Dangerous zones on the face: important information for dermatocosmetologists

Aesthetic medicine is one of the most demanded medical fields today. Dermatocosmetologists work with the patient's face, performing many effective injection procedures that give amazing results, but sometimes can lead to dangerous consequences.

What are the danger zones on the face, and what is the secret of safe work in them – especially for readers of estet-portal.com told Doctor of Medical Sciences, plastic surgeon, head of the Department of Plastic Surgery of the Faculty of Postgraduate Education of St. Petersburg State Medical University. I.P. Pavlova, chief physician of the beauty clinic "Academy" Khrustaleva Irina Eduardovna.

What are the most dangerous areas on your face?

Those authors are right, and those respected doctors who believe that there are no safe zones on the face. Any area in which we work, due to the variability of anatomical structures, and, first of all, the arterial network, can be dangerous. Therefore, talk about the fact that there is nothing in a certain zone, at the moment, is either very self-confident or very illiterate. Moreover, I can say that everyone who picks up a syringe should understand the extent of their responsibility, which will come after the injection.

Bypassing Dangerous Zones: Filler Injection Points

I always say in my training courses that both plastic surgery and cosmetology, including injection cosmetology, are a specific specialty, because, on the one hand, we graduated from higher medical institutions: universities, academies, institutes, and received medical degrees. On the other hand, we provide paid services, we do not save lives, but we are called upon to improve their quality, and the degree of our responsibility is also very specific. If we transfer a somatically healthy or not somatically healthy person to the category of a disabled person, then this indicates that we are not professionals. Injections – this is a very dangerous manipulation in terms of the development of undesirable consequences, and this must always be remembered.

There are no safe zones on the face, all zones are dangerous.

Certainly, the most dangerous – these are the areas of anastomosis between the internal and external carotid arteries, and this is, in fact, the entire central oval of the face.

What complications can beauticians face when working in hazardous areas?

I'll start by saying that the leading word – these are doctors. I am amazed at the ease with which charlatanism flourishes in the post-Soviet space, because there is no other way to describe it. Quackery, turning into a criminally punishable act of performing injections by persons who do not have higher medical education, but are limited to secondary nursing, but by persons who do not have a medical education at all. Unfortunately, we often come across a situation where companies sell drugs not to clinics, but to individuals, and they are not at all interested in who it is – this is an individual, what kind of diploma is in his hands, is it a certificate of a dermatologist-cosmetologist or is it a diploma of a lawyer, or is it a diploma of a culinary college in general. Of course, these dangerous manipulations should be handled by specialists,

Anatomical zones and facial correction: how to achieve optimal results

And I urge patients, not clients who seek these injections, to use their brains, not to chase cheap prices, because the miser pays twice, thrice, or even four times, and can still remain disabled, and find out who is that sweet girl, or that cute young man, or the gray-haired master who will carry out the injection, and what is behind him. If we are working with dangerous areas, and I have already said that these are the areas of anastomosis between the external and internal carotid arteries, in the first place, then of course the issues of intravascular embolism, that is, the entry of a drug site into a blood vessel, are the most dramatic, because they may cause consequences that, unfortunately, will no longer be correctable.

This could be blindness, a stroke that developed after the drug entered the cerebral arteries, or severe necrosis, which will require a long-term staged reconstructive treatment. And I repeat once again, and I appeal to NOT specialists who call themselves masters: come to your senses and change your mind! I would like to take, if not the Bible, then some thick textbook, and go to the people to carry and sow the word of God, because I have no idea how these people work.

Which do you personally prefer to use: a needle or a cannula?

It is my deep conviction that the choice between a needle and a cannula should be made in favor of the latter. Of course, the cannula has its drawbacks, if we talk about the technique, a larger amount of the drug is consumed. But you don't need to use a very long cannula 70 mm long on the face because its path is unpredictable, you don't need to use a flexible cannula because its trajectory is unpredictable, especially if you work with patients, and these patients are the majority who already have some then cicatricial changes at the subcutaneous level due to previous injections, threads, operations, physical factors, and so on.

That is, the disadvantages of the cannula technique are less than the advantages that this technique provides. And the main advantage – it's safety. The 22 G cannula, rather than the 25 or 27, blunt tip, is now considered a fairly safe cannula that will insure you against the risk of penetration and injection of the drug into a large artery.

Prophylactic methods to prevent the occurrence of complications when working in hazardous areas?

Actually, these methods exist, but it would probably be unfair of me to take and start teaching someone who is not clear now, because, unfortunately, the entire YouTube is full of some kind of videos, including mine, which are not made very well and with my permission, where I conduct some master classes. And then, on their basis, again, nurses and it’s not clear at all who start to study, and then they run and start injecting someone in the kitchen, after which we encounter complications. Therefore, of course, there is a very large prevention of these complications, but in order to carry it out, the person who performs the injection must be a specialist, he must be a doctor, first of all.

I keep saying that cosmetology, not to mention plastic surgery, is a medical specialty, not a bath and laundry plant.

Unfortunately, many people associate the word cosmetology with manicures, pedicures, some dirty cotton wool, hydrogen peroxide and salons where all this is done next to the hairdresser's chair. You need to run away from there, because any invasive cosmetic procedures, be it injections, polishing, peeling, in general, everything that does not concern care, I mean creams, massages, relaxing procedures and all sorts of other pleasant things, such as body wraps, should be performed in clinics. Only in this case, a professional aesthetic procedure will be safe and effective.

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