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Hello community. Clarius. How is everyone? Today we are going to learn how to use the ultrasound to

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be able to plan a facial procedure. If you have patients in your office who are

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going to undergo facial procedures, it is important to learn the protocols to be able to evaluate the

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facial anatomy. In this case we are going to evaluate the superficial extension of biopolymers. The

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biopolymers we will be able to identify with patterns and with important ultrasounds and that are

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images that we cannot forget. Next we are going to use an L15 to be able to observe the

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superficial extension of biopolymers. And in this topic today on lips, what does it work for? So that

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we can then evaluate how much topography is invaded by this product and that facial surgeons

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can analyze whether or not they can perform a procedure in that topography. Next,

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it is always important to know where our notch is, yes, to connect our equipment safely

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and never forget an ultrasound tip that you will find on our networks. The notch from

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now on is the reference for what is the Clarius logo. So the Clarius logo

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is equal to the screen's notch. Next, what we are going to do then is

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identify that we are in the right place. Look at the right side and the right side on the

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screen. The screen looks at you. So it's the right side of the screen, the right side,

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the transducer towards the right side of the patient. How are we going to evaluate the lips?

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We are going to project our transducer cephalad and we are going to place ourselves on the lower lip.

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Why do I like to do it this way? Because this way I can also know the

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superficial extension of the lip or the product that is there. Ok. In this

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way we hold our lip. We squeeze and we are going to place our transducer with a

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sufficient amount of gel. And there what we are going to see is the layers of the skin and we are going to see an

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extension and a thickness of the soft tissues of the lip. That is very important because

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there we are going to be able to know how far and what topography of the lip this

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non-absorbable product is taking up as you see it on the screen. We are seeing all this

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snowstorm pattern that does not let us identify and now what we do is look for an anatomical reference image

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and in this case it is the teeth and the muscle. Remember that with Clarius

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L15 we are also going to be able to analyze the anatomy using T mode. T mode

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will give us an anatomical guide with artificial intelligence so that we can understand a

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little where we are located there. So, what we see is if I see all the

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anatomical structures from top to bottom and even the teeth. That

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muscular line that looks very good. And the soft tissue? What we do is a scan

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towards the inner face. We are scanning and we see the transition point and this transition point

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We are going to place them in the midline of our screen in the middle of the screen.

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And this for what? So that we can see in the midline of the transducer a location where

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the transition point of our biopolymers is precisely found.

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So we already see where our natural or adequate or normal anatomy is and the

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transition point with the largest volume of lesion there. So being able to mark and

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evaluate we are going to evaluate the transition. Look how it changes and begins to

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analyze the Snowstorm pattern. What does this indicate? It indicates that in

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deep planes in the lip we do not have this product and in the superficial planes

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we do have the material, because when we make the transition with the sweep from

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the lower part of the lip towards the superficial face of the lip and the depth changes,

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we see how all the snowstorm pattern appears intensely and precisely

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In this way we can identify and tell our

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surgeons or our colleagues or yourself if you are going to do an injection, to be able to evaluate how far

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you will be able to perform the procedure. Another important tip that we are going to do on the lip is

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go towards the labial commissure and in the labial commissure we are going to place Color Doppler

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Remember that Color Doppler does not mean arteries and veins. Color Doppler means

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flow direction. Here we are going to see how the vascular bifurcation is. And we also put

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Power Doppler. With Power Doppler we identify the vascular flow

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and we can see then in both longitudinal and transverse sections the bifurcation and how

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the facial artery becomes the superior pathway and the inferior pathway. This gives us the

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peace of mind that these deposits of non-reabsorbed products are not generating an increase in

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intra-luminal pressure. And the only way to know this is to identify the resistance index of the

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arteries. Remember that with the ultrasound we are going to do real-time anatomical dissection

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and we are going to pinpoint the planes to be able to plan a safe procedure.