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Volumetric Approach to the Upper Face
Published in Neil S. Sadick, Illustrated Manual of Injectable Fillers, 2020
Deborshi Roy, Sachin M. Shridharani
Almost all of the available dermal fillers can be used in the treatment of the temporal and lateral brow areas. Prior to treatment, the patient’s photos should be taken in the standard fashion (Figures 5.1 and 5.2). Additional photos in the Waters view are important in order to adequately assess the temporal and brow area. After photos are taken, the patient should be marked in the upright position. The areas to be treated as well as the injection plan should be clearly defined with the marking (Figure 5.3). Regardless of the material used, the usual technique is a depot injection followed by massage (Figure 5.4a and b). The depth of the injection is the critical part of the treatment—care must be taken to stay in the supraperiosteal plane. Postinjection massage is used to spread the product evenly. Superficial injections and inadequate massage can lead to palpable and/or visible depots of filler agent.
Skull and Facial Radiography
Published in Russell L. Wilson, Chiropractic Radiography and Quality Assurance Handbook, 2020
Facial bone and sinus studies use the same views. Collimation and the small focal spot are very important. The Waters view is the single most useful view for sinus and facial bone or orbit injuries. Each view will demonstrate a particular area of the sinuses. The Caldwell will give a clear view of the frontal sinuses. The lateral view is good for the sphenoid sinus. The basilar view will demonstrate the sphenoid and ethmoid sinuses.
Advanced Cerebrovascular Arteriography: Applications in Carotid Stenting
Published in Peter A. Schneider, W. Todd Bohannon, Michael B. Silva, Carotid Interventions, 2004
The AP and Townes views tend to superimpose the supraclinoid and horizontal portions of the internal carotid artery. The lateral view of the distal internal carotid artery usually demonstrates the siphon well but will not delineate the internal carotid artery bifurcation. If there is disease suspected in the distal internal carotid artery that requires further evaluation, a 15–45° oblique is useful to help “unfold” the multiple curves of the carotid siphon and demonstrate the internal carotid artery bifurcation (transorbital oblique, Fig. 6). The cavernous internal carotid artery may also be interrogated using a paraorbital oblique (55° oblique). An anterior–posterior projection with caudo-cranial angulation (Caldwell view) also provides information about the distal internal carotid artery and will permit its various curves to be separated (Fig. 7). Further caudo-cranial angulation (Waters view) places the petrous ridges in the inferior part of the field of view. This approach is useful for evaluation of siphon aneurysms or basilar artery aneurysms, especially when combined with side-to-side rotation of the image intensifier. In patients with substantial cross-filling to the contralateral hemisphere through a patent anterior communication artery, the bilateral anterior cerebral arteries will be superimposed in the lateral projection. An oblique is useful in this situation.
Management of pediatric orbital wall fractures
Published in Expert Review of Ophthalmology, 2019
Plain radiography, ultrasound, and magnetic resonance imaging (MRI) have also been studied as possible imaging modalities for orbital wall fracture. Orbital posteroanterior and Waters’ view X-rays can show opacification of the maxillary sinus, orbital fat prolapse, and orbital line changes but also have a high false-negative rate and do not aid in surgical planning [44]. Thus, it is rarely used as the sole imaging study. Ultrasound using a curved array transducer has been considered in orbital fractures in adults. While it compares favorably with CT for the identification of orbital floor fractures (sensitivity: 79–94%; specificity: 57–100%), it has poor interobserver reliability [45,46]. Conversely, MRI has been found to be as sensitive as CT in demonstrating orbital floor fractures and is superior to CT for soft tissue herniation [47]. Kolk et al. [48] investigated the use of high-resolution MRI with an orbital coil for imaging in a small group of pediatric orbital floor fractures and found that it provided excellent imaging results, with high intra- and interrater agreement.
Regenerative application of stromal vascular fraction cells enhanced fat graft maintenance: clinical assessment in face rejuvenation
Published in Expert Opinion on Biological Therapy, 2020
Pietro Gentile, Aris Sterodimas, Claudio Calabrese, Barbara De Angelis, Angelo Trivisonno, Jacopo Pizzicannella, Laura Dionisi, Domenico De Fazio, Simone Garcovich
Between January 2007 and December 2019, 33 females patients (study group) (SG) diagnosed with loss of volume (hypoplasia) in zygomatic and cheek regions (15 patients with moderate grade of bilateral hypoplasia, 8 patients affected by high grade of bilateral hypoplasia, 5 patients with outcomes of hyaluronic acid filler, 5 patients with low grade of bilateral hypoplasia were treated with FG-SVFs for face rejuvenation. The SG was comprised of 33 females aged 19–68 years (average age 43.5). Pre-menopausal females were 25 (75.8%). To establish the long-term follow-up of fat graft maintenance, the authors compared the results obtained with a control group (CG) made up of 30 females patients treated with fat graft not enhanced with SVFs (FG) according to Coleman technique [27,28], (centrifuged fat graft alone). The CG comprised 30 females aged 20–61 years (average age 40.5), all affected by hypoplasia in zygomatic and cheek regions (15 patients with moderate grade of bilateral hypoplasia, 7 patients affected by high grade of bilateral hypoplasia, 5 patients with outcomes of hyaluronic acid filler, 3 patients with low grade of bilateral hypoplasia). Pre-menopausal females were 21 (70%). All enrolled patients (SG and CG were composed exclusively by females) were underwent a full pre-operative screening, including a complete clinical evaluation, photographic and instrumental assessment performed by MRI and US. The photographic assessment was done performing, for each patient, seven basic photographs, including the frontal view, quarter views (right and left), profile views (right and left), chin-up view (waters view), and chin-down view (helicopter view). Post-operative follow-up took place at 1, 3, 7, 12, 24, 48, weeks and then annually for five years.