Correction of various areas of the face with hyaluronic acid – an extremely popular procedure that allows you to eliminate a number of aesthetic imperfections. There are many products and techniques that practitioners can use to achieve the desired results, but there is no such correction method that would guarantee the complete absence of complications and side effects. Dr. Wolfgang Redka-Svoboda shared his views on the basic safety rules when working with HA fillers in an interview for estet-portal.com.
Wolfgang Rareka-Svoboda – surgeon, associate professor at the Paracelsus Private Medical University in Salzburg, member of the German Society of Surgeons and the International Society of Aesthetic Medicine, speaker, author of scientific articles on volumetric facial modeling and the treatment of complications when using fillers, head of the anatomical course Expert Day Anatomy.
When is it better to perform hyaluronic acid correction with a cannula than with a needle?
I will say this: absolutely all procedures can be performed with a needle if you know where the danger zones are located and at what level you are injecting the drug. But I believe that in some cases it is more dangerous to work with a needle than with a cannula. This applies mainly to deep injections in the middle part of the face, since this area is characterized by an extremely high risk of vascular complications, as well as the area around the mouth.
The choice of instrument, of course, remains with the doctor, but at the same time, he must have a good knowledge of the anatomy and the exact location of the danger zones.
The choice of instrument, of course, remains with the doctor, but at the same time, he must have a good knowledge of the anatomy and the exact location of the danger zones.
Are there any areas where needles are not allowed?
Personally, I work mainly with cannula, because for me this instrument is much safer than a needle. However, problems can occur in any area, even when using the cannula – it all depends on how you perform the procedure, as the misuse of any instrument can lead to complications.
Therefore, I believe that there are no such areas that cannot be corrected with a needle. The main thing for a doctor – understand that problems are not excluded, and in case of such occurrence, be able to recognize them in time.
It is important to remember that even the most experienced professionals are not immune from complications, they are not only faced by beginners who are not well versed in anatomy.
Thus, the practitioner, when dealing with a particular area, must be aware of what problems may arise and identify them in a timely manner. For example, it is possible that the doctor may ignore the damage to the vessel, mistaking it for a normal hematoma.
What should I do if the above complications occur?
In case of complications during hyaluronic acid correction, you have the advantage – the ability to use hyaluronidase to break down HA. Working with fillers made on the basis of other substances is fraught with great risks: the absence of an antidote leaves the doctor with only one option – wait and hope everything goes well.
How does age-related osteoporosis affect the choice of drug and the technique of its administration?
As a rule, age-related osteoporosis is not a significant problem with facial fillers. However, this disease in certain areas can cause some complications.
Thus, it is important to be careful when injecting the drug with a needle into the temporal region, as well as when injecting it deeply into the middle part of the face. In the latter case, the bone tissue can be severely thinned due to osteoporosis, and if the drug is administered too quickly, you risk piercing the bone and injecting the drug into the sinus. But such problems can be easily avoided, so I do not consider them very dangerous.
What preparations and techniques are best used to correct dark circles under the eyes?
Of course, to correct dark circles under the eyes, it is necessary to use preparations based on hyaluronic acid. And most manufacturers today offer gels with a high degree of uniformity – these are so-called non-reticulated products containing a small amount of hyaluronic acid. And it is these HA-based preparations that should be used to correct this zone.
The use of fillers is not justified in case of pigmentation disorders, if dark circles under the eyes are not accompanied by depressions in the area of the nasolacrimal sulcus.
But no less important is the question of the appropriateness of using fillers to eliminate this aesthetic problem. The fact is that dark circles under the eyes are not always an indication for correction with hyaluronic acid. Thus, the use of fillers is not justified in case of pigmentation disorders: if dark circles under the eyes are not accompanied by depressions in the area of the nasolacrimal sulcus, the use of HA to eliminate them is not recommended. In fact, the indications for injection correction of the periorbital zone are less than patients and some doctors believe.
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