from the tip of the nose towards glabella to treat the dorsum, rhinion and nasion, as well as glabellar furrows. Secondly, the needle is withdrawn and redirected towards the columella to lift the tip if desired. Perfectha® Deep is injected in the midline in a
retrograde liner fashion after aspiration, while two fingers hold the sides of the nasal bones to avoid lateral migration of the filler.
The nasolabial angle filling enables lifting of the tip of
the nose. For women, this angle must be 100 or 110° to produce a delicate appearance of the nose. Care should be taken not to widen the columellar base too much by putting the thumb and index finger in a position and applying gentle pressure during injection. Immediately following injection, digital pressure is applied and the implant molded into position. Finally, an ice pack is applied to minimise postoperative bruising and oedema. Patients are informed that they may experience some swelling, tenderness and redness for 1–2 days, but no specific aftercare instructions are necessary.
Discussion The major advantages of this unifocal non-surgical technique with Perfectha® Deep are: ■Patient is fully awake. No risks associated with general anaesthesia
■Instant results ■More precise procedure than surgical rhinoplasty, more detailed adjustments to nasal contour are possible
■The patient is in complete control of the results ■Less postoperative pain ■Does not cause nose bleeds or persistent swelling ■The procedure is temporary and reversible ■Less expensive. Injection augmentation of a deep radix will soften the
fronto-nasal angle and may disguise a prominent rhinon and dorsal cartilaginous hump. Medial linear subcutaneous threading of the bony and cartilaginous dorsum will narrow a broad nose, and lengthen a shortened nose. Saddle nose deformity and/or upper lateral collapse may be disguised with injection superficial to perichondrium. Functional internal valve collapse may be addressed with an endonasal ‘spreader’ injection of Perfectha® in to the apex of the internal nasal valve. An underprojected tip may be built up by supratip injection followed by moulding to the desired aesthetic result. For patients desiring the appearance of
(A) Before and (B) after treatment with Perfectha®
(A) Before and (B) after treatment with Perfectha®
a narrower nose, the height of the nasal bridge is augmented to create the illusion of a thinner and longer nasal rhinion. Nasal tip ptosis can be addressed with single puncture
injection into the columellar base to open the nasolabial angle.
Complications of surgical rhinoplasty may also be
treated with Perfectha® Deep HA injection. Columellar and alar retraction may be corrected. These are often complicated by scarring, and the absence of a bony plate to stabilise the implant; however, prior infiltration of local anaesthetic can help stretch the scarred tissue before injection of the filler. Minor post-rhinoplasty asymmetries, irregularities and bony prominences may also addressed.
Further information The product used for this article is Perfectha Deep. Discover the Perfectha range on our website www.
obvieline.com
AMWC Monaco Stand M1
prime-journal.com | March 2013 ❚
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