Objectives: To evaluate the safety and efficacy of diagnostic ultrasound for nonsurgical rhinoplasty to prevent vascular occlusion complications.

Introduction: Nonsurgical rhinoplasty is a popular aesthetic procedure with high patient satisfaction, but it carries a relatively high risk of vascular complications, including blindness. Previous recommendations included injecting fillers in the supraperiosteal and supraperichondrial plane in the midline. However, individual anatomy may vary or be distorted by prior procedures. We review our experience using real-time high resolution ultrasound, including Duplex ultrasound, to prevent vascular occlusion complications and improve precision of nasal filler injections.

Materials / method: 42 consecutive patients underwent 58 nonsurgical rhinoplasty procedures between October 2020 and October 2021. Real-time ultrasound examination was done to identify the location and extent of blood vessels, cartilages, filler deposits, and surgical changes. Injection plans were modified as necessary based on this information. Ultrasound examination after the injection confirmed normal blood flow and evaluated filler placement. Standard photographical images were taken before and after each procedure and at the time of follow up to assess the efficacy of the filler injection.

Results: There were no instances of vascular occlusion. Filler placement in the supraperiosteal and supraperichondrial plane was confirmed by ultrasound. 41 patients (98%) were satisfied with the results of the procedure. 1 patient (2%) requested removal of the filler by dissolving it at the time of follow up. Follow up ranged from 1 month to 11 months. Filler deposits remained stable over the period of follow up as confirmed by standard photography and ultrasound examination.

Conclusion: High resolution ultrasound examination for nonsurgical rhinoplasty is safe and effective. It offers a unique opportunity to assess anatomic variables in real-time and helps to optimize the safety and precision of nasal filler injections. Further investigation can better delineate best practices for use of ultrasound in nonsurgical rhinoplasty.

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Objectives: how to approach the nose with fillers and the technique I use and why.

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Objectives: Exploration of direct midface enhancement and indirect regional benefits of malar fillers

Introduction: Prior to the development of manufactured volumising fillers, liposuction surgeons utilising aspirated fat for augmentation grafting to the midface soon appreciated unexpected indirect improvements in regional facial aesthetics. Along with pleasing outcomes in the grafted midface, regional enhancement of the lid-cheek junction and nasolabial fold were noted. Graft placement was directed into superficial and deep planes (including muscle tissue) at a time when these tissue planes were not as anatomically defined and appreciated as they are currently.

Materials / method: Fat grafting may be regarded as the forerunner of advanced manufactured filler technique.
Currently, rheologically appropriate manufactured fillers to the malar region are showcased, demonstrating the benefits of pleasing local and region outcomes.
Some of these outcomes are outlined as follows.

Results: 1. Healthy appearance
2. Induce positive emotion: warmth improved self-esteem
3. Develop pleasing mid-face contours (OGEE Curves) and PHI proportions
4. Support to superimposed layers 1-2-3 (SKIN-S/C FAT-SMAS)
5. Periorbital wrinkle reduction
6. Elevation lateral canthi towards a positive canthal tilt
7. Shortening eyelash to orbital rim distance
8. Support & Tension to facial ligaments eg.ORL & Zygomatic
9. Shortening the lid margin-orbital rim distance
10. “Coat hanger” support of the face below eg jowl
11. Improvement in nasolabial fold (sulcus)
12. Positive vectoring of oral commissures

Conclusion: Practitioners conversant with contemporary anatomic principles are empowered to direct injected fat or manufactured fillers into well-defined midface deep tissue spaces and fat pads that can result not only in a profoundly positive effect on the targeted midface and but also indirectly benefit regional aesthetics.

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请注明名称（个人，公司，学会等等）: Teoxane

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这项工作的完成感谢以下机构的支持： Teoxane