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  • PRESENTI COME ESPOSITORI
    15-16 SETTEMBRE 2017

    62░ congresso ANDI
    Palazzo dei congressi - RICCIONE

Preface I
Preface II
Acknowledgments
Introduction
Index
 

HYALURONIC ACID IMPLANT IN THE LABIAL AND PERIORAL REGION

NOTARRIGO P.

Pag. 88 - 249 illustrazioni a colori

ISBN 978-88-7572-150-3

Prezzo di copertina 75,00 €

Se acquista online, sconto internet -15%


63,75 €

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Preface I

I am pleased to introduce this latest editorial work by my friend and colleague Piero Notarrigo. For several years the author has been teaching in the Master’s Program of Aesthetic Medicine, which I direct, at the University of Parma. He scores resounding success among the students, thanks to his linear, detailed, practical and interactive lessons. Many Aesthetic MD, beginners or not, will I am sure make the most of his sound experience in this specific field, the filler practice, which is widespread. The text is enriched by a complete iconography, which guides the reader step by step in the correct injective practice. The author gives some precious practical advice on how to manage these specific clinical cases. I sincerely congratulate Piero Notarrigo, wishing this book the success it deserves.

Prof. Edoardo Raposio

Director of Plastic Surgery and the school
of specialization in Plastic,
Reconstructive and Aesthetic Surgery,
University of Parma.

Preface II

When the editor Martina sent me the draft of this book, I immediately thought: perhaps I am not the most appropriate person to write this preface. Then, I read the book thoroughly and I was struck by the Doctor’s mild manners and his detailed indications for the treatment. At a time when every dental practice is ruled by the “over treatment”, this book maintains a conservative approach while responding to those who want to familiarise with this discipline.
Never forget the first rule of Medecine: primum non nocere (First, do no harm).
I wish you good reading.

Prof. Angelo Putignano
Full professor of Restorative Dentistry
President of the degree course in
Dental hygiene
Marche Polytechnic University
Scientific editor of the magazine
“Cosmetic Dentistry”

Acknowledgments

I would like to express my personal thanks to Martina publishers, to my friends Alfredo and Vincenzo, who supported, helped and encouraged me to complete this project. I want to thank them for the patience they showed respecting my work patterns which I sometimes, had to slow down due to my work commitments.
Immediately after the publisher Martina, I would like to thank Raffaella of Zanini Graphics, She has constantly been present , diligent, and very competent in effecting the layout of the texts and photos.

Warm thanks go to my models, Eva, Lola, Vanessa and Francesca who enthusiastically accepted to undergo the treatments I proposed, later appearing as the main characters in this book. Finally, a special thank to my family, my wife Cristina and my daughter Margherita, who patiently dealt with me being absent at times, the weekends spent working on my computer, the moments in which, immersed in my work, I was not very present.

My final thanks go to the reader who has demonstrated his/her trust by reading my book and I sincerely hope it was worth it. I am always available to receive any suggestions, disapproval, advice by e-mail info@pieronotarrigo.it.

Dr. Piero Notarrigo

Introduction

The book, which I would define as an illustrated volume or handbook, has its origin in a practical course I held in my Medical Office. During this course I presented some clinical cases through a didactic itinerary designed to progressively illustrate the related complications. The book is rich in images and represents a sort of flow-chart of the different moments with the patient: the medical examination, the shared decision on what kind of treatment to undertake, the injection techniques employed, and the final result. In order to keep to this outline, the opening chapters, concerning the anatomy and vascularisation of the lips and perioral area are also structured with the use of real images of the patients’ faces.

This illustrated volume has a marked practical purpose, indeed, I reported references to other volumes for any possible detailed study regarding the chemical-physical characteristics of hyaluronic acid and international scientific literature’s review. My practical experience goes back to the end of the 1990s, when hyaluronic acid began to be employed for aesthetic purposes, and was combined with my teaching experience within the Masters Course of Aesthetic Medicine at the University of Parma and the Republic of San Marino (Italy). In this illustrated volume I wanted to include all the “fundamentals”, the basic techniques I learned, in order to help the beginner who aims to carefully and correctly approach step by step the injection of hyaluronic acid into the lips and perioral area.

The more experienced colleague may find it constructive to compare his approach when interacting with the patient to that recommended in this book as a sort of “peer review”. The basic techniques I have illustrated, are applied first in simple cases, such as the reduction of the nasolabial folds and “Marionette lines”, in order to gradually familiarise with the consistency of the product, the pressure to apply on the syringe plunger, the quantity of product to employ, the resistance encountered while penetrating the needle and how to manage the patient’s reaction. At a later stage, you can deal with an increase in fullness and tone of the lips, remembering to use a lighter product to make any mistakes look less pronounced.

Only then, following a regular learning curve, can you treat an increase in the volume of the lip respecting and highlighting the critical points, such as the Vermilion border, a well-proportioned increase of the Vermilion, the Cupid’s Bow, the tubercle. This will be a long and gradual learning process but, in the end, you will be rewarded with the satisfaction you deserve, which is represented by the patient’s enthusiastic expression and compliments!

Dr. Piero Notarrigo

Index

Preface I
(Prof. Edoardo Raposio)

Preface II
(Prof. Angelo Putignano)

Acknowledgments

Introduction

1. BASIC KNOWLEDGE
OUTLINE OF THE ANATOMY AND HISTOLOGY OF THE LABIAL AND PERILABIAL REGION
1.1 Young lips
1.2 Aesthetic proportions in young lips
1.3 Ageing of labial and perioral region
1.4 Vascularisation of the lower third of the face
1.5 Perilabial areas prone to bruising after injection of material
1.6 Injection areas and vascularisation
1.7 Lip hystology
1.8 Hyaluronic acid injection areas
1.9 What am I going to inject? Biocompatibility and chemical-physical characteristics of HA

2. THE PRACTICE
THE REDUCTION OF NASOLABIAL FOLDS AND MARIONETTE LINES
2.1 General considerations
2.2 Prepare the patient for the treatment: facial cleansing, application of topical anaesthetic, disinfection
2.3 Treatment of Marionette lines, injection techniques, critical issues
2.4 Treatment of the nasolabial fold, injection techniques, critical issues
2.5 Final result

3. LIP INCREASE IN TONE AND VOLUME
3.1 General considerations
3.2 Prepare the patient for the treatment: facial cleansing, application of topical anaesthetic, disinfection
3.3 Treatment execution – injective techniques, critical issues
3.4 “Before and after”

4. NASOLABIAL FOLDS REDUCTION, MARIONETTE LINE REDUCTION AND INCREASE IN THE VOLUME OF THE LIPS
4.1 General considerations
4.2 Prepare the patient for the treatment: cleansing, application of topical anaesthetic, disinfection
4.3 Reduction of Marionette lines – injection techniques, critical issues
4.4 Nasolabial folds reduction – injection techniques, critical issues
4.5 Increase in lip volume – injection techniques, critical issues
4.6 “Before and after”

5. INCREASE IN VOLUME OF THE VERMILLION AND THE TUBERCLE IN A PATIENT WITH ASYMMETRIC UPPER LIP LINER TATTOO
5.1 General considerations
5.2 Prepare the patient for the treatment: cleansing, application of topical anaesthetic, disinfection
5.3 Increase in volume of the Vermillion and the tubercle – injection techniques, critical issues
5.4 “Final result”

6. SIDE EFFECTS AND COMPLICATIONS
6.1 a) Side effects
6.1.1 Reddening-oedema
6.1.2 Bruise
6.1.3 Pain, itching
6.1.4 Local hardening
6.1.5 Post-treatment asymmetries
6.1.6 Tyndall effect
6.2 b) Complications
6.2.1 Infection
6.2.2 Ischaemic necrosis

7. THE ROAD MAP
7.1 Which product should I use?
7.2 How much should I charge?
7.3 Informed Consent
7.4 Case of emergency
Bibliography