Facial Anatomy & Volumizing Injections 2nd Edition

How to Inject According New Anatomical

Evidences

Opening this book the reader will dive into the new anatomy world of the fat compartments of the face. He will discover, trough the analysis of more than 400 images of focused fresh cacaver dissections, the clinical anatomy useful to perform safe and effective modern injection procedures in the upper and midle third of the face.

According the newest anatomical evidences, the modern concept of “Fat Compartment Anatomy Related Injections” developed in the last 10 years by Dr. Ingallina is described and illustrated in depth.

Each injection procedure described in the book is showed directly on the fresh cadaver disection images allowing the reader to easily correlate the injection technique to the pertinent anatomy.

Inside the Reader will find:

• More than 400 images of fresh cacaver dissection with multi colour stained compartments and injected vessels.
• More than 100 images over- drawn to facilitate the comprehension of the anatomy of septa and ligaments.
• Several images of the different pathways of the arteries and vein of the face and focused chapters on related dangers.
• Several images of the authors face showing how to read the deep anatomy only through the recognition of specific cutaneous landmarks.
• Each injective procedure and the related anatomy are also showed in step-by-step video guidance’s.

PREFACE

The Facial Anatomy & Volumizing Injections is an attempt to translate and concentrate in a book my experience of several years of conducting cadaver dissection courses and live injections workshops finalized to the teaching of the facial anatomy and filler volumizing injection techniques. The content of this book can be summarized in a phrase: How to inject fillers in the face according new anatomical evidences. The atlas format is a deliberate choice to make the book easily readable. More than 400 photos and draws will lead the reader by hand in discovering in depth the anatomy useful to inject filler and the more advanced techniques of injection. The aim is to describe the new anatomy of fat compartments and the subjective anatomical variations directly on cadaver dissections images. The reader will understand where the cannula and the needle penetrate and slide, how to avoid the dangerous zones and improve the quality of his result knowing the topography of the fat compartments. An important chapter is devoted to the description of the superficial cutaneous landmarks that identify the deep anatomical structures: fat compartments, septa, ligaments, arteries and veins. The reader will be able, identifying the cutaneous landmarks, to create a road map of the upper and the middle third of the face. Different needle or cannula techniques of injection per each region of the face are analyzed and described in depth.

This book is addressed both to experienced doctors that want deeply improve their knowledge of the anatomy and resident or beginners doctors who want to learn how to inject according new anatomical evidences. I hope it will be useful in your daily activity!! In this second edition, after seven years, the further experience gained in conducting more than 100 dissection courses and masterclass has been summarized. New more explicative anatomy photos have been added and substituted, a new paragraph on the deep anatomy of the zygomaticus/temporal region added and some techniques that I stopped to use removed. The replacement/adding of new anatomy photos has the aim to make the book even more understandable.

Fabio M. Ingallina M.D.

Dr. Fabio M. Ingallina

Plastic Reconstructive and Aesthetic Surgery – Catania – Italy

Dr. Fabio Ingallina received his Medical and Surgery degree at Catania University in 1992. In 1999 he specialised in Plastic Reconstructive & Aesthetic Surgery, still in Catania, and obtained the Microsurgery University Diploma in the Ecole de Chirurgie Université Paris Nord as well. He practiced in the St. Anne Hospital (Paris) and in Mondor Hospital (Paris), where he participated in the “face transplantation project”, he also had a fellow-ship in the Universidade do Estado do Rio de Janeiro with Prof. Cardoso de Castro. In 2002, Dr. Ingallina became the Head of the Aesthetic and Reconstructive Plastic Surgery Department of the Clinic Di Stefano Velona in Catania. In the last nine years he participated as docent and he has directly organized several anatomy dissection courses and facial volumizing injections masterclass.

CONTENTS

PART 01 – GENERAL CONCEPTS

1. Topographical Anatomy of Fat Compartments

a. Anatomy of Fat Compartments: General Concepts b. Upper Third Fat Compartments c. Middle Third Fat Compartments d. Facial Danger Zones: Upper and Middle Third. 2. Hyaluronic Acids 47

3. Patient Position and Instrumentation 09

13

21

33

48

4. 5. 6. Technique of Injection by Cannula: The Fanning Technique Technique of Injection by Needle: The Bolus Technique Technique of Injection by Needle/Cannula: Anatomical Double Plane Technique 51

52

54

CHAPTER 02 – UPPER LID & TEMPORAL REGION

1) Clinical Anatomy

a) The Forehead, the Eyebrow and the Upper Eyelid 59

b) The Temporal Region 91

2) Technique of Injection: Forehead, Eyebrow and Upper Eyelid

a) General concepts 109

b) Technique of injection Upper Eyelid Eyebrow 110

i) The Deep Cannula Fanning Technique

ii) The Deep Needle Bolus Technique

iii) The Superficial Cannula Fanning Technique

c) Technique of injection Forehead 129

i) The Deep Needle/Cannula Bolus Technique

ii) The Superficial Cannula Fanning Technique

3) Technique of Injection: Temporal Region 135

a) The Superficial Subcutaneous Cannula Fanning Technique

b) The Middle Retro-Fascial Cannula Fanning Technique

c) The Deep Retro-Muscular Needle Bolus Technique06 06

CHAPTER 03 INFERIOR EYELID – CHEEK – ZYGOMA

1) Clinical Anatomy

a) The Inferior Eyelid 155

i) Tear Trough 156

ii) Lid-Cheek Crease 171

b) The Cheek 185

i) Mediogiugal Groove, Malar and Zygomaticus regions 189

2) Technique of Injection: Tear Trough Deformity 232

a) The Deep Cannula Fanning Technique

b) The Deep Retro – Orbicularis Needle Bolus Technique

3) Technique of Injection: Lid-Cheek Crease 219

a) The Deep Cannula Fanning Technique

b) The Deep Needle Bolus Technique

4) Technique of Injection: Cheek Region 235

a) The Deep Needle Bolus Technique

b) The Superficial Cannula Fanning Technique

c) The Anatomical Double Plane Technique: Deep Bolus & Superficial Cannula

d) The Deep Cannula Fanning / Bolus Technique

5) Technique of Injection: Zygomatic Region 275

a) The Anatomical Double Plane Technique: Deep Bolus & Superficial Cannula