Skip to main content

Facial Danger Zones: Ultrasound Anatomy

  • Chapter
  • First Online:
Image-Guided Aesthetic Treatments

Abstract

Soft tissue fillers are a common cosmetic procedure to correct unwanted facial feature discrepancies. The use of these fillers has grown significantly over the last few years. When proper technique is used, facial fillers typically have a successful outcome with minor complications. However, due to the high vascularity of the head and neck, major complications can occur. With any procedure, it is crucial to know how to manage complications when they arise, but more importantly, how to reduce the risk of major complications occurring. New technology and techniques have been discovered to help aid in reducing the risk, including ultrasound for visualization of important anatomical structures and soft tissue filler after placement. This chapter explores proper technique for soft tissue filler placement in the head and neck while reviewing the various filler materials and introducing ultrasound as an aid in placement.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ferneini EM, Beauvais D, Aronin SI. An overview of infections associated with soft tissue facial fillers: identification, prevention, and treatment. J Oral Maxillofac Surg. 2017;75(1):160–6. https://doi.org/10.1016/j.joms.2016.09.004.

    Article  PubMed  Google Scholar 

  2. Ferneini E, Boynton T, Almunajed H, Dimitrov K, Banki M. Review of facial fillers and injectable neurotoxins. Am J Cosmet Surg. 2013;30(2):53–60. https://doi.org/10.5992/AJCS-D-12-00028.1.

    Article  Google Scholar 

  3. Ramanadham SR, Rohrich RJ. Newer understanding of specific anatomic targets in the aging face as applied to injectables: superficial and deep facial fat compartments—an evolving target for site-specific facial augmentation. Plast Reconstr Surg. 2015;136(5 Suppl):49S–55S. https://doi.org/10.1097/PRS.0000000000001730.

    Article  PubMed  Google Scholar 

  4. Rohrich RJ, Bartlett EL, Dayan E. Practical approach and safety of hyaluronic acid fillers. Plast Reconstr Surg Glob Open. 2019;7(6):e2172. https://doi.org/10.1097/GOX.0000000000002172.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Newman J. Review of soft tissue augmentation in the face. Clin Cosmet Investig Dermatol. 2009;2:141–50. https://doi.org/10.2147/ccid.s3631.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Vedamurthy M, Vedamurthy A. Dermal fillers: tips to achieve successful outcomes. J Cutan Aesthet Surg. 2008;1(2):64–7. https://doi.org/10.4103/0974-2077.44161.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bass LS. Injectable filler techniques for facial rejuvenation, volumization, and augmentation. Facial Plast Surg Clin North Am. 2015;23(4):479–88. https://doi.org/10.1016/j.fsc.2015.07.004.

    Article  PubMed  Google Scholar 

  8. Ferneini EM, Ferneini AM. An overview of vascular adverse events associated with facial soft tissue fillers: recognition, prevention, and treatment. J Oral Maxillofac Surg. 2016;74(8):1630–6. https://doi.org/10.1016/j.joms.2016.03.009.

    Article  PubMed  Google Scholar 

  9. Beleznay K, Carruthers JDA, Humphrey S, Jones D. Avoiding and treating blindness from fillers: a review of the world literature. Dermatol Surg. 2015;41(10):1097–117. https://doi.org/10.1097/DSS.0000000000000486.

    Article  PubMed  Google Scholar 

  10. Ferneini EM, Hapelas S, Watras J, Ferneini AM, Weyman D, Fewins J. Surgeon’s guide to facial soft tissue filler injections: relevant anatomy and safety considerations. J Oral Maxillofac Surg. 2017;75(12):2667.e1–5. https://doi.org/10.1016/j.joms.2017.08.026.

    Article  PubMed  Google Scholar 

  11. Chatrath V, Banerjee PS, Goodman GJ, Rahman E. Soft-tissue filler–associated blindness: a systematic review of case reports and case series. Plast Reconstr Surg Glob Open. 2019;7(4):e2173. https://doi.org/10.1097/GOX.0000000000002173.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Schelke LW, Van Den Elzen HJ, Erkamp PPM, Neumann HAM. Use of ultrasound to provide overall information on facial fillers and surrounding tissue. Dermatol Surg. 2010;36(Suppl 3):1843–51. https://doi.org/10.1111/j.1524-4725.2010.01740.x.

    Article  PubMed  Google Scholar 

  13. Schelke LW, Decates TS, Velthuis PJ. Ultrasound to improve the safety of hyaluronic acid filler treatments. J Cosmet Dermatol. 2018;17(6):1019–24. https://doi.org/10.1111/jocd.12726.

    Article  PubMed  Google Scholar 

  14. Romana Grippaudo F, Mattei M. The utility of high-frequency ultrasound in dermal filler evaluation. Ann Plast Surg. 2011;67(5):469–73. https://doi.org/10.1097/SAP.0b013e318203ebf6.

    Article  Google Scholar 

  15. Micheels P, Besse S, Flynn TC, Sarazin D, Elbaz Y. Superficial dermal injection of hyaluronic acid soft tissue fillers: comparative ultrasound study: fillers. Dermatol Surg. 2012;38(7):1162–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Christiansen, C.P., Ferneini, E.M. (2023). Facial Danger Zones: Ultrasound Anatomy. In: Bard, R.L. (eds) Image-Guided Aesthetic Treatments. Springer, Cham. https://doi.org/10.1007/978-3-031-36266-8_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-36266-8_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-36264-4

  • Online ISBN: 978-3-031-36266-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics