The correct steps to fill uneven forehead with hyaluronic acid

Hyaluronic acid is a common substance in cosmetic surgery. Many skin care products contain hyaluronic acid, which has a great effect on our skin. Nowadays, plastic surgery is a very popular industry. Many people who are not satisfied with their appearance will choose plastic surgery. Hyaluronic acid will be used to fill the uneven forehead. So how does the whole process proceed?

1. Block anesthesia

The forehead is the most suitable for anesthesia in the entire face because the forehead is mainly innervated by two groups of sensory nerves: the supraorbital nerve and the supratrochlear nerve, which are distributed in the brow and the middle eyebrow respectively. The former runs under the frontalis muscle and is close to the frontalis aponeurosis, while the latter runs superficially and above the subcutaneous frontalis muscle. Therefore, after blocking and anesthetizing these two groups of neurovascular bundles, the entire forehead will not feel anything, and the patient will feel very comfortable during the injection. However, the blockade can only cover the end of the eyebrow. Beyond the end of the eyebrow, it will exceed the anesthesia range, and some anesthetics will have to be applied in the temporal area.

2. Anatomy and injection levels

There are two main anatomical layers in the forehead, from superficial to deep: skin, frontalis muscle, periosteum, and frontal bone. The injection level refers to the gap between the skin and the frontalis muscle and the gap between the frontalis muscle and the periosteum.

3. Injection method

Areas like the forehead, which have thin tissue and a large area, are the best places to use blunt needle injections. It is strongly recommended not to use the short needle that comes with the injection. For such a large area, each needle is large, easily uneven, and the probability of hitting a blood vessel is much greater. When using a blunt needle, at most the needle will hit a blood vessel at the insertion point. Once it enters the correct layer, you can inject as you like without bleeding. Mark the injection range. The forehead is bounded by the ends of the eyebrows on both sides, and the injection range is mainly between the eyebrow arch and the temple angle. Mark the injection range with a marker in advance, then perform block anesthesia, and select several injection points nearby the injection range, usually at the beginning and end of the eyebrows and the edge of the hairline. The principle is that the injection should be comfortable for you. At the same time, the two injection points should be crossed to form a grid injection for a more uniform distribution. After preparation, install a blunt needle on the hyaluronic acid syringe, enter from the injection point and move towards the deep cavity. Grasp the skin and frontal muscle with one hand and insert the needle with the other hand to ensure that the blunt needle moves on the periosteum. Withdraw the needle, push the medicine and press at the same time. Take your time and try to inject it evenly. Inject a part at one injection point, and then inject some from another injection point in different directions. This will be more even. The position where frontotemporal injections are most prone to unevenness occurs above the end of the eyebrow, which is where the forehead and temple meet. There is a ligament at this location, which creates greater resistance when passing through it. During surgery, this location requires subperiosteal dissection to allow the eyebrows to be free. In short, inject slowly and as evenly as possible at this location.

4. Post-injection treatment

After the injection, do not press with your fingers, as this will create a dent. Instead, press with the thenar eminence of your palm, and press evenly on uneven areas. Be sure to seal the needle hole with antibiotic ointment and then immediately incubate it with ice packs. This way, there will be basically no swelling after the operation and patient satisfaction will be much higher. Do not touch the injection site with water for 24 hours after the injection. There are no dietary restrictions. It usually stabilizes in about a week, so avoid high-temperature saunas during this week to prevent swelling.