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Doody's Review ServiceReviewer: Patricia Wong, MD (Stanford University Medical Center)
Description: This is a comprehensive teaching reference on how to perform injection techniques using hyaluronic fillers and neuromodulators for facial and neck rejuvenation. The chapters are divided into anatomic sites. Risks of performing the injection, indications for the injection, and anatomic considerations to be aware of to properly perform the procedure are succinctly outlined, and helpful tips are mentioned. The book includes an access code for a website with online videos of the injection techniques discussed in the book.
Purpose: The purpose is to teach the proper techniques of injecting neuromodulators (botulinum toxin), L-polylactic acid, and hyaluronic acid fillers.
Audience: The audience is dermatologists, plastic surgeons, ENT physicians, and medical providers such as RNs, NPs, etc., who perform such services.
Features: I liked the authors' concept of integrating the teaching videos demonstrating the techniques discussed in each chapter, but they varied in their educational value. The videos on botulinum toxin had a moderate amount of background conversation noise, which is distracting when trying to listen to the narration. In some of the demonstrations, the injections are being done on the lateral aspect of the face and the camera does not change angles so the viewer is unable to see where the injections are being performed. In some instances, only the gloved hands of the injector are seen as the procedure is performed. Dr. Kontis's narration as she performs the injections is very useful, as she points out the condition(s) that are intended for correction and the cause (hypertrophic muscle, volume loss, prominence of fat pad, etc.). It would be of additional value if the injector consistently would mention approximately the amounts of product that are being injected to give viewers an idea of what is reasonable needed for correction. The more advanced injection techniques, such as correction of the tear troughs and Sculptra, do not have any accompanying narration on specifics in performing the injections. Overall, however the videos are very good and the accompanying text provides helpful information. There are excellent anatomic diagrams showing the muscles and nerves that are targeted by botulinum toxin. There are advanced techniques for performing nonsurgical nasal defect corrections using fillers. The injection corrections are ranked according to level of difficulty and injector skill required. The authors have carefully emphasized and diagrammed critical zones of precautions when performing injections (important vessels and nerves to avoid complications). There is a chapter on how to treat complications, and sample consent forms are included in the appendix.
Assessment: This is a thoughtful approach to how to perform injections using neuromodulators and dermal fillers. Beginners as well as advanced injectors will find it a useful reference. It provides a wonderful overview of the broad applications of these products for nonsurgical facial rejuvenation. I look forward to the next edition.