Venous Tributaries of the Lip: Implications for Lip Filler Injection.
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
01 08 2023
01 08 2023
Historique:
medline:
31
7
2023
pubmed:
3
2
2023
entrez:
2
2
2023
Statut:
ppublish
Résumé
Demand for lip filler injection continues to increase. Despite the current literature's acknowledgement of the role both venous and arterial vasculature play in minor and major side effects, research addressing the venous vasculature of the lower one-third of the face is scarce. A photographic analysis of the venous vasculature of 26 participants was performed using a vein transilluminator to display the venous flow around the perioral region. The data were analyzed for commonalities among participants and then compared with common lip filler injection techniques and locations. Venous tributaries were identified in all patients, with slight variation in pattern, superior to the upper vermilion border between the nasolabial fold and philtral column on each side of the mouth. Venous tributaries were noted approximately 1 to 1.5 cm lateral to the oral commissures extending inferiorly to the chin and along the labiomental crease. Four areas of venous pooling were deemed significant: a small area approximately 2 mm superior to the Cupid's bow, along the middle tubercle of the upper lip, along the wet-dry line of the lower lip; and centrally along the vermilion border between the lower lip tubercles. Perioral venous mapping provides a guide for injectors performing lip enhancement procedures in identifying areas at risk for injury because of venous pooling. Avoiding these anatomically vulnerable regions can minimize the potential for inflammation and ecchymosis associated with intravenous injection and prevent dissatisfactory aesthetic results because of lumps, excessive bruising, swelling, or asymmetry.
Sections du résumé
BACKGROUND
Demand for lip filler injection continues to increase. Despite the current literature's acknowledgement of the role both venous and arterial vasculature play in minor and major side effects, research addressing the venous vasculature of the lower one-third of the face is scarce.
METHODS
A photographic analysis of the venous vasculature of 26 participants was performed using a vein transilluminator to display the venous flow around the perioral region. The data were analyzed for commonalities among participants and then compared with common lip filler injection techniques and locations.
RESULTS
Venous tributaries were identified in all patients, with slight variation in pattern, superior to the upper vermilion border between the nasolabial fold and philtral column on each side of the mouth. Venous tributaries were noted approximately 1 to 1.5 cm lateral to the oral commissures extending inferiorly to the chin and along the labiomental crease. Four areas of venous pooling were deemed significant: a small area approximately 2 mm superior to the Cupid's bow, along the middle tubercle of the upper lip, along the wet-dry line of the lower lip; and centrally along the vermilion border between the lower lip tubercles.
CONCLUSIONS
Perioral venous mapping provides a guide for injectors performing lip enhancement procedures in identifying areas at risk for injury because of venous pooling. Avoiding these anatomically vulnerable regions can minimize the potential for inflammation and ecchymosis associated with intravenous injection and prevent dissatisfactory aesthetic results because of lumps, excessive bruising, swelling, or asymmetry.
Identifiants
pubmed: 36728199
doi: 10.1097/PRS.0000000000010212
pii: 00006534-202308000-00018
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
257e-263eInformations de copyright
Copyright © 2023 by the American Society of Plastic Surgeons.
Références
Ashton MW, Taylor GI, Corlett RJ. The role of anastomotic vessels in controlling tissue viability and defining tissue necrosis with special reference to complications following injection of hyaluronic acid fillers. Plast Reconstr Surg. 2018;141:818e–830e.
Sclafani AP, Fagien S. Treatment of injectable soft tissue filler complications. Dermatol Surg. 2009;35:1672–1680.
Rohrich RJ, Bartlett EL, Dayan E. Practical approach and safety of hyaluronic acid fillers. Plast Reconstr Surg Glob Open 2019;7:e2172.
Kassir R, Kolluru A, Kassir M. Extensive necrosis after injection of hyaluronic acid filler: case report and review of the literature. J Cosmet Dermatol. 2011;10:224–231.
Scheuer JF, Sieber DA, Pezeshk RA, Gassman AA, Campbell CF, Rohrich RJ. Facial danger zones: techniques to maximize safety during soft-tissue filler injections. Plast Reconstr Surg. 2017;139:1103–1108.
Cotofana S, Pretterklieber B, Lucius R, et al. Distribution pattern of the superior and inferior labial arteries: impact for safe upper and lower lip augmentation procedures. Plast Reconstr Surg. 2017;139:1075–1082.
Trévidic P, Criollo-Lamilla G. French kiss technique: an anatomical study and description of a new method for safe lip eversion. Dermatol Surg. 2020;46:1410–1417.
Braz A, Eduardo CCP. Reshaping the lower face using injectable fillers. Indian J Plast Surg. 2020;53:207–218.
de Maio M, Wu WTL, Goodman GJ, Monheit G; Alliance for the Future of Aesthetics Consensus Committee. Facial assessment and injection guide for botulinum toxin and injectable hyaluronic acid fillers: focus on the lower face. Plast Reconstr Surg. 2017;140:393e–404e.
Mckee D, Remington K, Swift A, Lambros V, Comstock J, Lalonde D. Effective rejuvenation with hyaluronic acid fillers: current advanced concepts. Plast Reconstr Surg. 2019;143:1277e–1289e.
Hotta TA. Lip enhancement: physical assessment, injection techniques, and potential adverse events. Plast Surg Nurs. 2018;38:7–16.
Yamasaki A, Lee LN. Facial fillers in lip reconstruction. Oper Tech Otolaryngol Head Neck Surg. 2020;31:38–44.
Surek CC. Facial anatomy for filler injection: the superficial musculoaponeurotic system (SMAS) is not just for facelifting. Clin Plast Surg. 2019;46:603–612.
Von Arx T, Tamura K, Yukiya O, Lozanoff S. The face—a vascular perspective. A literature review. Swiss Dent J. 2018;128:382–392.
DeLorenzi C. Complications of injectable fillers, part I. Aesthet Surg J. 2013;33:561–575.
DeLorenzi C. Complications of injectable fillers, part 2: vascular complications. Aesthet Surg J. 2014;34:584–600.
Snozzi P, van Loghem JAJ. Complication management following rejuvenation procedures with hyaluronic acid fillers: an algorithm-based approach. Plast Reconstr Surg Glob Open 2018;6:e2061.
Surek CC, Guisantes E, Schnarr K, Jelks G, Beut J. “No-touch” technique for lip enhancement. Plast Reconstr Surg. 2016;138:603e–613e.
Fernández R, Armada M. Multisensory system for the detection and localization of peripheral subcutaneous veins. Sensors (Basel) 2017;17:897.
Francisco MD, Chen WF, Pan CT, et al. Competitive real-time near infrared (NIR) vein finder imaging device to improve peripheral subcutaneous vein selection in venipuncture for clinical laboratory testing. Micromachines (Basel) 2021;12:373.
Onishi S, Imanishi N, Yoshimura Y, et al. Venous drainage of the face. J Plast Reconstr Aesthet Surg. 2017;70:433–440.
Houseman ND, Taylor GI, Pan WR. The angiosomes of the head and neck: anatomic study and clinical applications. Plast Reconstr Surg. 2000;105:2287–2313.
Lamb JP, Surek CC, Vargo JD. The perioral area, the chin, and the jowl. In: Lamb JP, Surek CC, eds. Facial Volumization: An Anatomical Approach. New York: Thieme; 2018:37–57.
Zhuang Y, Yang M, Liu C. An islanded rabbit auricular skin flap model of hyaluronic acid injection-induced embolism. Aesthetic Plast Surg. 2016;40:421–427.
Taylor GI, Shoukath S, Gascoigne A, Corlett RJ, Ashton MW. The functional anatomy of the ophthalmic angiosome and its implications in blindness as a complication of cosmetic facial filler procedures. Plast Reconstr Surg. 2020;146:745.
Cotofana S, Steinke H, Schlattau A, et al. The anatomy of the facial vein: implications for plastic, reconstructive, and aesthetic procedures. Plast Reconstr Surg. 2017;139:1346–1353.
Sieber DA, Scheuer JF, Villanueva NL, Pezeshk RA, Rohrich RJ. Review of 3-dimensional facial anatomy: injecting fillers and neuromodulators. Plast Reconstr Surg Glob Open 2016;4(Suppl Anatomy and Safety in Cosmetic Medicine: Cosmetic Bootcamp):e1166.