Safe Filler Injection Technique Demonstration

Part 1 Filler Types and Choosing Fillers

1. Types of Fillers 4
2. Characteristics of Each Filler 6
1. Characteristics of HA Fillers 7
1) Physical Characteristics of HA Fillers 7
(1) Cross-linking 11
(2) Cross-linking Ratio 11
(3) Gel Hardness 14
(4) HA Degradation 14
(5) Viscoelasticity 15
(6) Filler Concentration and the Relative Degree of Hydration 16
(7) Filler Injection and Anti-Oxidant Substances 17
(8) Fillers that Harden after Injection 19
(9) Spread of Fillers 21
(10) Cohesiveness 22
2) HA Filler from Physician’s Perspective 25
3) Summary of Characteristics of Fillers 27
2. Characteristics of Calcium Fillers 35
3. Characteristics of Fillers Composed of Polycaprolactone (PCL) 39
3. Categorization of the Filler Market 43
4. Filler Selection 44
1. Standards for Filler Selection 44
2. Filler Selection and Safety 46

Part 2 Basic Introduction

1. Design Method 52
1. Designing the Whole and Parts 52
2. Design Considering Facial Expressions 53
3. Tricks for Safe Procedures 54
2. Filler Administration with Cannulas 57
1. Puncturing Method for Cannula Insertion 59
2. Method of Using Cannula Depending on the Depth 60
3. Cannula Advancement and Separation of Tissue 63
3. Basic Method of Using a Needle 65
1. Method of Using a Needle 65
2. Considerations of Bevel Location in Procedures 67
3. Post Dermal Subcision Injection Method 68
4. Perpendicular Pulling Injection Method 69
5. Perpendicular Injection of a Large Bolus 70
4. No Bleeding Technique 71
5. Molding 76
1. What is Molding? 76
2. Molding Method for Each Facial Area 84
1) Molding Under Eyes (the Smile Line) 84
2) Under Eye Guider 85
3) Nasolabial Folds and Cheeks 86
4) Massage after Injection 86
6. Dissolution Test 88
1. How to Use Hyaluronidase 88
2. An Experiment for Melting HA Fillers 90

Part 3 Basic Anatomy

1. The Vasculature 107
1. The Facial Artery & Vein 107
2. Variations in the Facial Artery 109
3. The Supratrochlear Artery (STA) &
Supraorbital Artery (SOA) 109
4. Superficial Temporal Artery (SfTA) 110
5. The External Carotid Artery & Internal Carotid Artery 111
6. Palpation of the Artery 112
7. Visual Inspection of Veins 113
2. Nerves 114
1. CN V (Trigeminal Nerve) - Sensory 114
2. CN VII (Facial Nerve) - Motor 116
3. Fat Compartments 118
1. Superficial Fat 118
2. Deep Fat 119
4. Muscles 120
1. Muscles around the Eyes 120
2. Muscles around the Mouth 120
3. Muscles of the Nose 121
5. The SMAS & Retaining Ligaments 122
1. The SMAS (Superficial Musculo-Aponeurotic System) 122
2. The Retaining Ligaments 125
1) True Retaining Ligaments 125
2) False Retaining Ligaments 126

Part 4 Filler Treatment for Each Facial Area

Upper Face
1. Forehead 130
2. Glabella 148
3. Temples 160
Mid Face
4 Nose 178
5. Nasolabial Folds 190
6. Cheek (Upper Cheek and Lower Cheek) 210
7. Dark Circles 230
8. Lower Eyelid Pretarsal Augmentation 248
9. Sunken Eyes 254
Lower Face
10. Chin 260
11. Marionette Line 268
12. Lips 274

Part 5 Filler Complications

1. Filler Complications and Interventions 284
1. Bruising and Hematoma 285
2. Erythema 286
3. Edema 287
4. Neovascularization 288
5. PIH 288
6. Nodule 288
7. Infection 290
8. Skin Necrosis (Blood Vessel Complications) 291
2. Mechanism and Treatment of Skin Necrosis 294
1. Predisposing Factors of Skin Necrosis 294
2. Factors Affecting the Extent of Skin Necrosis 295
3. Symptoms of Skin Necrosis 295
4. Treatment of Skin Necrosis 297
5. Notes for Preventing Necrosis during Procedures 301
6. Tips for Early Discovery and Treatment of Necrosis 303
7. Factors Affecting the Prognosis of Skin Necrosis 303
3. Other Blood Vessel Complications 304
1. Blindness and Cerebral Infarct 304
2. Pulmonary Embolism 306