Restorative arts week 6 hypodermic tissue building

What are the hidden points of entry for the chin?

Behind the earlobe and/or lower center of the chin

What are hidden injection points for the cheeks?

Behind the wing of the nose, corners of the mouth, outside the ear behind the lobe, inside the ear behind the tragus, angle of the jaw.

What are the injection points on the back of the hand?

Between the closest knuckles and the wrist.

Where is the sunken supraorbital area located?

Between the eyebrow and the upper eyelid.

What are the injection points on the sides of the hand?

Between the thumb and index finger and at the knuckle of the baby finger.

What direction should the bevel of the needle be facing during injection?

Bevel up

Why is it necessary to work on both ends of the line of closure when restoring lips?

Both ends of the line of closure need to be addressed because you cannot reach all areas of the lips without making multiple entries.

What are the hidden points of entry for the nose?

Bridge of nose and/or inside nose

How can sunken eyes be restored?

By injecting tissue builder behind the eye

How can the sunken supraorbital area be restored?

By inserting the needle in the eyebrow and injecting downward.

What should be considered when restoring the lips?

Care must be taken to avoid over-injection during lip restoration, as it can lead to undesirable results.

What should be done after completion of all tissue building?

Clean all equipment.

What should you ensure when injecting the cheek?

Ensure the nasolabial fold is not distorted.

What is a common characteristic of sunken temples in elderly individuals?

Expect to have a slight concavity in this region.

What are hidden entry points for facial restoration?

Hair regions, nostrils, corners of mouth, receded part of the ears, posterior portion of the angle of the jaw, corners of eye.

Tools

Hypodermic syringe, needle, tissue/feature builder solution, solvent

when to hypo inject

Hypodermic tissue building is performed after embalming.• Why? Your injection solution will contain chemicals that modifydehydration.• Never perform tissue/feature building prior to embalming!• It can alter the tissue too much during embalming and possibly restrict the flow of fluid.• Embalming can swell the tissue a little and reduce the need for tissue building.• Pre-injection and adding a humectant (hydrating/moisturizing fluid) to the embalming fluid can help improve the effects of emaciation and reducethe need for tissue building.

What can cause sunken eyes?

Illness, emaciation, or dehydration

What are the hidden points of entry for the forehead?

In the eyebrow and/or the hair

What are the hidden points of entry for the neck?

Inside the ear and/or angle of the jaw

What is the gauge and characteristic of a 12 gauge needle?

It is a larger needle with a visibly larger hole for injecting.

What is the gauge and characteristic of a 22 gauge needle?

It is a small needle with a very tiny opening.

What should you do with the tip of the needle during injection?

Keep it as close to the surface of the skin as possible without puncturing

What are the hidden points of entry for the ear?

Lobe and/or behind top of helix

What are the key areas to remember in emaciated and restorative cases?

Neck, chin, and forehead area

Where should the needle be inserted to restore sunken eyes?

On the medial side of the inner canthus

When should you start injecting during the hypodermic process?

Once the needle is farthest away from your point of entry

What should be avoided when restoring the sunken supraorbital area?

Overfilling the area and causing swelling or leaking of fluid.

What technique can help prevent puncturing the skin during injection?

Place the other hand on the skin to keep it taut

What is the term for a discreet point-of-entry for injections?

Point-of-entry

What technique may be required when injecting tissue builder in sunken temples?

Radiating the needle to achieve the correct look.

How can you access a larger area with fewer puncture points during injection?

Redirect the needle to a new area without fully withdrawing and radiate in different directions

What are separated mucous membranes of the lips?

Separated mucous membranes of the lips refer to the distinct layers of tissue that need to be restored during lip reconstruction.

What are the injection points on the fingers?

Sides of fingers and between knuckles.

What should you do after fully inserting the needle into a sunken area?

Slowly withdraw the needle while applying pressure to the plunger

Why is it useful to keep a bottle of solvent cleaner?

So you can draw it up into the syringe and push it back into the bottle without wasting it.

What should be used to clean both the needle and the syringe?

Solvent.

What should be monitored while injecting tissue builder for sunken eyes?

The eyeball for it to rise

Where can the needle be inserted for tissue building on the lips?

The needle for tissue building can be inserted at both ends of the line of closure on the lips.

What happens to the size of a needle as the gauge number increases?

The needle itself becomes smaller.

Where can you go to see the differences in needle sizes and gauges?

The prep room.

Why might multiple points of entry be needed in facial restoration?

To reach all emaciated areas in the face.

who needs tissue building

When performing restorative work such as tissue building on an elderly person, consider thatthey may be naturally emaciated.• Remember the importance of having a recent photo of the deceased, if possible• Individuals that have been sick or have suffered from prolonged disease are more likely toneed tissue building.• Be mindful of those that DO NOT need it

How much tissue builder is needed for the procedure?

A very small amount

What type of needle works best for restoring the sunken supraorbital area?

A smaller gauge and a shorter length of needle.

What are the four locations for injection of tissue builder for a sunken temple?

1. Outer edge of eyebrow 2. Sideburn, when present 3. Hair above the temple 4. Hairline behind the top of the ear

What does a larger needle correspond to in terms of gauge number?

A smaller number/gauge.

What tool may be needed to shape the nasolabial fold after injection?

A blunt tool, such as an aneurysm hook.

What type of needle is needed for thicker, more viscous fluids?

A larger needle.

site selection

A non-conspicuous area is desired for the insertion site of the needle

What should you do immediately after injecting tissue filler?

Apply pressure to the newly-filled area to spread the filler evenly

What should be done once the needle reaches the back of the orbital cavity?

Apply pressure to the plunger and slowly withdraw the needle

What are sunken tissues of the hands?

Areas where the tissue appears depressed or hollow.