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Review Downloaded from https://journals.lww.com/plasreconsurg by ZoaEWhhzYovG2DbCmEC8o294qSbBgwURYIi2tPDTawxXULb+uUp7fTWM2e6NHNI4JCHTXGCZOpvnMq3hs1Swdcy+buHPgMM8yaGqvdsrlkJMfeibtMJid+FVATjrOVuYQ7av+k1mTkZpadyaFOb+TXSd0UZAOxW7WV42+OKcjH4= on 03/22/2019
Cosmetic Injection Techniques: A Text and Video Guide to Neurotoxins and Fillers By Theda C. Kontis and Victor G. Lacombe. Pp. 202. Thieme Medical Publishing, New York, N.Y. 2012. Price: $99.99.
T
he authors have clearly indexed and organized Cosmetic Injection Techniques such that the reader can focus on a specific clinical objective and then have an illustration of injection site anatomy. This is a useful introduction for physicians beginning to use neurotoxins and fillers. The authors review a great diversity of potential uses, but do not always deal with subtleties of injections and complications. Fifty-six videos of injection techniques are accessible on the publisher’s Web site. These videos add minimal insight into the techniques. The injector’s hand often obscures the injection site, the depth of injection is not routinely shown, and neurotoxin dose and filler volumes are not routinely discussed. I would prefer fewer repetitions of sites but greater emphasis on the details and use of close-ups. Section I, Introduction to Neurotoxins, reviews six different brands and four different dilutions, but it does not discuss pros and cons. Section II, Neurotoxin Injection Techniques, is divided into 25 chapters, each describing a specific clinical objective. There are chapters entitled “Neurotoxin Injection for Glabellar Frown Lines,” “Injections for Smile Lines and Crow’s Feet,” “Neurotoxin Injection for Profusely Sweating Underarms,” “Neurotoxin Injection for Migraines,” and 20 other clinical problems. Each chapter is divided into Indications, Anatomic Considerations, Injection Techniques, Precautions, Postinjection Instructions, Risks, and Pearls of Injection. There are helpful illustrations showing the regional muscle anatomy, the
injection sites, and, sometimes, pertinent vascular and nerve anatomy. However, I think there should be more discussion of how to avoid the most common significant problems of eyelid ptosis, glabellar ischemia, facial muscle paralysis, intravascular injections, and bruising. Section III, Introduction to Fillers, reviews fillers by chemical classification and product name. The list includes collagens, hyaluronic acids, and other, longer-lasting products, such as Radiesse, Artefill, and Sculptra. Because hyaluronic acids are the primary filler in use, I would have liked a more extensive description and comparison of the appropriate use of the many hyaluronic acid products. The “Filler Injection Methods” chapter has diagrams of serial puncture, linear threading, fanning, crosshatching, grids, and ferning. It also includes a paragraph about using blunt needles and cannulas. The “Anesthesia Techniques” chapter would be better with more diagrams. Even in the video chapters, regional nerve blocks are not adequately described. Section IV describes and illustrates 25 chapters of clinical problems, such as “Filler Injection for Nasolabial Folds,” “Filler Injection for Cheekbone Augmentation,” and “Filler Injection for Aging Hands,” along with 22 more. For some clinical problems, the authors discuss their preference for a class of filler (e.g., hyaluronic acid) but not which variations of each brand (e.g., Juvéderm, Juvéderm Ultra, Juvéderm Ultra Plus, or Juvéderm Voluma). There are separate chapters for the more problematic Radiesse, Artefill, and Sculptra. Most chapters discuss which level in the skin should be injected and which technique the authors use. However, the authors do not usually describe advantages and disadvantages or why they choose each class of product. I would like to emphasize that the book and video are appropriately titled “Injection Techniques.” The book is a “how I do it” and does not focus on basic science or alternative methods. It is a useful starter book for early-stage clinicians or residents seeking basic concepts and techniques. However, the book and video should be combined with hands-on clinical training before attempting these treatments. It is of limited value to an experienced plastic surgeon. DOI: 10.1097/PRS.0000000000000046
Copyright © 2013 by the American Society of Plastic Surgeons
462
www.PRSJournal.com
Ernest Kaplan, M.D.
Cosmetic Injection Techniques: A Text and Video Guide to Neurotoxins and Fillers By Theda C. Kontis and Victor G. Lacombe. Pp. 202. Thieme Medical Publishing, New York, N.Y. 2012. Price: $99.99.
T
he authors have clearly indexed and organized Cosmetic Injection Techniques such that the reader can focus on a specific clinical objective and then have an illustration of injection site anatomy. This is a useful introduction for physicians beginning to use neurotoxins and fillers. The authors review a great diversity of potential uses, but do not always deal with subtleties of injections and complications. Fifty-six videos of injection techniques are accessible on the publisher’s Web site. These videos add minimal insight into the techniques. The injector’s hand often obscures the injection site, the depth of injection is not routinely shown, and neurotoxin dose and filler volumes are not routinely discussed. I would prefer fewer repetitions of sites but greater emphasis on the details and use of close-ups. Section I, Introduction to Neurotoxins, reviews six different brands and four different dilutions, but it does not discuss pros and cons. Section II, Neurotoxin Injection Techniques, is divided into 25 chapters, each describing a specific clinical objective. There are chapters entitled “Neurotoxin Injection for Glabellar Frown Lines,” “Injections for Smile Lines and Crow’s Feet,” “Neurotoxin Injection for Profusely Sweating Underarms,” “Neurotoxin Injection for Migraines,” and 20 other clinical problems. Each chapter is divided into Indications, Anatomic Considerations, Injection Techniques, Precautions, Postinjection Instructions, Risks, and Pearls of Injection. There are helpful illustrations showing the regional muscle anatomy, the
injection sites, and, sometimes, pertinent vascular and nerve anatomy. However, I think there should be more discussion of how to avoid the most common significant problems of eyelid ptosis, glabellar ischemia, facial muscle paralysis, intravascular injections, and bruising. Section III, Introduction to Fillers, reviews fillers by chemical classification and product name. The list includes collagens, hyaluronic acids, and other, longer-lasting products, such as Radiesse, Artefill, and Sculptra. Because hyaluronic acids are the primary filler in use, I would have liked a more extensive description and comparison of the appropriate use of the many hyaluronic acid products. The “Filler Injection Methods” chapter has diagrams of serial puncture, linear threading, fanning, crosshatching, grids, and ferning. It also includes a paragraph about using blunt needles and cannulas. The “Anesthesia Techniques” chapter would be better with more diagrams. Even in the video chapters, regional nerve blocks are not adequately described. Section IV describes and illustrates 25 chapters of clinical problems, such as “Filler Injection for Nasolabial Folds,” “Filler Injection for Cheekbone Augmentation,” and “Filler Injection for Aging Hands,” along with 22 more. For some clinical problems, the authors discuss their preference for a class of filler (e.g., hyaluronic acid) but not which variations of each brand (e.g., Juvéderm, Juvéderm Ultra, Juvéderm Ultra Plus, or Juvéderm Voluma). There are separate chapters for the more problematic Radiesse, Artefill, and Sculptra. Most chapters discuss which level in the skin should be injected and which technique the authors use. However, the authors do not usually describe advantages and disadvantages or why they choose each class of product. I would like to emphasize that the book and video are appropriately titled “Injection Techniques.” The book is a “how I do it” and does not focus on basic science or alternative methods. It is a useful starter book for early-stage clinicians or residents seeking basic concepts and techniques. However, the book and video should be combined with hands-on clinical training before attempting these treatments. It is of limited value to an experienced plastic surgeon. DOI: 10.1097/PRS.0000000000000046
Copyright © 2013 by the American Society of Plastic Surgeons
462
www.PRSJournal.com
Ernest Kaplan, M.D.
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