An outline of facial assessment principles and anatomical considerations regarding augmenting the cheek and mid-face is explored. Background statistics are stated regarding the number of injectable procedures performed, referenced to American Society for Aesthetic Plastic Surgery (ASAPS) data, 2016. Attention is paid to ethnic and gender variations, from an anatomical, as well as a practical assessment perspective with technical discussion on appropriate treatment strategies including the Ogee curve, reinforcing the aim for a ‘natural’ result. There is detailed discussion of the facial ligaments, supported by current literature, as well as an insightful critical exploration of the literature describing the characteristics and morphology of subcutaneous fat in comparison to deep fat in the face. The author provides an overview of some of the genres of dermal filler with explanation of each as well as indications. There is a strong focus on the senescent anatomy throughout this paper, which is important to the reader; associated emergency complications such as necrosis, arterial / venous occlusion and blindness are briefly outlined, with emphasis being placed on aspiration, which is an ambiguous and contentious current debate, yet to be conclusively resolved. To acknowledge more commonly occurring side-effects and adverse events from dermal fillers may have given a more comprehensive overview on complications arising from dermal fillers to the reader.

From the angular artery to the zygomatic arch: cheek augmentation from A to Z.
Miller A.
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Anna Baker

BJN Aesthetic Nurse of the Year 2016.

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