hi it's Dr John Arlette in Calgary Alberta Canada this next section that we're going to talk about is the mid face and that's really the area bounded by the zygomaticus major the nasolabial fold the lateral wall of the nose and The Tear trough we're going to look at all of those areas really important structures that we consider every day when we're injecting patients also primary areas where we're going to have great Improvement in the results of our treatments one area that's important for you that's very helpful to use as a landmark is to find the zygomatic as major muscle look at that I got it right on so the zygomaticus major muscle is this striated band going horizontally through the middle of our screen and this originates in the zygomatic Arch and extends down to and inserts in to the modiolus so that's the lateral aspect of the mid face the medial component we've gone over extensively as the nasolabial fold the lateral wall of the nose we're now going to come up and we're going to look for the infraorbital foramen and here's the infrarital frame and we'll see this increased density of our image more Echoes coming back to it with a little bit of reverberation and mirroring we'll also see this little hook on the side which is also helpful when we're injecting from the lateral aspect towards the medial aspect it actually protects the area and here we have the infraorbital foramen and the infrarbital artery you know pulsing out of it and just Superior to that we have the facial vein which is very easy to compress and lose so there we have all of our structure we have the vein superiorly so here we have our infraorbital frame and and our infraorbital artery coming out of it Superior to that you just see the facial vein if we take a little bit of pressure off of it we can see a little bit better so on this image what we can see is we see the maxilla we see the smaz and we see the Deep medial fat compartment and superficially the more superficial fat compartment as part of the mid face and so the mid face an important structure for us to be looking at no it's also very important for us to check our patients before we inject because if they're we need to know what their vascular structure is before we inject in an area because if we come back to look after we've injected and we don't know where the vessels were beforehand we'll be surprised and perhaps even a bit confused as why we're not seeing vessels because if they didn't have them before they're not going to suddenly appear so checking before is really important if you're going to be using ultrasound imaging as part of your approach to patient safety and patient results and and efficacy foreign
