ArtiCle | fACiAlAeSTHeTiCS |
strands to ensure a neat, close band of product pulling
along the correct vector (Figure 3c). Repeat these marks just below the first fan of product along the line of the vector. Continue until jaw line has been reached (Figure 3d). This process should be repeated for other areas of concern, such as marionette lines and nasolabial lines. Again, test to check whether the correct vector has been identified by pulling skin at a superior lateral point perpendicular to the area to be corrected.
The technique The key to 3D vectoring is finding the best corrective vectors, and planning and marking the areas to be treated before starting the procedure. With all the injection sites and guide marks planned and marked before any injections are done, the procedure is consequently quicker, with more predictable and reliable results. Take a 1.5 ml syringe of Radiesse, for example, then
using a separate 2 ml syringe and a female-to-female luer lock connector, mix 0.3 ml of lignocaine 2% (without adrenaline) evenly throughout the Radiesse, with a
Figure 4 Technique. (A) Small amount of 2% lignocaine with adrenaline to anaesthetise cannula entry point; (B) 26 gauge needle used as introducer for 27 gauge cannula; (C) 27 gauge cannula inserted and advanced subdermally; (D) to confirm cannula is in subdermal plane, pull up and outline of cannula should seen, though not distinctly
minimum of ten passes11
. Attach the chosen cannula to
the Radiesse syringe and prime it. Now prepare a second syringe with a 30 gauge needle
and a solution of 2% lignocaine with adrenaline. Use of a lidocaine solution containing adrenaline for tissue infiltration for the area of the insertion points when using a cannula will not only reduce a patient’s pain when making an insertion point, but also provides the injector with a landmark of the infiltrated area (blanching), and may help reduce tissue swelling and bruising.
Supraperiosteal Once the skin and hairline has been cleansed with a high percentage alcohol-based product, a small amount of local anaesthetic is administered to the marked point midway along the zygomatic arch. Using the 30 gauge needle, place approximately 0.1–0.2 ml of lignocaine with adrenaline subdermally. The adrenaline, through vasoconstriction, will reduce the risk of bleeding and bruising at this insertion site. After a few moments, take a needle with the same gauge, or a bigger gauge than
30
❚
September 2011 |
prime-journal.com
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76