatic bone

Lateral cheek - zygomatic arch - zygomatic bone & temporal bone

Piriform fossa - maxilla

42
Q

Point of insertion of cannula in midface deep fat pad treatment

A

Vertical plane of lateral orbit

43
Q

Deep fat pad targets for treatment

A

deep medial and lateral cheek pad

44
Q

Superficial targets for treatment

A

Lateral fat pad - Pre auricular

Nasiolabial fold

45
Q

Point of insertion for lateral superficial fat pad treatment

A

Vertical plane of anterior masseter

46
Q

Lateral cheek fat pad/preauricular treatment technique

A

Cannular fanning with mid-prime

47
Q

Layer of prezygomatic space

A

layer 4

48
Q

Movement of the facial fat pads

A

Deep - static

Superficial - dynamic - use soft filler that moves with expression

49
Q

Pre-zygomatic space borders

A

posterior - preperiostel fat

anterior - SOF

ORL - superiorly

zygomatic ligament - inferiorly

LVL7 revision (18 decks)

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