Treatment areas Flashcards
- Forehead muscle target
Occiptofrontalis - frontalis fibres
- Brow ptosis risks
Hyperkinetic frontalis patients
Female
Short forehead
Lid laxity
Hooded eyelids
- ‘Mephisto’ ‘Spock’ look
Undesired wrinkling of lateral forehead from undertreatment of lateral fibres
keep lateral injection point 1cm from temporal fusion line
- Lateral injection point for glabella
female - mid pupillary line for brow lift
male - lateral corner of eye
- Treating high forehead
Second line can be placed close to hairline
- Forehead dose & injection points
10-20 units, 5 points
- Glabella line muscle targets
Procerus
Depressir supercilii
Corrugator supercilii
- Glabella dose & injection points
20-40 units
3-5 injections
- Glabella anatomical landmarks for injection
1cm above orbital rim
- Complications of Glabella treatment
Eyelid ptosis - diffusion of toxin to levator palpebrae
treated with 0.5% aproclonidine eyedrops
medial brow drop if placed too high into frontalis
- Brow lift aim
Lift lateral eyebrow
Upper eyelid fullness/hooding
Improve sad/tired look
Address descent of aging
- Brow lift muscle target
lateral fibres orbicularis oculi
frontalis
- Gummy smile
Escessive gum show during smile or laugh, inversion of upper lip whilst smiling
- Muscle targets for gummy smile
Raise and evert the upper lip
Levator labii superioris alaeque nasi
Levator labii superioris
Zygomaticus Minor
Triangle formed by these three muscles
- Gummy smile dose and injection areas
Below the level of orbicularis oris lateral to pirifrom apeture
or 3-5mm lateral to each nostril
Prominent nasiolabial fold - one injection per side 2-4 units targeting LLSAN
Flat nasolabial fold and longer lips - one injection per side targeting LLSAN and LLS 1-2 units
- Gummy smile injections, prominent vs flat nasiolabial folds
Inject lower with flat nasiolabial folds and longer upper lip
- Correcting medial brow ptosis
See if there is residual medial corrugator activity
treatment can restore some lift
- Glabellar injection depths
Procerus - half needle
Medial corrugator - full needle (supraperiosteal attachment)
Lateral corrugator - upper third
Crows feet treatment complications
Diplopia - lateral rectus
Zygomaticus muscles - disrupt the smile
Dry eyes - lacrimal gland affected by deep superior injections
Malar oedema - loss of lymphatic drainage from sphicter action
Dangers of treating infra orbital lines
Risk to intraocular muscles
corneal abrasions if eye closure is affected
Local malar oedema
pseudoherniation of infraorbital fat pad
Dangers of nasalis treatment
2-4 units per side
infiltration into origin of levator labii superioris
affecting lip elevation/smile appearance
Injection points and dose for smokers lines
Targeting orbicularis oris
Up to 4 injection point placed superior to vermillion border
1-2 units per point
2.5-5 SU
Cautions when treating smokers lines
Articulation changes
Intstrument playing
Straw drinking
Upper lip lengthening (lip flip)
Muscles that can accidentally be treated during smokers line treatment
LLSAN
zygomaticus minor
Mentalis - injections and dose
4 units or 10SU
Directly into muscle - midline injection
1.5cm away from lower lip
2 points may be necessary for wider square chins
Cautions when treating mentalis
Avoid depressor labii inferioris - lateral
avoid orbicularis oris - superior
Depressor anguli oris - injections and dose
2 units or 5 SU
approx 1cm lateral and inferior to the corner of the lip
superifical plane
Cautions when treating depressor anguli oris (3)
Too deep will hit the depressor labii
causing smile assymetry
stay medial to anterior border of buccinator muscle
Platysmal bands - injections and dose
2 units or 5SU per point, do not exceed 40 units
unlicesnsed indication
points 2cm intervals along bands
Cautions when treating platysma (4)
cannot correct excess loose skin or fat
deep injection or too much product will cause dysphagia
can affect the layrnx
neck flexion via the sternocleidomastoid
Bunny lines - injection and dose
2 units or 5SU
the pars transverse portion of the nasalis
superficial
single point lateral to nose bridge
Cautions when treating nasalis
Origin of levator labii superioris - smile assymetry
Masseter - injection and dose
20 units or 50SU
injection placed .5-1cm from each border of safe zone
2-4 injections
Safe zone for masseter ijection
anterior - anterior border of masseter
posterior - posterior border of masseter
inferior - inferior endge of mandible
superior - imaginary line from mouth corner to ear lobe
Cautions of treating the masseter (5)
chewing weakness
asymmetry
paradoxical bulging from not treating superfical and lateral planes in harmony
paralysis of marginal mandibular nerve
asymmetric smile - risorius
Hyperhidrosis - injection and dose
prepare 100 units in 4ml
50 units per side
intradermal injections 1-2cm apart
62.5 SU units per side. 125 units in 0.63ml
Hyperhidrosis target
Eccrine Sweat glands - cholinergic
How to prep the axilla
iodine starch to delineate areas of highest sweating
