Skull Anatomy | THE SCHOOL OF AESTHETICS by Mauricio de Maio, MD

[Music] hi we're going now to start our anatomic lesson with the skull If You observe the formation of the skull and it's very important when we are working with injectables is to reveal the muscles and the bones that will be important to work with so in the front part we have the frontal bone Dent is limited by the superior orbital Rim when we have a lateral Vil we see the parieto bone the temperal and the spinoid the back part we have the occipital bone the frontal view again we see that the maxilla is seen in the anterior View and on the lateral view we have the zygomatic bone the zygomatic bone has the temporal process of the zygomatic bone and here we have the zygomatic process of the temporal bone when we are analyzing the nose we have the nasal bone and a very important Landmark which is the anterior nasal spine so when we are providing volume replacement starting from top to bottom and with age some of the patients may have a reduction of protrusion of the upper aspect of the ibram we may deliver the filler at the superior orbital level in some cases is when we have to replace volume at the te trough we know that medially speaking in the inferior orbital Rim we have the maxilla and laterally we have the zygomatic bone now one of the most interesting parts for volume replacement is the tempos when you're getting into the temple and here we have this sphenoid bone we have to be aware Ware of depending on where we place our syringe or Canola we may require more or less product the closer we go down into the zygomatic Arch the more volume requirement is needed so a suggestion to minimize the impact is to go a little bit upper and with a needle or Canola just touch the sphenoid bone and with a bolus technique produce delivery of the product followed by massage now one other important aspect for volumizing the face is the anterior aspect and also the lateral when it comes to the cheekbone area all that we see is this there are some patients that they present what we call uh maxilla retrusion so volume requirement will be bigger depending and that's why it's very important to provide with the pation to see what is the bonus structure that we can take advantage of so mainly chick bone area and canine fosa are two areas that volume requirement is bigger when we are getting into nosy shape as mentioned before the interior nasal spine is very important patients that present an evident anterior nasal spine will have the lifting of the tip of the nose much easily done in Asians and those patients that they do not have such an evident Pro protuberance at the anterior Nas or spine level will require much more product to lift the tip of the nose another aspect that we see is this the reshape of nose dorson because of the fact that we have the nasal bone at this level it is considered a not very difficult technique and easy to perform as long as we can't deliver the substance on the bone part and also the cartilage part that's is not here but I want you to take a look now at the importance of the maxilla and all also demandable with a teeth upper teeth and lower teeth when we are considering volume replacement at the lip level depending on the aspect of the teeth also depending on the protrusion or retrusion of the maxilla we will need more or less volume and some of the times the treatment becomes very difficult because we associate volume loss we associate lack of structure of the lips and we have patients that they have protrusion both of the up and lower part of the maxilla another important aspect when we analyze the profile is the balance between the glabella area nose and Chin the use of volume replacement at the chin level is very beneficial especially with the patients that they have already good bone support if they don't don't have bone support we can provide that with a volumizer first through a deeper injection and afterwards with a more superficial injection to provide the volume if we have patients that are in need of jawline reshape because of the formation of the jws we can also inject a volumizer along the drawline which will enable a bettery shape in those cases that they have like a short distance between the vertical Dimension and they are a wide distance regarding the horizontal Dimension we can use also a volumize injected below the mandible to increase and increase in verticalization of the face providing a better balance now the importance of all with this is when you are analyzing and proposing a treatment plan with your patients regarding volum replacement don't forget that we can count on bone as a foundation and a very good structure to provide the use of less product and again repeating temporal volumization the upper we go perpendicular the less volume is required in contrast if you go too close to the zygomatic Arch we will probably need too much volume injected another important eror is if you in are used to injecting the technique at the te level don't forget that perpendicular injection touching the inferior orbital Rim very low dose is one of the most um efficient methods to treat the te deformity with injectables another important tip is whenever we are getting provide volume replacement at the cheekbone area don't forget that the more lateral we go because of the aspect of the zygomatic bone in the latal respect we need less volume the more medially we need the injection of more and more volume take a look it's because the canine fosa is at this level now those patients with huge volume deficiency which is the deficiency of the subm area or sub zygomatic area may require a lot of volume to replace the maler fat pet the Deep one that gets it so volume replacement should be done in sessions