Hello everyone, welcome back to fact
facial assessment with Clarius
technology. I'm Dr. Roya Zarmamin and
today episodes is about bal fatbat an
important structure for midface volume
and contour. It's crucial to um
pre-treatment assessment with ultrasound
in terms of its size position and
relation to adjacent structure. BUL
fatpad is a we can see it as a triangle
or oval structure a little bit hypercoic
uh in ultrasound image
and a parotted duct sometimes it's
visible on upper part of this fat pad
and facial vein in a lateral part of
this area.
Why it's important to have uh this
pre-treatment assessment because not
everybody is a good candidate for boual
fat pad reduction surgical or
non-surgical. I'm using
L20 linear probe for this area and
choose the preset of chin and jaw.
A scan should start from the lateral
part to see all the layer and especially
mandible
bone and massar muscle. As you see we on
the lateral part or left side of the
image we see the a little bit hazy
cloudy structure which is proed gland.
On top is paridto masetary fascia fascia
as a parallel lines hypercoic lines and
bone as hypercoic in the bottom of the
image. A bulky hypocoic structure with
hypercoic line inside which is the deep
inferior tendon inside the massar
muscle. I ask my patient to clinch
and this is your muscle. Now relax and
we are scanning
and gliding anteriorly
and rotate
our scanner.
We need to change a little bit of the
gain because of the fat pad here in
cheek area.
In the left part you see the anterior
border of mear muscle
oblique hypocoic lines. It might be
vaccinator but we don't know. We ask the
patient to animate.
Yeah that's the vaccinator muscle. Now
you see it as a very very thin delicate
hypoechic line. Relax. And now between
this on the left side is masser below is
the oblique
vaccinator muscle. Oblique means it's
coming from the deep part and medially
going superiorly and medially and the
triangle area which is the bal fat fat
and
I can just
show you the area.
This is the bal fat pad beneath the
parotidomic fascia anterior to mass
muscle superior to boxinator muscle.
Now let's use power doppler because
there is a crucial area here
which is the
facial vein.
You see the facial vein
and I see a little bit hypocoic
docked hypocoic
structure which is proided docked. It's
very important to see the size to see
the depth and the thickness
onroposterior diameter of this fat fat.
Let's go back to the
And now I can even measure the entro
posterior
diameter of the bal fat bath here is 9
mm.
It concludes that ultrasound can help us
determine the candidacy of bal fat pad
reduction. The second is to avoid a
crucial structure like vein uh arteries
and protect.
The second is to plan accordingly if we
are going for surgical or non-surgical
fat pad reduction. And the last one is
to have a baseline
anatomical landmark and an anatomical
measurement to compare
after treatment as well. Thank you for
joining us uh in this fact series and
stay tuned for the next one.