BOOK
Soft Tissue Augmentation E-Book
Jean Carruthers | Alastair Carruthers | Jeffrey S. Dover | Murad Alam
(2012)
Additional Information
Book Details
Abstract
Soft Tissue Augmentation, 3rd Edition helps you make optimal use of these techniques and provide the optimum results your patients expect. Drs. Alistair and Jean Carruthers provide you with evidence-based, procedural how-to's and step-by-step advice on proper techniques, pitfalls, and tricks of the trade, equipping you to successfully incorporate the very latest procedures into your busy practice!
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Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability. Compatible with Kindle®, nook®, and other popular devices.
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Offer your patients the best care and avoid pitfalls. Evidence-based findings and practical tips equip you with the knowledge you need to recommend and discuss the most effective treatment options with your patients.
- Proceed confidently with current, to-the-point guidance on the cosmetic use of traditional and new fillers edited by pioneers in the field, Drs. Jean and Alastair Carruthers.
- Expand your repertoire and refine your skills with a wealth of color illustrations, photographs, and procedural videos (including lip augmentation and treatment of hands and feet) depicting cases as they appear in practice.
- See how non-invasive cosmetic procedures apply to real-life situations with new case studies and pearls throughout.
- Stay on top of cutting-edge techniques and topics including darker skin and fillers; platelet rich plasma; and tower technique of filler injection as well as new and novel non-permanent fillers including Elastin and Soft Tissue Augmentation; and a combination of Carboxymethyl Cellulose (CMC) and Polyethylene Oxide (PEO).
- Take advantage of a dynamic and up-to-date focus on the latest soft tissue techniques with 25 new chapters and the unmatched guidance of expert contributors - many new to this edition.
- Browse the fully searchable text online at Expert Consult, along with expanded video content and downloadable images.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Half title page | i | ||
| Series page | ii | ||
| Soft Tissue Augmentation | iii | ||
| Copyright page | iv | ||
| Table of Contents | v | ||
| SERIES PREFACE THIRD EDITION | vii | ||
| Series Preface First edition | ix | ||
| Preface | xi | ||
| Contributors | xiii | ||
| Acknowledgements | xvii | ||
| Dedication | xix | ||
| 1 Introduction | 1 | ||
| Further reading | 2 | ||
| 2 Fillers: | 3 | ||
| Fat as a filling agent | 4 | ||
| Collagen (Zyderm®, Zyplast®, Cosmoderm®, Cosmoplast®, Evolence®) | 4 | ||
| Hyaluronic acids (Restylane®, Perlane®, Juvéderm® Ultra, and Ultra Plus) | 5 | ||
| Silicone | 6 | ||
| Poly-L-lactic acid (Sculptra®) | 6 | ||
| Calcium hydroxylapatite (Radiesse®) | 7 | ||
| Polymethylmethacrylate (Artefill®) | 7 | ||
| Conclusion | 8 | ||
| Conflicts of interest | 8 | ||
| Further reading | 9 | ||
| 3 NASHA™ family | 10 | ||
| Introduction | 10 | ||
| Background | 10 | ||
| Basic science | 10 | ||
| Choosing the right NASHA™ | 11 | ||
| Patient evaluation | 11 | ||
| Patient preparation | 12 | ||
| Physician preparation | 12 | ||
| Treatment techniques | 12 | ||
| Serial puncture | 12 | ||
| Linear threading | 12 | ||
| Fanning | 12 | ||
| Cross-hatching | 13 | ||
| Site-specific treatment strategies | 13 | ||
| Nasolabial folds | 13 | ||
| Melolabial folds | 14 | ||
| Jowls | 14 | ||
| Cheeks | 14 | ||
| Lips | 15 | ||
| Postoperative care and complication management | 15 | ||
| Conclusion | 16 | ||
| Further reading | 16 | ||
| 4 Juvéderm® family | 17 | ||
| Introduction | 17 | ||
| Juvéderm formulations | 17 | ||
| Contraindications and safety considerations | 18 | ||
| Using Juvéderm® | 19 | ||
| Clinical choices | 20 | ||
| Volumizing with Juvéderm® gels | 21 | ||
| Further reading | 22 | ||
| 5 Non-permanent fillers: | 23 | ||
| Introduction | 23 | ||
| Hyaluronic acid dermal fillers | 23 | ||
| Methods | 23 | ||
| Belotero® | 23 | ||
| Randomized controlled trial | 23 | ||
| Case series | 25 | ||
| Esthélis® | 25 | ||
| Teosyal® | 26 | ||
| Randomized controlled trial | 26 | ||
| Conclusion | 26 | ||
| Further reading | 27 | ||
| 6 Radiesse® / Radiesse® with lidocaine | 28 | ||
| Introduction | 28 | ||
| Indications for calcium hydroxylapatite | 29 | ||
| Specific characteristics of calcium hydroxylapatite | 29 | ||
| Mechanism of action | 29 | ||
| Injection techniques | 29 | ||
| Serial puncture | 29 | ||
| Linear threading (Figs 6.1, 6.2) | 29 | ||
| Cross-hatching / fanning | 29 | ||
| Adverse events | 31 | ||
| Comparative research studies | 32 | ||
| Outcomes in subjects with Fitzpatrick skin types IV–VI | 32 | ||
| Safety outcome of calcium hydroxylapatite | 32 | ||
| Large-particle calcium hydroxylapatite injection | 32 | ||
| Patient satisfaction | 33 | ||
| Acknowledgments | 33 | ||
| Further reading | 33 | ||
| 7 Poly-l-lactic acid | 34 | ||
| Introduction | 34 | ||
| Product and mechanism of action | 34 | ||
| Poly-L-lactic acid: technical considerations | 34 | ||
| Product reconstitution | 34 | ||
| Product amount | 35 | ||
| Product placement | 35 | ||
| Product placement precaution | 35 | ||
| Aftercare | 35 | ||
| Additional comments | 35 | ||
| Prevention and treatment of adverse events | 35 | ||
| Patient selection, expectations, and satisfaction | 36 | ||
| Pathophysiology of the aging face: structural and morphologic | 36 | ||
| Conclusion | 39 | ||
| Further reading | 40 | ||
| 8 Artefill®: | 41 | ||
| Introduction | 41 | ||
| Biocompatibility | 41 | ||
| Patient selection / treatment areas | 43 | ||
| Patient evaluation and injection technique | 44 | ||
| Pitfalls and how to correct them | 44 | ||
| Post-injection care | 47 | ||
| Clinical trials | 47 | ||
| Pivotal trial | 47 | ||
| Summary of 5-year follow-up safety and efficacy study | 47 | ||
| Ratings of success and satisfaction | 48 | ||
| Statistics | 48 | ||
| Patient demographics and response rates | 48 | ||
| Masked observer facial fold assessment ratings of efficacy at 5 years compared with baseline | 48 | ||
| Secondary measures of efficacy at 5 years compared with baseline | 48 | ||
| Efficacy at 5 years compared with efficacy at 6 months | 48 | ||
| Potential biases | 49 | ||
| Safety review | 50 | ||
| Summary of post-approval study of the safety of Artefill®: interim report | 50 | ||
| Conclusion | 51 | ||
| Acknowledgments | 52 | ||
| Further reading | 52 | ||
| 9 New and novel fillers: | 53 | ||
| 10 Liquid injectable silicone | 62 | ||
| Introduction | 62 | ||
| Basic science | 62 | ||
| Mechanism of action | 63 | ||
| Controversy | 63 | ||
| Indications and patient selection | 63 | ||
| Materials | 66 | ||
| Patient preparation | 66 | ||
| Injection technique | 67 | ||
| Side effects and managing complications | 67 | ||
| Conclusion | 68 | ||
| Further reading | 68 | ||
| 11 Aquamid® | 70 | ||
| Product | 70 | ||
| Patient selection | 71 | ||
| Technique / treatment | 71 | ||
| Efficacy | 71 | ||
| Complications | 72 | ||
| Discussion | 73 | ||
| Further reading | 73 | ||
| 12 Bio-Alcamid® | 75 | ||
| Introduction | 75 | ||
| Clinical use of Bio-Alcamid® | 75 | ||
| Complications of Bio-Alcamid® | 76 | ||
| Conclusion | 80 | ||
| Further reading | 80 | ||
| 13 Forehead and temporal recontouring using calcium hydroxylapatite pre-mixed with lidocaine | 81 | ||
| Introduction | 81 | ||
| Patient evaluation | 81 | ||
| Anatomy | 82 | ||
| Temple | 82 | ||
| Forehead | 82 | ||
| Selecting the right filler | 82 | ||
| Materials, injection sites, and injection techniques | 83 | ||
| Materials | 83 | ||
| Injection site for the forehead | 83 | ||
| Injection technique for forehead recontouring | 83 | ||
| Injection site for the temples | 84 | ||
| Injection technique for temple recontouring | 84 | ||
| Safety considerations and adverse events | 84 | ||
| Conclusion and discussion | 86 | ||
| Further reading | 86 | ||
| 14 Glabella/central brow | 88 | ||
| Introduction | 88 | ||
| Epidemiology and patient selection | 89 | ||
| Anatomical considerations | 90 | ||
| Muscles of the glabella and central brow | 90 | ||
| Medial brow depressors | 90 | ||
| Brow elevator | 90 | ||
| Important nerves, vessels, and other structures | 90 | ||
| Decision-making: selection and preparation of filler product, selection of injection plane | 91 | ||
| General considerations | 91 | ||
| Selection of injection plane and filler product | 91 | ||
| Deep approach | 91 | ||
| Superficial approach | 93 | ||
| Pre-procedural consultation, assessing and preparing the patient | 94 | ||
| Injection technique | 95 | ||
| Post-procedural course and recovery | 98 | ||
| Avoidance and management of adverse events | 98 | ||
| Tips for maximizing patient satisfaction | 99 | ||
| Conclusion | 99 | ||
| Further reading | 99 | ||
| 15 Volumetric treatment of the brows | 100 | ||
| Introduction | 100 | ||
| The ‘local preview’ | 100 | ||
| The injection | 101 | ||
| Intra-arterial injection | 102 | ||
| Who is a candidate for brow volume treatments? | 103 | ||
| Further reading | 104 | ||
| 16 Infraorbital hollow and nasojugal fold | 105 | ||
| Introduction | 105 | ||
| Candidates for augmentation of the infraorbital hollow | 105 | ||
| Appropriate filling agents | 106 | ||
| Augmentation techniques | 107 | ||
| Skin preparation, anesthetic, and syringes | 107 | ||
| General techniques | 107 | ||
| Augmentation of the infraorbital hollow | 108 | ||
| Post-treatment management and follow-up | 108 | ||
| Complications | 109 | ||
| Adjunctive therapy | 109 | ||
| Conclusion | 110 | ||
| Further reading | 110 | ||
| 17 Nose | 112 | ||
| Introduction | 112 | ||
| The attractively proportioned nose and face | 112 | ||
| Ethnic differences | 113 | ||
| Vascular patterns of the nose (Fig. 17.3) | 114 | ||
| Types of filler | 114 | ||
| Anesthesia | 114 | ||
| Injection technique (Fig. 17.4) | 114 | ||
| Injection techniques by nasal region | 116 | ||
| Nasal dorsum augmentation (Fig. 17.4) | 116 | ||
| Correction of the nasal tip | 117 | ||
| Correction of the columella | 117 | ||
| Correction of the nasolabial angle | 117 | ||
| Injection techniques by each type of nose | 117 | ||
| Hump (Fig. 17.5) | 117 | ||
| Short nose and saddle nose (Figs 17.6, 17.7) | 118 | ||
| Flat nose | 118 | ||
| Wide nasal base (Fig. 17.7) | 118 | ||
| Bulbous tip | 118 | ||
| Plunged tip and inadequate tip projection (Fig. 17.8) | 119 | ||
| Deviated nose | 119 | ||
| Concavely or convexly bent nose | 119 | ||
| Slanted nose (deviation to one side) | 119 | ||
| Irregular nasal profile on lateral view | 120 | ||
| Adverse effects | 120 | ||
| Further reading | 122 | ||
| 18 Cheeks | 123 | ||
| Introduction | 123 | ||
| Anatomical and technical considerations when filling the cheeks | 125 | ||
| Poly-l-lactic acid and hydroxylapatite | 126 | ||
| Volumizing hyaluronic acid | 126 | ||
| Sharp cannula approach | 128 | ||
| Blunt cannula approach | 129 | ||
| Further reading | 131 | ||
| 19 Perioral filling | 132 | ||
| Introduction | 132 | ||
| Anatomical considerations | 132 | ||
| Ideal filling agents for perioral rejuvenation | 132 | ||
| Pain management | 133 | ||
| Injection techniques | 133 | ||
| Vertical lip lines | 134 | ||
| Oral commissures | 134 | ||
| Augmentation of the jaw and chin | 135 | ||
| Perioral complications | 135 | ||
| Conclusion | 137 | ||
| Further reading | 138 | ||
| 20 Lip augmentation | 140 | ||
| Introduction | 140 | ||
| The aging process on the lips | 140 | ||
| An approach to achieving youthful lips | 141 | ||
| Filler products | 142 | ||
| Injection techniques for lip rejuvenation | 144 | ||
| Potential side effects | 145 | ||
| Conclusion | 145 | ||
| Further reading | 146 | ||
| 21 Melomental folds | 147 | ||
| Introduction | 147 | ||
| Anesthesia | 147 | ||
| Basic principles for melomental fold correction | 148 | ||
| Injection strategies for melomental fold correction | 148 | ||
| Choosing the proper filler | 149 | ||
| Complications | 151 | ||
| Adjunctive treatments | 153 | ||
| Conclusion | 154 | ||
| Further reading | 154 | ||
| 22 Hands and feet | 155 | ||
| Introduction | 155 | ||
| Soft tissue augmentation of the hands | 155 | ||
| Calcium hydroxylapatite | 155 | ||
| Poly-l-lactic acid | 157 | ||
| Fat transplantation | 158 | ||
| Hyaluronic acid | 158 | ||
| Soft tissue augmentation of the feet | 158 | ||
| Further reading | 159 | ||
| 23 Buttocks | 160 | ||
| Aesthetic characteristics of the buttocks | 160 | ||
| Gluteal augmentation with fat grafting | 160 | ||
| Fat preparation for injection | 161 | ||
| Fat grafting with growth factors | 161 | ||
| Injection | 161 | ||
| Correction of gluteal depressions with hyaluronic acid gels | 161 | ||
| Technical aspects | 162 | ||
| Conclusion | 163 | ||
| Further reading | 165 | ||
| 24 Earlobe rejuvenation | 166 | ||
| Introduction | 166 | ||
| Anatomy and classification of earlobes | 166 | ||
| Use of fillers for earlobe rejuvenation | 167 | ||
| Conclusion | 169 | ||
| Further reading | 169 | ||
| 25 Tower technique of filler injection | 170 | ||
| Introduction | 170 | ||
| Anatomical considerations | 170 | ||
| Biological characteristics of filler materials | 171 | ||
| Autologous fat | 171 | ||
| Hyaluronic acid | 172 | ||
| Calcium hydroxylapatite | 172 | ||
| Poly-l-lactic acid | 172 | ||
| New concepts in injection techniques | 172 | ||
| The tower technique | 173 | ||
| Vertical supraperiosteal depot technique | 174 | ||
| Injection tips and post-treatment recommendations | 174 | ||
| Conclusion | 177 | ||
| Further reading | 177 | ||
| 26 Complications of temporary fillers | 179 | ||
| Introduction | 179 | ||
| Injection site reactions | 180 | ||
| Pain | 180 | ||
| Edema and ecchymosis | 181 | ||
| Nodules and papules | 181 | ||
| Inflammation (hypersensitivity reactions) | 182 | ||
| Infection | 183 | ||
| Biofilms | 184 | ||
| Granulomas | 185 | ||
| Necrosis | 186 | ||
| Conclusion | 186 | ||
| Further reading | 186 | ||
| 27 Complications of permanent fillers | 188 | ||
| Introduction | 188 | ||
| Products (Box 27.1, Table 27.1) | 188 | ||
| Silicone | 189 | ||
| Polyalkylimide gel | 190 | ||
| Polyacrylamide gels | 190 | ||
| Polymethylmethacrylate | 190 | ||
| Acrylic hydrogel plus hyaluronic acid | 191 | ||
| Treatment sites | 191 | ||
| Complications | 192 | ||
| Evaluation methods | 196 | ||
| Treatment | 197 | ||
| Conclusion | 198 | ||
| Further reading | 199 | ||
| 28 Reversers | 200 | ||
| Introduction | 200 | ||
| Filler complications | 200 | ||
| Hyaluronidase | 200 | ||
| Hyaluronidase in cosmetic dermatology | 201 | ||
| Available formulations | 202 | ||
| Injection techniques and dosing | 203 | ||
| Side effects and precautions | 203 | ||
| Other enzymatic reversers | 203 | ||
| Conservative ‘reversers’ | 203 | ||
| Antibiotics, corticosteroids, and 5-fluorouracil | 204 | ||
| Invasive reversal techniques | 205 | ||
| Conclusion | 206 | ||
| Further reading | 206 | ||
| 29 Consent for photography: | 208 | ||
| Introduction | 208 | ||
| Photography | 208 | ||
| Regulation | 208 | ||
| Fillers used in investigational studies | 209 | ||
| Medical education, teaching, or publicity | 209 | ||
| Media photography during filler injections | 209 | ||
| Telemedicine or internet | 209 | ||
| Policies | 210 | ||
| Maintenance of photographs and other images | 210 | ||
| Disclosure | 210 | ||
| Liability reduction | 210 | ||
| Standard of care in negligence actions | 210 | ||
| Clinical recommendations, guidelines, and policies | 211 | ||
| Committee records and reports | 212 | ||
| Innovative / experimental approaches | 212 | ||
| Establishing negligence | 213 | ||
| The physician extender | 213 | ||
| Conclusion | 213 | ||
| Further reading | 213 | ||
| 30 Pre- and post-treatment photography | 214 | ||
| Introduction | 214 | ||
| Technical considerations | 214 | ||
| Lighting | 214 | ||
| Color | 215 | ||
| Printing | 216 | ||
| Consent | 217 | ||
| Photography procedure | 217 | ||
| Makeup | 220 | ||
| Viewing photographs at follow-up | 221 | ||
| Further reading | 222 | ||
| 31 Conclusions | 223 | ||
| How will medical fillers change? | 223 | ||
| Further reading | 224 | ||
| Index | 225 | ||
| A | 225 | ||
| B | 225 | ||
| C | 225 | ||
| D | 226 | ||
| E | 226 | ||
| F | 226 | ||
| G | 227 | ||
| H | 227 | ||
| I | 227 | ||
| J | 227 | ||
| K | 228 | ||
| L | 228 | ||
| M | 228 | ||
| N | 228 | ||
| O | 229 | ||
| P | 229 | ||
| Q | 229 | ||
| R | 229 | ||
| S | 230 | ||
| T | 230 | ||
| U | 230 | ||
| V | 230 | ||
| W | 230 | ||
| X | 230 | ||
| Y | 230 | ||
| Z | 230 |