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Clinical anatomy for botulinum toxin and filler
( Shamshik Shin ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2
Facial vessels Arteries of face 1. Facial artery: External carotid a.의 가지 1) Facial portion (1) inferior labial a. (2) superior labial a. (3) inferior ala br.: 콧구멍의 아래를 따라 columella로 주행 (4) lateral nasal br.: 콧방울과 콧등 ↔ infraorbital a. & ophthalmic a.와 교통 (5) angular a.: medial canthus에서 끝남 ↔ dorsal nasal a. of ophthalmic a.와 교통 (6) muscular br. 2) Cervical portion - submental a. 2. Superficial temporal artery: Auriculotemporal n. 와 함께 머리의 가쪽면을 지남 1) Transverse facial a.: zygomatic arch 바로 1cm 내외 아래에 위치, 귀밑샘 및 볼 분포 ↔ facial a.와 교통 2) frontal & parietal brs.: tragus 위쪽 37mm, 앞쪽 18mm에서 분지 3. Maxillary artery 1) Infraorbital a.: inferior palpebral a., external nasal a., superior labial a. 2) Zygomaticofacial a.(광대부위와 볼 피부) & zygomaticotemporal a.(관자부위) 3) Buccal a.: 볼의 피부와 점막, 아래턱 큰 어금니의 볼쪽 잇몸 4) Mental a.(←inferior alveolar a.): 턱, 아랫입술, 아래턱 앞니 잇몸 4. Ophthalmic artery: internal carotid a.에서 분지 1) Lacrimal a. 2) supraorbital a 3) supratrochlear a. 4) dorsal nasal a.: 5) posterior ciliary a. → central a.: optic n.의 중앙부로 들어가 retina에 분포 6) anterior ethmoidal a.→ external nasal a.: 코뼈와 코 연골의 접합에 있는 정중면을 지나 나옴, 바 깥 코의 중간부분 분포 Veins of Face 1. Facial vein: Facial a.와 평행하게 더 뒤에서 더 곧은 경로로 동맥의 반대방향으로 달림 2. Venous connection 3. Superficial temporal v. (얕은 관자정맥): 머리덮개와 옆머리 4. Retromandibular v. (아래턱뒤 정맥) Sensory Innervation of Face 1. Ophthalmic nerve 1) Lacrimal n.(눈물샘신경) 2) Frontal n.(이마신경, 전두신경) a. supratrochlear n. b. supraorbital n. → supraorbital notch: 이마, 관자, 위 눈꺼풀 3) Nasociliary n.:(코섬모체 신경, 비모양체 신경) a. short ciliary n. b. long ciliary n. c. infratrochlear n. d. posterior ethmoidal n. e. anterior ethmoidal n. → nasal cavity → external nasal n. 2. Maxillary nerve 1) Zygomatic n.(광대 신경) 2) Infraorbital n.(눈확아래 신경) 3) Mandibular nerve (1) Auriculotemporal n.(귓바퀴 관자신경) (2) buccal n.(볼 신경 = long buccal n.) (3) Inferior alveolar n.(아래이틀 신경) c. mental n.: 입꼬리와 아래턱을 포함한 아랫입술 → 마취: 입꼬리에서 수직으로 2 cm 아래 Motor Innervation of Face (Facial n. 얼굴신경) - 운동신경으로 stylomastoid foramen을 통하여 나온 후, parotid gl. 내에서 귀밑샘신경 얼기(parotid plexus)를 형성 1) n. to stapedius 2) posterior auricular n. 3) digastric br. 4) stylohyoid br. 5) parotid plexus (in parotid gland) - facial m. 지배 a. Temporal branch → 위눈꺼풀을 향해 위안쪽으로 주행 b. Zygomatic branch: 눈둘레근의 아랫부분, 큰 및 작은광대근의 잇는곳 c. Buccal branch . LLSAN, LLS, Zmi, Zmj, risorius m., 입둘레근 위부분, 볼근 d. Marginal mandibular branch: DAO, DLI, 입둘레근 아랫부분, mentalis m. e. Cervical branch: platysma m. Clinical Facial Anatomy for Filler · 5 Layer · Fat compartment . superficial, deep · Space · Retaining ligament . true, false · Vessel . artery, vein · Muscle · Nerve . motor, sensory · Salivary gland . parotid, submandibular Possible Filer Injection Plane · Forehead: subgaleal space/ SQ · Glabella: subdermal · Temple: sub.SMAS space(between STF and DTF)/ STFP / above temporal bone · Supraorbital hollowness: preseptal space · Tear trough deformity: below OO muscle / subdermal · Palpebromalar groove: below OO muscle/ Subdermal · Pretasal roll: SQ/ OOM · Anteromedial cheek hollowness: prezygomatic space · Buccal cheek hollowness: SQ/ prebuccal space/ (buccal fat) · Lateral cheek hollowness: SQ/ premasseteric space with ML releasing, subdemal · Nasojugal groove, Midcheek groove: SQ with ZCL releasing/ subdermal · Nose: supraperiosteal (midline) · Nasolabial fold: Ristow’s space/ SQ · Perioral wrinkle: subdermal · Commissural line: subdermal · Marrionett line: Below DAO/ SQ/subdermal · Labiomandibular fold: Below DAO/ SQ/subdermal · Lip: submucosal(wet-dry margin) plane · Chin: sub-mentalis fat/ SQ · Labiomental crease: SQ
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Yangwon Chae,Kwangsik Jang,Yesol Jo,Shamshik Shin,Sohi Kang,SeEun Kim,Kyung Mi Shim,Seong Soo Kang 한국실험동물학회 2021 한국실험동물학회 학술발표대회 논문집 Vol.2021 No.7
Introduction Radio frequency technology has been developed as a noninvasive method to reduce subcutaneous fat. This study aimed to measure the safety and effectiveness of the radiofrequency fat reduction system (RF system). We evaluated the efficiency of heat transfer to the subcutaneous layer by using ex vivo model. And then, we tried to verify the safety of the RF system by measuring skin surface temperature changes and the effectiveness by evaluating histological changes in subcutaneous lipocytes in pigs. Materials & Methods The RF system was developed and manufactured by PolyBioTech co., Ltd., Gwangju, Republic of Korea. In ex vivo model, fresh pork containing skin, subcutaneous, and muscle layer was treated with the RF system at 43℃ or 40℃ for 15 minutes. The temperature changes in the cut section of the pork were measured during treatment. In in vivo model, a dorsal skin of pig was also treated with the RF system at 45℃ for 30 minutes. The skin surface temperature of the pig was measured before and after treatment. Moreover, the treated sites were biopsied and evaluated histologically immediately, 1 day, and 7 days after treatment. Results In ex vivo model, the skin surface temperature of the pork did not exceed the set temperature value for most of the treatment time. And as the treatment time progressed, the heat gradually transferred to the deep layer. In in vivo model, the skin surface temperature of the pig remained below the set for the entire treatment time. In histological evaluation, no skin damage was observed and the sizes of subcutaneous lipocytes in pigs had shrunken by 27.87% immediately after, 30.83% 1 day after, and 34.81% 7 days after treatment. Conclusion The RF system used in this study effectively reduced subcutaneous fat without side effects such as skin damage. Based on this, it is expected that safe and effective use of this system will be possible for non-invasive fat reduction.
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