Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_19_библиотеки_им_акад_М_И_Перельмана
.pdf
294
https://t.me/medicina_free
Glossary of common terms
edema and malar mounds is often not easily discernable. The presence of excess tissue
along with bulge is characteristic of a malar mound versus malar edema.
Masseter The masseter is a muscle of mastication and is an extremely powerful muscle. It is
responsible for patients who suffer from TMJD. A hyperactive masseter muscle is a
broader look to the lower jaw. Think of Angelina Jolie; she has a well-defined jaw with
an active masseter, enhancing her unique jaw presentation. When neuromodulation is
placed in the masseter muscle, it can create a slimmer jawline and reduce TMJD’s pain
and discomfort. It is important to note that if the patient has some jowls and or lax skin,
treating this area will slim the jawline while enhancing the jowls and exacerbate the lax
skin. This muscle is responsible for elevating and protruding the chin.
Mentalis The mentalis (levator Menti) are two deep but small conical fasciculus structures that
lie on the side of the frenulum of the lower lip. It arises from the incisive fosa of the
mandible and then on the descent attaches to the skin on the chin. It is responsible
for wrinkling the skin on the chin in an upward fashion. When the mentalis is activated,
it raises the lower lip base, thus allowing for protrusion of the lower lip to an everted
position to allow for easy drinking. This muscle is also responsible for eliciting emotions
of doubt and concern. Over action of this muscle will also create a deep mental crease
under the lip.
Nasalis This thin muscle lays across the bridge of the nose and connects with the process. It is
at this connection when you can often see a static rhytid across the bridge of the nose.
The nasalis muscle draws the tissue up and creates a bunny nose appearance. When
active, the nasalis will pull the ala up and, depressors the cartilage of the bridge of
the nose. An active nasalis will create horizontal lines on the bridge of the nose and diagonal lines on either side of the nose near the inner canthus.
Orbiculars oculi The orbicularis oculi is a broad, flat, and elliptical muscle that surrounds
the orbital rim’s circumference and is responsible for the eyelids closure. Much like the
orbicularis oris muscle, it is also a sphincter muscle and is ultimately a depressor muscle.
The muscle spans several facial regions, which include the eyelid, the cheek, and the
forehead. This sphincter muscle’s primary function is to act as a depressor muscle. It
is partly responsible for the early onset of creasing in the skin at the lateral canthal area
and nasalis line.
Orbicularis oris muscle (labi) The orbicularis oris muscle is a superficial yet complex
sphincter muscle that encircles the mouth. This muscle is extremely superficial to the
upper and lower lips. It is responsible for closing the mouth and protruding the lips.
The deep portion of this muscle is responsible for pressing the lip to the teeth. There
is an upper and a lower muscle, and then it is further segmented into four quadrants
(upper, lower, left, and right).
Photophobia Photophobia is light sensitivity. If injections of neuromodulation position the
eyelid to not fully close and the patients lose their ability to shield their eyes from bright
light, photophobia will occur.
Platysma The platysma is a superficial muscle of the neck that lay in the subcutaneous tissue
and overlaps the sternocleidomastoid. It is considered a broadsheet of muscle with various prominence that covers the majority of the lateral and anterior neck. The platysma
fibers cross the clavicle and ascend medially to the side of the neck. The anterior fibers
intertwine to the menti while other fibers connect to the mandible and the lower lip.
The platysma is responsible for accentuating skin laxity in the aging process. Be careful in
the central portion treating bands over the thyroid notch. Just below the thyroid notch
Glossary of common terms
https://t.me/medicina_free
sits the laryngeal prominence and below that is the cricothyroid ligament. If a neuromodulator was to affect here, the patient could have significant trouble swallowing.
The platysma is responsible for tensing the neck.
Procerus The procerus is a pyramid-shaped muscle located within the glabellar region. It
extends from the nasal bone to roughly the middle of the forehead between the eyebrows; this is where it attaches to the frontalis muscle. When injected with neuromodulator, it raises the bridge of the nose and softens the horizontal rhytids on the bridge of
the nose. It is responsible for drawing the medial brows down, hence its depressor
function.
Ptosis Ptosis is a greek word developed in reference to dropped or fallen. Patients can expe-
rience ptosis after neuromodulation if the injections are not precise. Ptosis can occur
when treating any muscle that is an elevator. Commonly ptosis is seen in the eyebrow,
eyelid, or smile.
Risorius muscle This is a superficial muscle of expression. This muscle pulls the corners
of the mouth laterally; it runs through the masseter muscle originating in then fascia.
Understanding the anatomical position of this muscle is critical when treating a patient
for TMJD. This muscle aids in a number of dynamic expressions such as smiling, grimacing, laughing, and so many others.
Sclera The sclera is the white outermost portion of the part of the eye.
Urticaria Urticaria is also referred to as hives where wheals rise in the skin due to chemical
mediators’ release. Many factors cause this skin eruption. In terms of urticaria associated
with neuromodulation, it would be an IgE mediated drug reaction. Over the counter
antihistamine medication is recommended should a patient experience urticaria posttreatment.
Xerophthalmia Xerophthalmia is a condition known as dry eye or aqueous deficiency.
Neuromodulation can also be used to treat aqueous deficiency of the eye. If the patient
suffers from an aqueous deficiency treating the orbicularis oculi muscle will help reduce
contractility and blinking, resulting in a slowed pump motility, improving the eye’s
dryness.
Zygomatic major This superficial muscle inserts on the lateral aspect of the zygomatic
bone posterior to the zygomatic minor muscle. This muscle inserts into the orbicularis
oris, the DAO, and the levator angel oris. The zygomatic major muscles draws the angle
of the mouth up and out when smiling or laughing. It attaches to the zygomatic bone,
and at times it will snuggle under the orbicularis oculi muscle. This muscle is another
crucial muscle to avoid when injecting the lateral canthal lines, and the DAO as the smile
can be interrupted in an unnatural and displeasing way.
Zygomatic minor The zygomatic minor is a superficial muscle. The ZM elevates the
upper lip outward and upward, allowing to show the maxillary teeth. This muscle sits
beneath the orbicularis oculi on the zygomatic bone and connects to the subcutaneous
tissue of the upper lateral lip muscle, and sits on the lateral portion of the zygomaticus
bone. The ZM is essential in the function of smiling. This muscle can be inadvertently
injected when the lateral canthal lines are treated in the ill-prepared injector’s hands.
295
This page intentionally left blank
https://t.me/medicina_free
Index
https://t.me/medicina_free
Note: Page numbers followed by f indicate figures and t indicate tables.
A
Acetylcholine release inhibitors, 17, 19
Aesthetic new patient history
current skin care regimen, 263–264f
in house use only, 264–265f
medical history, 263f
Aftercare instructions, 258–259, 269–270,
269f
Aging
aging face
effects, 69–71, 70f
onset and pace, 69
reasons, 71
aging muscles, 77–78, 78f
intrinsic and extrinsic aging, 71–72
patient assessment
animation, 81
art of assessment, 81f
consultation, 79–80
ideas, 80
at rest and in motion, 81–82
rotation, 82
tilting, 82
patient selection, 78–79
physical assessment, 82
static vs. dynamic lines
concomitant procedures, 92–95
consult process, 90–92
definition, 84–85
patient expectations, 85–89
upper face assessment
brows, 84
frontalis, 83
Mephisto sign, 83
orbicularis oculi, 84
youthfulness, 72–75, 73–74f,76f
Aging self, 2
Alcoholic beverages, 277
Allergy, 35
Anatomy, 5–6. See also Facial anatomy
Animation, 81
Anti-aging, 13
Anti-inflammatory/blood thinning
medications, 277
Asymmetries, 254
Autonomic dysfunction, 27
Axillary Hyperhidrosis, 30
B
Body dysmorphia, 78
Botox, 13, 98t, 100–102, 269–270, 269f
Botox Cosmetic, 23
Botox supply list, 289
®
Botox
Botulinum toxin A (BoNT-A), 13, 15t
Botulism, 46
Breathing/swallowing disorders, 38–39
Brow ptosis, 238–239
Brows, 84
Buccolabial muscle group, 63–65
Bunny lines
treatment, 3–5, 11
acetylcholine release inhibitors, 17, 19
binding phase, 20
blockade phase, 21
Botox Cosmetic, 23
Clostridium,17
commercially available variety, 23–26
cosmetic and therapeutic uses, 26–27
Dysport (abobotulinumtoxinA), 24
extrusion force, 236
internalization process, 20
Jeuveau (prabotulinumtoxinA-xvfs), 24
mechanism of action, 20
Merz Aesthetics, 24
nervous system, 18–19
process, 20–22, 21f
release and nerve terminal reaction, 22–23
risk categories, 236
assessment, 182
complimentary locations, 181
documentation, 181–182
dosing, 181
duration, 184
Dysport allergy, 186–187, 186f
297
298
https://t.me/medicina_free
Index
Bunny lines (Continued)
emotion, 180
equipment, 182
follow up and special consideration, 184,
184–185t
indications for treatment, 180
muscles in treatment area, 180
muscles to be treated in the targeted zone,
180–181
pre-procedure steps, 182–183
results, 183
special considerations, 181
technique, 183
treatment area, 180
treatment goals, 181
Business relationships, 251–252
Buying followers, 250
C
Cardiovascular disease, 37
Chin
assessment, 217
complimentary locations, 216
documentation, 216
dosing, 216
duration, 219
Dysport allergy, 221–223, 221–222f
emotion, 215
equipment, 216–217
follow up and special consideration,
219–220, 220–221t
indications for treatment, 215
muscles in treatment area, 215
muscles to be treated in the targeted zone,
215–216
pre-procedure steps, 217–218
results, 219
special considerations, 216
technique, 218–219
treatment area, 215
treatment goals, 216
Circumorbital group, 65
corrugator supercilii, 61
levator palpebrae superiors, 61
orbicularis oculi, 61
Clostridium, 17, 29
CO
resurfacing/eye surgery, 37
2
Common myths, 45–46
Complaint, 10
Complications, 7
brow ptosis, 238–239
complications section, 235
cosmetic application dosing, 239
frontalis muscles, 240
glabellar complex facial lines, 239–240
lateral canthal lines, 240–241
lid ptosis, 239
management
static and dynamic rhytids, 241–242,
241–242f
understanding risk, 242–244t
negative sequela/displeasing results, 235
paresis, 235
ptosis risk, 240
reconstitution, 235
toxin spread
allergic reactions, 237
drugs intended effect, 236–237
extrusion force, 236
immunogenicity, 238
risk categories, 236
transient ptosis, 238–239
Compound sphincter muscle group, 65
Concomitant procedures
aging process, 94
decision process, 94–95
neuromodulation, 92–93
treatment options, 93–94
Confidence Tools, 257
Consult process, 90–92
Cosmetic application dosing, 239
Cosmetic providers, 2
Cosmetic uses, 26
Crows feet injections
assessment, 151–152
complimentary locations, 150
documentation, 150–151
dosing, 150
duration, 155
Dysport allergy, 158, 159–160f, 160–162,
162f
emotion, 149
Index
https://t.me/medicina_free
299
equipment, 151
follow up and special consideration,
155–156, 156–157t
indications for treatment, 149
muscles in treatment area, 149
muscles to be treated in the targeted zone,
149
pre-procedure steps, 152–153, 153f
results, 155
special considerations, 149–150
technique, 153–155, 154f
treatment area, 149
treatment goals, 150
D
Deep lines, 45
Dermal filler, 11
Discount, 8–9
Documentation, 259–260
Downtime, 8, 46
Drug to drug interactions, 41–43
Dysport (abobotulinumtoxinA), 24, 31, 99t,
103
E
Education, 256–257
Emails, 247–248
Emotionally charged side effects, 34
Emotional well-being, 2
Extrinsic aging, 71–72
Eyebrow lift
assessment, 165
complimentary locations, 164
documentation, 164
dosing, 164
duration, 167
Dysport allergy, 169–171, 170–171f
emotion, 163
equipment, 164–165
follow up and special consideration, 167,
168–169t
indications for treatment, 163
muscles in treatment area, 163
muscles to be treated in the targeted zone,
163
pre-procedure steps, 165–166
results, 167
special considerations, 163
technique, 166–167
treatment area, 162–163
treatment goals, 164
Eyelid wrinkle. See Lower eyelid wrinkle
F
Face, aging
effects, 69–71, 70f
onset and pace, 69
reasons, 71
Facelift, 46
Face Tune, 3
Facial anatomy
buccolabial muscle group, 63–65
circumorbital group, 61
compound sphincter muscle group, 65
for cosmetic purposes
bone and cartilage, 68f
deep muscles, 59f
muscles, 58–59f
skin, 49–50, 49f
superficial fat pads, 57f
superficial nerve, 67f
vessels, 67f
fat pads, 56–58
hypodermis, 53–56
muscles by facial groups and areas, 60t,
65–66
muscles of the face, 58–59
nasal muscle group, 61–63
skeletal structure, 66–68
soft tissue, 50–52
Facial features, 1
Fat pads, 56–58
FDA approval for therapeutic use, 29
Follow up call, 259
Frontalis, 83, 240
Frontalis-forehead wrinkles
assessment, 131, 132f
complimentary locations, 130
documentation, 130–131
dosing, 130
duration, 134
emotion, 129
300
https://t.me/medicina_free
Index
Frontalis-forehead wrinkles (Continued)
equipment, 131
follow up and special consideration,
134–135, 135–136t
glabellar complex with frontalis,
140–141f, 141–148, 143–146f
indications for treatment, 129
muscles in treatment area, 129
muscles to be treated in the targeted zone,
129
peaked brow expression, 147–148f, 148
results, 134
special considerations, 129–130
static and dynamic rhytids, 137– 138f,
139–141
treatment area, 129
treatment goals, 130
Funny filters/unrealistic filters, 3
G
Gastroenterology, 27
Glabellar complex facial lines, 239–240
Glabellar complex injections
assessment, 111
complimentary locations, 110
documentation, 110
dosing, 110
duration, 113–114
Dysport allergy
dynamic expression lines, 122–124,
123f
frown lines, 119–122, 119–120f,
124–126, 124f
lash line, 126–128, 126–127f
static lines, 116–117f, 117–119,
122–124, 122f, 128–129, 128f
symptoms, 116
emotion, 109
equipment, 110–111
follow up and special consideration, 114,
115t
frown lines, 108–109, 108f
indications for treatment, 109
muscles in treatment area, 109
muscles to be treated in the targeted zone,
109
pre-procedure steps, 111–112, 112f
results, 113
special considerations, 109
technique, 112–113
treatment goals, 110
Gummy smile
assessment, 198
complimentary locations, 197
documentation, 197
dosing, 197
duration, 200
Dysport allergy, 202–207, 202–203f,
205–206f
emotion, 196
equipment, 197–198
follow up and special consideration, 200,
201t
indications for treatment, 196
muscles in treatment area, 196
muscles to be treated in the targeted
zone, 196
pre-procedure steps, 198–199
results, 199–
special considerations, 196
technique, 199
treatment area, 196
treatment goals, 197
200
H
History, 29–31
Human albumin and viral diseases
transmission, 39
Hyperhidrosis injection technique
axillae treatment, 232
duration, 234
follow up and special consideration,
233–234, 233–234t
indication, 231
palm treatment, 233, 233–234t
pricing, 231
safety, 231
sweat glands, 231
treatment area, 231
Hypersensitivity, 35
Hypodermis
collagen, 55
deflation, 54
elastin, 54
hyaluronic acid, 55
Index
https://t.me/medicina_free
301
lipocytes, 53
subcutaneous layer, 53
subcutaneous tissue sections, 53
I
Ice, 257–258
Identity, 1
Immunogenicity, 39
Infection/rash, 35
Injectables, 1–2, 4–5
Injection anatomy, 5–6
Injection preparation. See Reconstitution
Injection site, 38
Injection technique
bunny lines (see Bunny lines)
chin (see Chin)
crows feet injections (see Crows feet
injections)
eyebrow lift (see Eyebrow lift)
frontalis-forehead wrinkles
(see Frontalis-forehead wrinkles)
glabellar complex injections (see Glabellar
complex injections)
gummy smile (see Gummy smile)
hyperhidrosis (see Hyperhidrosis injection
technique)
marionette lines (see Marionette lines)
platysmal bands (see Platysmal bands)
smokers lines (see Smokers lines)
Intrinsic aging, 71–72
Point out the asymmetries, 254
Reconstitution, 258
Looks and image, 1
Lower eyelid wrinkle
assessment, 174
complimentary locations, 173
documentation, 173–174
dosing, 173
duration, 176–177
Dysport allergy, 179–180, 179f
emotion, 172
equipment, 174
follow up and special consideration, 177,
177–178t
indications for treatment, 172
muscles in treatment area, 172
muscles to be treated in the targeted zone,
172
pre-procedure steps, 175
results, 176
special considerations, 172–173
technique, 175–176
treatment area, 172
treatment goals, 173
Lower lip (elevators, retractors, and evertors)
depressor anguli oris (DAO), 64–65
depressor labii inferioris (DLI), 64
mentalis, 65
Luxurious lifestyle, 9–10
J
Jeuveau (prabotulinumtoxinA-xvfs), 24, 31,
99t, 103
L
Lateral canthal lines, 240–241.
See also Crows feet injections
Lid ptosis, 239
List for success, 6
Aftercare instructions, 258–259
Be the Expert, 253
Confidence Tools, 257
Documentation, 259–260
Educate, 256–257
Follow up Call, 259
Ice, 257–258
Photos, 254–256
M
Makeup, 279
Marionette lines
assessment, 209–210
complimentary locations, 208
documentation, 208–209
dosing, 208
duration, 211–212
Dysport allergy, 213, 214f
emotion, 207
equipment, 209, 209f
follow up and special consideration, 212,
212–213t
indications for treatment, 207
muscles in treatment area, 207
muscles to be treated in the targeted zone,
207
302
https://t.me/medicina_free
Index
Marionette lines (Continued)
pre-procedure steps, 210
results, 211
special considerations, 207–208
technique, 210–211
treatment area, 207
treatment goals, 208
Marketing
business relationships, 251–252
buying followers, 250
emails, 247–248
fun facts and tidbits, 251
online presence, 247
post care, 248–250
pre care, 248
referral program, 251
stock photos/memes, 250
Mephisto sign, 83
Merz Aesthetics, 24
Minimal downtime, 8
Minimally invasive procedures, 3,
6–7
Muscles, aging, 77–78, 78f
N
Nasalis lines. See Bunny lines
Nasal muscle group, 66
depressor septi, 62
levator labii superioris alaeque nasi
(LLSAN), 62–63
nasalis, 62
procerus, 61–62
Neurological disorder, 36
Neurology, 26
Neuromodulator, 2, 4–5, 11, 13, 14f
Neurotoxin, 13, 14f
Neurotoxins consent
payment, 273–274
photographs, 273
post treatment instructions, 272–273
pregnancy, allergies and neurologic
disease, 273
pre treatment instructions, 272
results, 274–275
rhytids (wrinkles), 271
risks and complications, 271–272
Non-surgical cosmetic industry, 2–3
Nonsurgical procedures, 11
O
OnabotulinumtoxinA, 30–31
Online presence, 247
Ophthalmology, 26
Orbicularis oculi, 84
Orbicularis oris, 65
Otolaryngology, 26
P
Pain therapy, 26
Patient satisfaction, 78–79
Patient selection, 78–79
Perioral rhytids. See Smokers lines
Photo consent form, 287–288, 287– 288f
Photos, 254–256
Platysmal bands
assessment, 225f, 226
complimentary locations, 225
documentation, 225–226
dosing, 225
Dysport allergy, 229–230, 230f
emotion, 224
equipment, 226
follow up and special consideration, 228,
228–229t
indications for treatment, 224
muscles in treatment area, 224
muscles to be treated in the targeted
zone, 224
pre-procedure steps, 226–227
results, 228
special considerations, 224
technique, 227–228
treatment area, 223
treatment goals, 225
Policy and procedure
authorized personnel documentation, 283
development of plan, 285
evaluation and competency, 282–283
limitations, 283
policy, 281
protocol for administration, 283–285
purpose, 281
record keeping, 282
setting, 281
supervision, 281–282
training/education, 282
Post care guidelines email, 269–270, 269f
Index
https://t.me/medicina_free
303
Post treatment instructions, 279–280
Pre care guidelines email, 267, 267f
Pregnancy/lactating, 35
Pre treatment instructions, 277
Profound Radiofrequency device
treatment, 85
Ptosis risk, 240
R
Reconstitution, 258
Botox
calculation, 100–102
dilution instructions, 98t
Dysport
calculation, 103
dilution instructions, 99t
Jeuveau
calculation, 103
dilution instructions, 99t
novice areas and advanced areas, 104–105
recommendations, 97–98
storage and handling, 100–102t, 104
suggested dosing guidelines, 100–102t
Xeomin
calculation, 102–103
dilution instructions, 99t
Referral program, 251
Reinnervation, 22
Return on investment (ROI), 245, 246t
Rotation, 82
S
Safety
adverse events, 33
ALL neuromodulators
allergy, 35
hypersensitivity, 35
infection/rash, 35
neurological disorder, 36
pregnancy/lactating, 35
drug to drug interactions, 41–43
emotionally charged side effects, 34
fixed needles, 33–34
injector
breathing/swallowing disorders, 38–39
cardiovascular disease, 37
CO
resurfacing/eye surgery, 37
2
human albumin and viral diseases
transmission, 39
immunogenicity, 39
injection site, 38
special events, 37
thick sebaceous skin, 36
zinc deficiency, 40–41
side effects, 34
silicone stoppers, 34–35
Sausage poison, 29
Side effects, 45
Silicone stoppers, 34–35
Skeletal structure, 66–68
Smokers lines
assessment, 190
complimentary locations, 188
documentation, 189
dosing, 188–189
duration, 192
Dysport allergy, 194–196, 194–195f
emotion, 188
equipment, 189
follow up and special consideration, 192,
192–193t
indications for treatment, 187
muscles in treatment area, 188
muscles to be treated in the targeted zone,
188
pre-procedure steps, 190
results, 191
special considerations, 188
technique, 190–191
treatment area, 187
treatment goals, 188
Snap chat filters and apps, 3
Social media, 3, 7–8, 11–12
Soft tissue
dermal layer, 52
dermis, 50
epidermis, 50
keratinocytes, 52
layers, 50
skin, 50–52
tissue planes, 50
Start up fees, 245, 246t
Static rhytids, 22, 47
Static vs. dynamic lines
concomitant procedures
aging process, 94
Соседние файлы в папке Библиотека им академика М.И. Перельмана