Ghannam Sahar, Sattler Sonja, Frank Konstantin, Freytag David L, Webb Katherine L, Devineni Aditya, Cotofana Sebastian
Director Sahar Polyclinic, Kuwait.
Department of Dermatology, Venereology and Andrology, University of Alexandria, Egypt.
Facial Plast Surg. 2019 Apr;35(2):193-203. doi: 10.1055/s-0039-1683856. Epub 2019 Apr 3.
Treating the lips to increase facial attractiveness and youthfulness is challenging when trying to consider ethnic differences in an increasingly more diverse society. Multiple injection techniques are currently available for treating lip contour and volume, but a validation in the cadaveric model under the aspects of safety has not been performed yet. The injection techniques presented in this study are based on the experience and personal selection of the authors. The authors have assessed, treated, and evaluated for more than 20 years patients from the Middle East and Central Europe. Cadaveric verification was performed for each of the presented techniques to identify the positioning of the injected product inside the lips and its relation to the superior/inferior labial arteries. The results of the anatomic analyses revealed that in 58.3% of the performed injections, the product was placed close to the superior/inferior labial arteries. In 60.0% of the cases, applications using a needle placed the injected product in endangered locations, whereas 57.1% of the cases using cannulas placed the product in endangered locations (i.e., in the vicinity of the superior/inferior labial arteries). This anatomic study revealed that injected material into the lips is frequently placed in close proximity to labial arteries representing a high risk for intra-arterial applications, leading to tissue loss (necrosis) and potential end-arterial embolism (potential blindness). Nevertheless, treatment of the lips should be a multistep approach focusing first on the far (upper and middle face) and close (labiomandibular and labiomental) perioral regions.
在一个日益多元化的社会中，考虑到种族差异，通过治疗唇部来提升面部吸引力和年轻化具有挑战性。目前有多种注射技术可用于治疗唇部轮廓和容积，但尚未在尸体模型上从安全性方面进行验证。本研究中介绍的注射技术基于作者的经验和个人选择。作者对来自中东和中欧的患者进行了20多年的评估、治疗和评价。对每种介绍的技术都进行了尸体验证，以确定注射产品在唇部内的位置及其与上唇/下唇动脉的关系。解剖分析结果显示，在58.3%的注射操作中，产品放置在上唇/下唇动脉附近。在60.0%的病例中，使用针头注射时将产品放置在了危险位置，而使用套管注射时，57.1%的病例将产品放置在了危险位置（即上唇/下唇动脉附近）。这项解剖学研究表明，注入唇部的材料经常被放置在唇动脉附近，这意味着动脉内注射存在高风险，会导致组织损失（坏死）和潜在的终末动脉栓塞（潜在失明）。尽管如此，唇部治疗应采用多步骤方法，首先关注远处（上半脸和中脸）和近处（唇下颌和唇颏部）的口周区域。
