๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Fillers
Fillers
Fillers with high viscosity are preferable. HA products such as Juvederm Voluma, Restylane Volyme, Belotero Volume, and Restylane Lyft are examples of products. CaHA is preferred by other injectors.88 Unlike HA fillers, CaHA is not reversible, something which is less than ideal in this zone which is at high risk for vascular events.
Product placement should be aimed in the supraperiosteal/supraperichondrial planes. Injections in the nasal tip is an exception and should be subdermal with less viscous products such as Juvederm Volbella, Juvederm Ultra, Restylane Refyne, Restylane Fynesse, and Belotero Balance. A 30-gauge needle or smaller can be used, though blunt cannulas (1ยฝ or 2 in, 27 gauge) are highly recommended to reduce the risk of vascular complications. Entry points are ideally placed distant from the desired injection site, usually from a lateral entry or at the nasal tip; however, an entry point at the nasal tip can provide access to the entire nasal septum and columella up to the nasal spine of the maxillary bone. Fillers can be placed in microaliquots (0.1 mL or less), usually proximal to distal through serial needle punctures or a blunt cannula.88 Injecting fillers above the nasal spine of the maxilla can help to correct downturned nasal tip deformities. Submucosal injections along the concave side of the curved anterior septum can also help to straighten the septum, correcting canted nasal tips caused by anterior septal deviation.89