Description

Dermal Fillers
Facial Anatomy and Injection Techniques

INTRODUCTION

The number of nonsurgical facial enhancements has skyrocketed in the past 10 years. As a consequence of client demand, many practitioners have begun to treat such clients. This manual is a guide and quick reference for the many professionals and paraprofessionals who have be- come facial injectors. It is not, however, a training manual for the naive injector. We highly discourage the novice injector from using this manual as a primer on injections. In our opinion, nothing can replace training that is offered by courses and by one-on-one preceptorships. This manual was designed to augment the knowledge of a beginner injector and to train the experienced injector in how to perform “finesse” injections. The face can be shaped, and minor irregularities and asymmetries improved by performing the techniques we describe. In addition, we hope to help the injector “look through” the skin to the underlying anatomy. This will help to identify both the targets of injection and the important structures to avoid. The products described in the manual are all U.S. Food and Drug Administration (FDA)-approved fillers and neurotoxins; however, most of the techniques described are considered “off-label” uses of the products. The doses of products described serve as a general guide for injection. Although the utmost care was taken in ensuring the accuracy of the dosing listed, we urge the injector to use his or her best judgment or experience in the unlikely event that a misprint suggests an inappropriate dose. The comments we make about specific products are often our opinion derived from clinical observation. Others may have different observations clinically, and we respect these variations in clinical practices and results. We realize that this manual will be utilized by injectors with different skill levels. In an attempt to promote safe utilization of these products, we have devised a rating scale for each technique. Each technique is evaluated terms of difficulty for the trainer, risks involved in performing the injection, and client satisfaction with the results. Below lists the sections by degree of difficulty, as a cross-reference for injectors who would like to safely advance to more challenging injection techniques.