Teoxane Expert Day: features of the injection technique from Dalvi Hamza

Under my guidance, this event will be a very effective learning process, taking into account the peculiarities of anatomy and the effect of the drug in terms of anatomical components.

That's why we're here today to provide injection specialists with all the information they need to be successful with Teoxane.

What are the advantages of the new RHA line compared to the competition

The RHA line is designed as a dynamic product. When I talk about anatomy, I mean that anatomy is not static. We learn anatomy from books, but it is very static and our patients age dynamically. Thus, changing fabrics – it is a dynamic process. The RHA line simulates dynamic changes. The RHA line features products that can stretch when you want, and new products allow you to lift fabrics and have less stretch. This way you know which products to use in the right place for the right person.

Instagram As a person ages, you move from one product to another. Maybe from RHA 2 to RHA 3, and someday you may need RHA 4 for areas with less mobility. RHA 2, on the other hand, is used in mobile areas, such as lips.

This way you use product knowledge and anatomical knowledge to get the best result for your patient.

I use several needles and many cannulas. Most of the injections I spend in the area of ​​the middle third of the face and eyes. I do a lot of deep injections in the middle of the face to add volume, and I use a lot of deep injections under the ligaments to lift the ligaments up, recreate the contour of the facial bone, and then I do soft tissue work around the eyes.

What complications can occur after injections

Problems arise when not enough is corrected in the right place by superficial injection. Also, during deep injections, sometimes too much is injected, and then intense swelling is obtained. The periorbital area is very sensitive to adding volume. Some people have a predisposition: in the morning the eyes swell, and by the evening the condition improves. With this group of patients, it is necessary to be extremely careful about injections, because this procedure can worsen the situation. Knowledge of anatomy – necessary condition for a successful injection

And the third problem – this is ignorance of anatomy and the introduction of a filler into the blood vessels, in which case blindness may occur. This is a very rare occurrence, but you should be aware of it nonetheless.

Today I was giving injections and I was distracted by providing answers to questions, I allowed myself to joke, but I was convinced of the safety of the patient. I have made sure that the watch has been removed, the skin is thoroughly cleansed, and that you do not allow bacteria to enter the area. Because if during the procedure, the infection gets into the area around the eyes, there are serious complications. You also really need to know where the blood vessels are when you inject. Regarding this aspect, I use the cannula for the most dangerous regions. The cannula allows me to move between blood vessels, get to the right layer and inject into the right area.

The most dangerous places for filler injection in the periorbital region are the bridge of the nose and the nose. So if you are injecting near the nose, you need to know the anatomy and you need to hit the correct layer. And if you feel insecure, then I advise you to stop and return to this procedure another time, after preliminary thorough preparation.

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What motivated you to participate in Teoxane Expert Day 2018

DH: The Teoxane Expert Day 2018 was very interesting because of the education opportunities to make sure that people not only use a good product, but they know where to put these products. So my background is teaching people particularly injection techniques and most importantly anatomy in training courses.

So it is very good to make sure that it is a very good anatomical teaching programme  and to understand: this is the anatomy and this is where the product goes in relation to the anatomy. So I think that brings it both together in our patient to make sure: everyone is very well educated.

What are the advantages of the  RHA range compared to competitors

DH: The RHA range is designed to be dynamic. When I talk about anatomy, I talk about anatomy not being  static. We learn anatomy from books, but it is very static and our patients are aging dynamically. So the tissue changes they are dynamic changes with just time and just smiling. The RHA range simulates that dynamic changes. So it is very nice to have products that can stretch when you want it to and these new products allow lifting but not stretching.

So you know which products to use in the right place for the right type of person. So as the person ages you would go from one product, maybe it is RHA 2, to RHA 3, and then you might want the RHA 4 where is not much movement. RHA 2 when there is a lot of movement, like lips. So you using knowledge of the product and knowledge of the area to get the best result for your patient.

DH: I am very flexible, I use some needles and I use a lot of cannulas. Now I use both but in the right places. The areas I do a lot of treatment on tend to be around the middle face and eyes. I do a lot of deep injections in the middle of face to correct fat, and I use a lot of deep injections on ligaments to lift ligaments up, recreate the facial bone structure and then I do the soft tissue work afterwards with  lots around the eyes in face area.

Which complications may occur after the injection

DH: The simple problems, which is not correcting in the right place by injecting too superficial. The problems when you go deep, because sometimes people inject too much deep and then they got that we call edema, it`s like swollen eyes. The periorbital region is very sensitive to volume addition.

Some people are extremely sensitive, those people who wake up in the morning and the eyes is swollen, and during the day it gets better. In those type of people I`m very careful about injection because it can make some worse.  And the third problem is not knowing the anatomy properly and then injecting into the blood vessels, and then you get the problem like blindness. It is very rare, but still, you need to be aware off.

Which precautions allow you to avoid the complications

DH: For my point of view I am very worried about people injecting around the eye and not taken care. Today I was injecting and I have made jokes but I made sure that the watches were taken off, the skin was cleaned thoroughly. When you finished your work the area is clean and you don’t allow bacteria to get into that site. Because if you will have an infection around the eye, that is extremely serious. 

You really need to know where the blood vessels are when you injecting. As for that I use the cannula for this region. It allows me to navigate in between the blood vessels, get to the right layer and inject. The most dangerous place to inject the periorbital area are the glabella and the nose. So if you are injecting near the nose, you have to know the anatomy, and you have to get into the right layer and respect the layer. And if you are worried about it, you should stop the injection, come back another day.

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