In different non-surgical facial procedures, fillers are used to inject in the dermis and mid-dermis skin layers. Out of these fillers, some are semi permanent while others are temporary fillers. As these fillers are not injected into deeper skin layer where nerves are located, so aesthetician think that there is not going to be any potential harm.
However, the important thing to understand in this regard is that it is not necessary that the fillers directly cause harm to the nerves, the injury can be also be caused due to some indirect cause. If any complication or infection develops at an early treatment stage, it can spread in the surroundings affecting the underlying nerves. Even in some cases, the late complications like granulomas or late skin infections can also involve the underlying nerves.
The key to injecting fillers is injecting the right filler at the appropriate level to the right patient and also at appropriate time.
Steps involved in injecting fillers
Many different studies had been performed regarding the facial nerves which only provide bi-dimensional guidelines to the practitioners. But for treating with precision three dimensional nerve understanding was required which has now been achieved through the redefinition of the various nerve layers, especially located in the temporal area.
For better understanding, here is a brief overview of various layers. First is the skin, then some subcutaneous tissue layer followed by SMAS or galea cells and then the superficial temporal fascia. There are also some loose tissues that separate the SMAS and the periosteum layer and are of significant importance.
Developing understanding about the various layers from the perspective of superficial temporal fascia is essential while injecting on the zygomatic arch because it helps in identifying the specific fat pad during the dissection for facelift.
There are seven facial nerves danger zones which should be avoided while injecting fillers to the face.
The injections of fillers in the pre-jowl region are increasingly becoming popular and practitioners should take into consideration that these nerves tend to become more fragile and superficial while leaving from the foramen. All this area is supplied by the nerves so it could lead to the severe complications, if injected wrongly.