Facial Danger Zones: Staying safe with surgery, fillers, and non-invasive devices

156 Pages·2019·39.921 MB·English

by  Rod J. Rohrich, James Stuzin, Erez Dayan, Edward Victor Ross

9
1
0
2
/
9
0
/
1
2

,
y
t
i
s
r
e
v
i
n
U

e
k
u
D

:
r
e
s
U
To access the additional media content available with this e-book via Thieme MedOne,
please use the code and follow the instructions provided at the back of the e-book.

Facial Danger Zones
Staying Safe with Surgery, Fillers, and Non-Invasive Devices
Rod J. Rohrich, MD, FACS
Founding Professor and Chair
Department of Plastic Surgery
Distinguished Teaching Professor
UT Southwestern Medical Center
Founding Partner
Dallas Plastic Surgery Institute
Dallas, Texas
James M. Stuzin, MD
Plastic Surgeon
Institute of Aesthetic Medicine
Chair
Baker-Gordon Cosmetic Surgery Meeting
Professor of Plastic Surgery (Voluntary)
University of Miami School of Medicine
Miami, Florida
Erez Dayan, MD
Harvard Trained Plastic Surgeon
Dallas Plastic Surgery Institute
Dallas, Texas
E. Victor Ross, MD
Director
Scripps Clinic Laser and Cosmetic Dermatology Center
Scripps Clinic Carmel Valley
San Diego, California
Illustrations by Amanda Tomasikiewicz, CMI
Thieme
New York • Stuttgart • Delhi • Rio de Janeiro
Executive Editor: Sue Hodgson Important note: Medicine is an ever-changing science undergoing
Managing Editor: Nikole Y. Connors continual development. Research and clinical experience are continually
Director, Editorial Services: Mary Jo Casey expanding our knowledge, in particular our knowledge of proper treatment
Production Editor: Sean Woznicki and drug therapy. Insofar as this book mentions any dosage or appli-
Illustrator: Amanda Tomasikiewicz cation, readers may rest assured that the authors, editors, and publishers
International Production Director: Andreas Schabert have made every effort to ensure that such references are in accordance
Editorial Director: Sue Hodgson with the state of knowledge at the time of production of the book.
International Marketing Director: Fiona Henderson Nevertheless, this does not involve, imply, or express any guarantee or res-
International Sales Director: Louisa Turrell ponsibility on the part of the publishers in respect to any dosage instructions
Director of Institutional Sales: Adam Bernacki and forms of applications stated in the book. Every user is requested to ex-
Senior Vice President and Chief Operating amine carefully the manufacturers’ leaflets accompanying each drug and to
Officer: Sarah Vanderbilt check, if necessary in consultation with a physician or specialist, whether the
President: Brian D. Scanlan dosage schedules mentioned therein or the contraindications stated by the ma-
nufacturers differ from the statements made in the present book. Such exami-
Library of Congress Cataloging-in-Publication Data nation is particularly important with drugs that are either rarely used or have
Names: Rohrich, Rod J., author. been newly released on the market. Every dosage schedule or every form of ap-
Title: Facial danger zones : staying safe with surgery, fillers, plication used is entirely at the user’s own risk and responsibility. The authors
andnon-invasive devices / Rod J. Rohrich, MD, FACS, Founding and publishers request every user to report to the publishers any discrepan-
Professor and Chair, Department of Plastic Surgery, cies or inaccuracies noticed. If errors in this work are found after publication,
Distinguished Teaching Professor, UT Southwestern errata will be posted at www.thieme.com on the product description page.
Medical Center, Founding Partner, Dallas Plastic Surgery Some of the product names, patents, and registered designs referred
Institute, Dallas, Texas, James M. Stuzin, MD, Plastic Surgeon, to in this book are in fact registered trademarks or proprietary names even
Institute of Aesthetic Medicine, Chair of the Baker-Gordon though specific reference to this fact is not always made in the text. Therefo-
Cosmetic Surgery meeting, Professor of Plastic Surgery re, the appearance of a name without designation as proprietary is not to be
(Voluntary), University of Miami School of Medicine, Miami, construed as a representation by the publisher that it is in the public domain.
Florida, Erez Dayan, MD, Plastic Surgeon, Dallas Plastic Surgery
Institute, Dallas, Texas, E. Victor Ross, MD, Director, Scripps
Clinic Laser and Cosmetic Dermatology Center, Scripps Clinic
Carmel Valley, San Diego, California.
Description: First edition. | New York: Thieme, [2019] | Summary:
“The goal of this book is three-fold: - Optimal knowledge of
facial anatomy is germane to obtaining the best results and safe
outcomes in facial aesthetic surgery. This is especially the case
with the intricate anatomy of the facial nerve in facelift surgery
as discussed by Dr. James Stuzin. - Refine and define your
knowledge on the vascular anatomy of the face to stay safe when
performing facial fillers to prevent dreaded complications
including blindness and skin loss, as discussed by
Dr. Rod R ohrich. - Define the limitations and safety areas for the
use of laser and minimally invasive technology from laser to
Radiofrequency to ultrasound technology to optimize results
and maximize safety in the face and neck areas as discussed by
Dr. Erez Dayan and Dr. Vic Ross”— Provided by publisher.
Identifiers: LCCN 2019021417 (print) | LCCN 2019981257
(ebook) | ISBN 9781684200030 | ISBN 9781684200047 (ebook)
Subjects: LCSH: Surgery, Plastic—Safety measures. | Face—Surgery. |
Facial bones. | Lasers in surgery. | Face—Laser surgery.
Classification: LCC RD119.5.F33 R64 2019 (print) | LCC RD119.5.F33
(ebook) | DDC 617.5/20592—dc23
LC record available at https://
lccn.loc.gov/2019021417
LC ebook record available at https://
lccn.loc.gov/2019981257
© 2020 Thieme Medical Publishers, Inc.
Thieme Publishers New York
333 Seventh Avenue, New York, NY 10001 USA
[phone], [email protected]
Thieme Publishers Stuttgart
Rüdigerstrasse 14, 70469 Stuttgart, Germany
+49 [0]711 8931 421, [email protected]
Thieme Publishers Delhi
A-12, Second Floor, Sector-2, Noida-201301
Uttar Pradesh, India
[phone], [email protected]
Thieme Publishers Rio de Janeiro, Thieme Publicações Ltda.
Edifício Rodolpho de Paoli, 25º andar
Av. Nilo Peçanha, 50 – Sala 2508,
Rio de Janeiro 20020-906 Brasil
[phone] / [phone]
www.thiemerevinter.com.br
Cover design: Thieme Publishing Group
Typesetting by DiTech Process Solutions
Printed in the United States of America by King Printing 5 4 3 2 1
This book, including all parts thereof, is legally protected by copyright. Any use,
ISBN 978-1-68420-003-0 exploitation, or commercialization outside the narrow limits set by copyright
legislation, without the publisher’s consent, is illegal and liable to prosecution.
Also available as an e-book: This appliesin particular to photostat reproduction, copying, mimeographing,
eISBN 978-1-68420-004-7 preparation of microfilms, and electronic data processing and storage.
Contents
Video Contents................................................................................................ vii
Preface .......................................................................................................... ix
Dedication/Acknowledgements........................................................................... xi
Contributors ................................................................................................... xiii
Part I: Facial Nerves
1 Overview of Facial Tissue Anatomy ....................................................................... 3
James M. Stuzin
2 Facial Fat Compartments .................................................................................... 16
James M. Stuzin
3 Overview: Facial Nerve Danger Zone ..................................................................... 25
James M. Stuzin
4 Frontal Branch of the Facial Nerve ......................................................................... 32
James M. Stuzin
5 Zygomatic and Buccal Branches ........................................................................... 40
James M. Stuzin
6 Protecting the Marginal and Cervical Branches of the Facial Nerve ................................ 47
James M. Stuzin
7 Great Auricular Nerve ........................................................................................ 55
James M. Stuzin
8 Technical Considerations: Extended SMAS Dissection and Lateral
SMASectomy/Platysma Window .......................................................................... 61
James M. Stuzin
Part II: Fillers and Neuromodulators
9 Introduction .................................................................................................... 73
Rod J. Rohrich and Dinah Wan
10 Facial Danger Zone 1 — Glabellar Region ................................................................ 75
Rod J. Rohrich and Dinah Wan
11 Facial Danger Zone 2 — Temporal Region ................................................................ 82
Rod J. Rohrich and Dinah Wan
12 Facial Danger Zone 3 — Perioral Region .................................................................. 87
Rod J. Rohrich and Dinah Wan
13 Facial Danger Zone 4 — Nasolabial Region ............................................................... 93
Rod J. Rohrich and Raja Mohan
14 Facial Danger Zone 5 — Nasal Region ..................................................................... 99
Rod J. Rohrich and Raja Mohan
15 Facial Danger Zone 6 — Infraorbital Region ............................................................. 107
Rod J. Rohrich and Raja Mohan
v
Contents
Part III: Energy-Based Devices
16 Maximizing Safety with Ablative Lasers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
E. Victor Ross, Erez Dayan, and Rod J. Rohrich
17 Maximizing Safety with Nonablative Lasers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
E. Victor Ross, Erez Dayan, and Rod J. Rohrich
18 Trichloroacetic Acid Combined with Jessner’s Chemical Peel Safety ............................... 122
Erez Dayan and Rod J. Rohrich
19 Maximizing Safety with Radiofrequency-Based Devices ............................................. 125
Erez Dayan and Rod J. Rohrich
20 Maximizing Safety with Cryolipolysis .................................................................... 130
Erez Dayan and Rod J. Rohrich
21 Maximizing Safety with Microneedling .................................................................. 133
Erez Dayan, David Dwayne Weir, Rod J. Rohrich, and E. Victor Ross
Index............................................................................................................. 136
vi
Video Contents
Video 1.1 Overview – Relationship of Facial Nerve to Superficial and Deep Fascia
James M. Stuzin
Video 2.1 Facial Fat Compartments
James M. Stuzin
Video 3.1 Overview Danger Zones: Facial Nerve
James M. Stuzin
Video 4.1 Danger Zone Frontal Branch
James M. Stuzin
Video 5.1 Danger Zone Buccal and Zygomatic Branch
James M. Stuzin
Video 6.1 Danger Zone Marginal and Cervical Branch
James M. Stuzin
Video 7.1 Danger Zone Great Auricular Nerve
James M. Stuzin
Video 8.1 Facelift Techniques
James M. Stuzin
Video 8.2 Extended SMA Dissection
James M. Stuzin
Video 8.3 SMAS Fixation Vertical Vector
James M. Stuzin
Video 8.4 Lateral SMASectomy SMAS Stacking
Rod J. Rohrich
Video 8.5 Neck Lift: Lateral Platysmal Window
Rod J. Rohrich
Video 10.1 Danger Zone 1: Brow and Glabella
Rod J. Rohrich
Video 10.2 Filler Injection in the Glabellar Region
Rod J. Rohrich
Video 11.1 Danger Zone 2: Temporal Region
Rod J. Rohrich
Video 11.2 Filler Injection in the Temporal Region
Rod J. Rohrich
Video 12.1 Facial Danger Zone 3: Oral Commissure and Lips
Rod J. Rohrich
Video 12.2 Filler Injection: Lips
Rod J. Rohrich
vii
Video Contents
Video 12.3 Filler Injection: Oral Commissure
Rod J. Rohrich
Video 13.1 Facial Danger Zone 4: Nasolabial Fold
Rod J. Rohrich
Video 13.2 Filler Injection: Nasolabial Fold
Rod J. Rohrich
Video 14.1 Filler Injection: Nose
Rod J. Rohrich
Video 14.2 Facial Danger Zone 5: Nose
Rod J. Rohrich
Video 15.1 Filler Injection: Infraorbital region
Rod J. Rohrich
Video 15.2 Facial Danger Zone 6: Infraorbital Region
Rod J. Rohrich
Video 18.1 TCA Peel
Rod J. Rohrich
Video 19.1 Radiofrequency: Microneedling with Bipolar Radiofrequency
Erez Dayan
Video 21.1 Microneedling
Erez Dayan
viii