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Case demonstration

CANNULA METHOD

This patient presents with depression in the lower two thirds
of her forehead when compared with the ideal forehead shape
for females (Figure 5). HA filler treatment will help achieve a
fuller forehead.

FIGURE 5 Patient assessment
The lateral entry points are located lateral to the temporal crest, about
1 cm above the supraborbital rim (Figure 6). Be aware of the superficial
temporal artery when choosing the entry point on each side.
1. Use a 23 G sharp needle to create the lateral entry point. 1 cm Temporal crest

Lateral
orbital rim

FIGURE 6
2. Pinch the skin and insert the 25 G cannula deep until it touches the
bone. Tilt the cannula upwards to see if the shaft is visible, to confirm
the cannula is at the periosteum. If the shaft is visible, the cannula has
been inserted too superficially (Figure 7A). Insert and tilt again until
the shaft is not visible (Figure 7B). Upon reaching the periosteum,
inject a small amount of filler for anaesthetic effect.

A B

FIGURE 7
3. Use the non-injecting hand to feel the injection volume to avoid
over-correction (Figure 8).

FIGURE 8
4. Start the injection from the lower to upper forehead because the
sensory nerves run along the same direction (Figure 9). This also
allows local anaesthesia to take effect more quickly and is less painful
for the patient. Inject 0.05 to 0.1 ml of Restylane Skinboosters Vital at
each fanning line.

5. Conduct multiple fanning across the depressed area slowly. Deliver
approximately 0.5 ml on each lateral side.

FIGURE 9

PENDING FOR GLOBAL MEDICAL AFFAIRS & LEGAL REVIEW