Subperiosteal injections during facial soft tissue filler injections-Is it possible?


Journal

Journal of cosmetic dermatology
ISSN: 1473-2165
Titre abrégé: J Cosmet Dermatol
Pays: England
ID NLM: 101130964

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 16 06 2019
accepted: 19 06 2019
pubmed: 17 7 2019
medline: 15 12 2020
entrez: 17 7 2019
Statut: ppublish

Résumé

It can be hypothesized that safety during soft tissue filler injection could be enhanced if the product could be positioned between the periosteum and the bone surface i.e. subperiosteal. This study investigated the feasibilityof subperiosteal injections. We analysed 126 injection procedures performed in seven Caucasian body donors (4 males, 3 females) with a mean age of 75.29 ± 4.95 years [range: 70 - 87] and a mean body mass index of 23.53 ± 3.96 kg/m Cadaveric dissections of the injection sites showed that no product was located deep to the periosteum in any of the investigated regions. This indicates that all performed injection procedures positioned the product superficial to the periosteum (100%) with a zero-success rate of subperiosteal injections. In the setting of this cadaveric investigation, despite varying needle size and injection angle, subperiosteal injection could not be achieved. This indicates that the product can spread uncontrolled into more superficial layers yielding an increased risk for adverse aesthetic and vascular events.

Sections du résumé

BACKGROUND BACKGROUND
It can be hypothesized that safety during soft tissue filler injection could be enhanced if the product could be positioned between the periosteum and the bone surface i.e. subperiosteal.
AIM OBJECTIVE
This study investigated the feasibilityof subperiosteal injections.
PATIENTS/METHODS METHODS
We analysed 126 injection procedures performed in seven Caucasian body donors (4 males, 3 females) with a mean age of 75.29 ± 4.95 years [range: 70 - 87] and a mean body mass index of 23.53 ± 3.96 kg/m
RESULTS RESULTS
Cadaveric dissections of the injection sites showed that no product was located deep to the periosteum in any of the investigated regions. This indicates that all performed injection procedures positioned the product superficial to the periosteum (100%) with a zero-success rate of subperiosteal injections.
CONCLUSION CONCLUSIONS
In the setting of this cadaveric investigation, despite varying needle size and injection angle, subperiosteal injection could not be achieved. This indicates that the product can spread uncontrolled into more superficial layers yielding an increased risk for adverse aesthetic and vascular events.

Identifiants

pubmed: 31310047
doi: 10.1111/jocd.13073
doi:

Substances chimiques

Dermal Fillers 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

590-595

Informations de copyright

© 2019 Wiley Periodicals, Inc.

Références

American Society of Plastic Surgeons. 2018 National plastic surgery statistics. 2018. https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-report-2018.pdf. Accessed April 14, 2019.
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van Loghem J, Humzah D, Kerscher M. Cannula versus sharp needle for placement of soft tissue fillers: an observational cadaver study. Aesthetic Surg J. 2017;38(1):73-88.
Pavicic T, Frank K, Erlbacher K, et al. Precision in dermal filling: a comparison between needle and cannula when using soft tissue fillers. J Drugs Dermatol. 2017;16(9):866-872.
Pavicic T, Webb KL, Frank K, Gotkin RH, Tamura B, Cotofana S. Arterial wall penetration forces in needles versus cannulas. Plast Reconstr Surg. 2019;143(3):504e-512e.
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Cho K-H, Dalla Pozza E, Toth G, Bassiri Gharb B, Zins JE. Pathophysiology study of filler-induced blindness. Aesthetic Surg J. 2019;39(1):96-106.
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Auteurs

Tatjana Pavicic (T)

Private Practice, Munich, Germany.

Mariya Yankova (M)

Private Practice, Munich, Germany.

Thilo L Schenck (TL)

Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany.

Konstantin Frank (K)

Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany.

David L Freytag (DL)

Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany.

Jonathan Sykes (J)

Facial Plastic and Reconstructive Surgery, UC Davis Medical Center, Sacramento, CA, USA.

Jeremy B Green (JB)

Skin Associates of South Florida, Coral Gables, FL, USA.

Hassan Hamade (H)

Department of Medical Education, Albany Medical College, Albany, NY, USA.

Gabriela Casabona (G)

Ocean Clinic, Marbella, Spain.

Sebastian Cotofana (S)

Department of Medical Education, Albany Medical College, Albany, NY, USA.
Department of Surgery, Division of Plastic Surgery, Albany Medical Center, Albany, NY, USA.

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