So here we are with our beautiful patient and I want to share with you some pearls, tips and tricks to identify
the DAO, DLI, mentalis, platisma and massitor muscle. I want you to
understand the depths, function and injection relevance and of course demonstrate the transverse
longitudinal and dynamic scanning. So if we want to identify the DAO muscle, this is the proof placement and this is how
the image we need to see with a little gel not touching too much the skin and
we can identify very very clear the epidermis dermis
epidermis dermis and here we can see how the dao muscle
can cross all the different planes in this area. Now, we're going to see the function of the DAO muscle.
Again, stop. Again, stop. And again, stop.
So, here we can see the video record how the contraction of the muscle
make us easily to identify this portion of the muscle.
here in a plane non-contracted and here in full contraction.
So here also we can see how the skin show us the different kind of wrinkles
that we do when we do the contraction of the DAIO muscle.
So now I want to show you the injection relevance to treat this muscle specifically because there are some
patients that are concerned about the less definition mandible angle. In this
case when she do this movement please do this area mark a little bit more the
jaw. So in case that we want to improve this area, we can use bottling and toxin
and obviously the ultrasound image is very very good to be very precise with
the injection. So in this case we can use a needle and go as specifically in this part of the muscle and we can get a
better clinical result. misunderstand the DAO to the DLI muscle is a warranted
asymmetry. What happen if we misunderstand the fibers of the different kind of muscles the the
patient two weeks later is going to be with this inferior lip with the asymmetry according to the
other side. So now for the mentalis muscle, the anatomy of the chin, the normal anatomy of the chin with no fillers is going to show us the bone,
the muscle, the different fibers that going through the dermis and the epidermis. This area is gel.
So after a normal position if we ask to the patient to contract we can identify different kind of fibers doing this more anequake area. Stop again.
Perfect. So we can see in this video how the fibers do the contraction and we can
even lose the image of the bone. This is all contraction.
In this longitudinal position, we can see all the planes. But also we can try with the transversal position.
Here we can see the different kind of planes.
So here we can identify the epidermis and dermis and then the different connections in the f to the fibers of
the muscle going more superficial to the dermis. And here the muscle in the more deep position here the bone.
The clinical relevance for this type of injections in our area is to identify
the problem of our patients especially for this kind of patient that has too much force or hypotonic muscle. And we can identify perfectly the muscle here.
And we can go and inject right into the muscle the bottling and toxin.
In another area, we can also treat the patient when she or he has less uh
projection of the chin. And in that case we can inject with a canula or needle
our filler in this area very right in the top of the bone or also we can put
our filler here in the subcutaneous area with a canula. So now we have a lot of patients that are concerned about the
neck. In this case the anatomy of the neck in a muscle area. We can see that here we have stop
and again stop and again stop and again here we can see the different kind of areas
epidermis dermis and then we can see the contraction of the muscle which is platisma.
This contraction help us to identify the muscle and then make our patient looks
more young and less platisma bands defined.
Okay. Now we will identify the massitor muscle which is a very important muscle especially for some patients that are
looking for a more defined area in the mandibular area.
If we can see here we can clearly identify the epidermis dermis subcutaneous layer then the masoteric
fasia and then both areas of the masser muscle the superficial one the deep one
and then the bone in a dynamic position if we ask to the patient to clinch clinch please. Yes.
Stop. And again.
Perfect. We can see here in the video that we can identify which fibers of the
muscle can do the compression, change the shape of the muscle. And this is
very important to analyze the uh kind of treatment that we want to do in our patient. For example, if we want to make
them look more uh slim and defined in the mandible area, we need to inject
very deep in this very deep area and then also superficial deep and superficial. We can inject
bottling and toxin here touching the bone and then do a retrograde injection until this portion of the muscle.
If we want to avoid this kind of complication called paradoxical
masoteric bulging, we need to do what I just said. Always inject deep and also
superficial including both areas of the masoteric muscle here and here.
Otherwise in the clinical material we will see that the patient is going to show here just like a ball very uncomfortable in anesthetic.