Restorative Art III - Hypodermic Tissue Building)

Liquid colloid (tissue builder/filler)

*Most superior type of tissue filler available.* Available from most mortuary suppliers.

Reusable metal type syringes

- Provided by mortuary suppliers. - More expensive - Less necessary to refill due to larger capacity cylinders

Types of Tissue Filler (3)

- liquid colloid - massage cream - humectant fluid

superficially

Correct procedure calls for inserting the needle ______________________ and directing it toward the distant point of the area to be treated.

hollow spaces on the back of the hand

Correction of the _______________________________ can be made using hidden points of injection in the hidden spaces between the knuckles at the back of the fingers.

hidden points of insertion

Depending on the area to be treated, it is advisable to make every attempt to utilize ________________________________ of the needle in order to conceal the mark often time made when the needle punctures the tissue.

Separated Mucous Membranes of the Lips

Entry of the needle is made into each mucous membrane at both ends of the line of closure. Insertion of the needle is only to the midline, injecting filler as the needle is retracted, working the upper mucous membrane first, and then the lower.

Sunken Integumentary Lips - Lower lip

For treating this, the hidden insertion of the needle can only be from the corner of the mouth on the lower mucous membrane.

Sunken Integumentary Lips - Upper lip

For treating this, the hidden insertion of the needle should be within the nostrils or from the corners of the mouth on the upper mucous membrane.

Treatment of Sunken Temples

Hidden points of injection: - Lateral end of eyebrow - Sideburn - Hair of temple - Behind top of the ear = Behind anterior part of helix

Treatment of Sunken Cheeks

Hidden points of injection: (at least 2 injection sides on opposite sides) - Nostrils - Corners of mouth - Behind lobes of ears - Behind tragus of ear - Behind upper part of jaw line

gauges; length

Hypodermic needles are available in varying ____________________, and it is wise to consider a supply of varying _______________ for the various types of tissue building techniques and areas that may be involved.

Treatment of Shrunken Eyeballs

If the eyeball is undamaged, tissue builder should be injected into the eyeball by inserting the needle from the lateral side of the eyeball in order to round out the globe to original and normal shape.

not observable; no need

If the puncture point of the needle is __________________ to the viewer, there is generally _______________ to treat the puncture cosmetically to cover the mark left on the skin.

Small diameter needles

More desirable for use with liquid fillers.

Larger diameter needles

More suited to cream type tissue fillers.

slowly injected as the needle is retracted

Once the needle has been inserted to its most distant point of treatment, the filler should be ______________________________________________________.

move superficially; quicker; less

Placing the sharp, pointed side of the needle against the skin when the needle is ready to be inserted helps the injected filler __________________________ as it is injected, and offers ___________ results with ___________ product necessary for treatment.

Massage Cream

Possible substitute if liquid colloid is unavailable. To make injection easier, it can be mixed with a small amount of mineral oil to soften its consistency.

over-inject

Remember not to ___________ when lesser is better.

cotton pad

Remove the needle with a __________________ in hand to quickly cover the puncture point, allowing minimal leakage until the filler product has begun to gel.

Place the sharp, pointed side of the needle against the skin when it is ready to be inserted

Since most hypodermic needles are tapered at the pointed end, it is suggested for best results to do what?

pad of each fingertip

The emaciated ______________________________________ may be filled from the same hidden point of entry as treating the sides of the fingers.

Treatment of Sunken Supra-orbital area

The normally convex area between the eyebrow and upper eyelid can be restored by injecting tissue filler downward through several puncture made in the eyebrow. If the operator's finger are lightly place on the eyelid, the filler can be contained in the area without flowing into the eyelid.

Plastic disposable syringes

These are generally very satisfactory and less expensive.

Recent photographs of the deceased when they were in a better state of health or condition

These can help determine how much tissue building may need to be done and where these alterations are best served.

Spreading and evenly distributing filler

This can be done as the filler is being injected with: - Application of finger pressure over the actual point of injection. - Light massage with the operators fingertips soon after injection.

Hypodermic Tissue Building

This is NEVER recommended prior to arterial injection, because the accurate requirements cannot be predetermined.

Humectant fluid (Moisture retainer)

This may be added to the embalming solution to be arterially injected and may serve as an internal tissue builder.

Embalming process

This may replace moisture in the tissues and erase most of the signs of emaciation.

accompanying solvent sent

When cleaning the needle and syringe, it is advised to only use the __________________________________ with the colloid product, and not to use water (because it will clog and ruin the syringe).

Liquid colloid (tissue builder/filler)

When this comes in contact with tissue moisture of any type, it changes from a liquid form to a gelatinous form and ultimately becomes quite dense.

Emaciated fingers

________________________ may be treated by inserting the needle at the sides of the joints of the fingers needing treatment. The needle can be directed either direction from this point for proper treatment.

Treatment of Sunken Eyes

A small amount of tissue builder should be injected behind the eyeball, in the tissue located in the back of the eye-socket. The medial canthus (corner) of the eye is the more appropriate point of entry for the hypodermic needle and moving the needle along the laterally running bone structure of the medial side of the eye-socket to avoid puncturing the eyeball and causing a leak.

Sunken Submandibular Area

A long needle is necessary to restore this area since the hidden point of entry is located behind each angle of the jaw, and must reach the midline below the chin.

Hypodermic Tissue Building

A post-operative treatment for altering the appearance of emaciation of the face, neck, and hands.

Humectant fluid (Moisture retainer)

An embalming solution additive, described as a moisture retainer and thus a possible substitute for tissue building (as a last resort). Due to this product remaining liquid once injected, its effect is very temporary. Over time, due to the product gravitating, concavities may reappear, and initial work redone.