I had this done with juviderm ultra and also my nasolaial folds. My right side I felt filler moving up the side of my nose underneath, it’s hard to explain. She said that was normal and I would feel stuffy nosed for a few days. This was in august. Now I have sunken eye on right side and pain behind eye. I went back and she said she does not want to dissolve filler or even soften it a bit even though it is overfilled and there is a bump in it. She said it looks beautiful and my eye is a different problem. But what a coincidence. I am now seeing ophthalmologist, ent and trying to figure out what happened to my eye and vision. Filler is still there and I regret it so much.
You’re doing right by getting your eyes checked by ophthalmologist. Coincidence is possible. It’s highly unlikely though that filler has migrated from this region to the back of your eye. Fingers crossed you get some answers from your doctor. Kind regards Mary. Clinical advisor for Dr Tim
You’re doing right by getting your eyes checked by ophthalmologist. Coincidence is possible. It’s highly unlikely though that filler has migrated from this region to the back of your eye. Fingers crossed you get some answers from your doctor. Kind regards Mary. Clinical advisor for Dr Tim
And this is why I will never get fillers until I actually 100% know that my injector is an expert. We got people like you going around injecting other people without having the full knowledge of how to inject.
I was given the injection in this area and it did lift the lip a little and gave more volume to the area but it did not fill the nasolabial fold... my question is if the fold is farther away from the area injected how can it fill the nasolabial fold? thank you
Why can’t fillers be done with some sort of scanning device to see where the arteries and blood vessels are? I’m sure not everyone has these situated exactly in the same place. Seems just so dangerous to me when injecting filler just millimetres in the wrong place could blind you forever. I’m honestly so surprised that this industry isn’t more strictly regulated and fillers should be scan assisted. Even if the filler doesn’t go into the artery it compress it enough to cause necrosis surely? I have a bad nasolabial fold on one side but because my mid face is flat, I don’t have the fold starting from my nose. The crease gets worse near my mouth and towards my jowl area. Is this a less dangerous area to fill?
Hi there. Great question. Yes, you could use that - the advantage being that it's a fixed point. But on a day to day basis I'd use the alar base more often. The artery is usually superior and lateral to the nasolabial fold, but you can palpate to make sure it's not in the fold. And then the alveolar ridge would represent your inferior boundary, and the nasolabial fold, your superior boundary. Thanks for the question, Tim
Dr Tim Pearce thank you for your response! May I also ask the direction of your needle? Is it approximately a 45 degree angle to the skin, and pointing towards the contralateral oral commissure? Thank you again for your time!
Thank you for a great info guys. I always thought 90 degrees down on the bone was Safe. What's the maximum amount of filler you would put in ? Thank you x
(1) Assuming the injector is experienced, how common is it to have serious complications from injecting treatments? 1 in a hundred? 1 in 500? 🤔 (2) Fillers and botox are both used to treat nasolabial folds. Is the injector risk equal for both?
Depends on the most recent data that’s available but the one cited in 2021 suggested that rates of occlusion using needle is 1:6000 and 1:40,000 using cannula. This was a cohort of experienced dermatologists but with the world also involving many non experienced practitioners and non medics providing dermal filler treatments we can’t know for sure without regular data collection. Our experience is though the more experienced the better the odds. But even the most experienced can still experience VO. Kind regards Mary. Clinical advisor for Dr Tim
I am also wondering how many are officially reported? Are only the most serious occurrences reported? And, it seems reporting would depend on the ethics of the provider. @@DrTimPearce
If you have an ultrasound machine and competent at how to read the results it will be a fantastic tool. But remember it is still just a screening tool. Nothing is 100% fool proof. Kind regards Mary. Clinical advisor for Dr Tim.
Hello!!!! I love your videos! I am a relatively new injector…..I do own a butterfly 🦋 ultrasound probe that attaches to my phone! And am learning how to use it…..do you have any tips for me or thoughts about injecting with needle visualization?? I have tried to look some things up but can’t find much to help me
My advice would be to hone your skill with needle/ cannula first. Safety measures such as aspirating will get you further and understanding depth and safety margins. Once you are proficient you can then look at multitasking.
@@DrTimPearce thanks for clearing my doubt. just a medical student who was actually searching for a video on piriform fossa in the hypopharynx and got totally confused🤣after watching this video
You are saying the wrong muscle. You keep saying o orbicularis oculi and it’s the orbicularis oris that your talking about in this pod cast.the orbicularis oculi is around the eye.
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The most informative video which I have ever seen!!! Thank you a lot, dr.Pearce!
Amazing and informative videos 🙏 thank you so much
Thank you ! But what do you recommend for 50+; fillers in pyriform fossa or nasolabial folds?
Fantastic advice!
I had this done with juviderm ultra and also my nasolaial folds. My right side I felt filler moving up the side of my nose underneath, it’s hard to explain. She said that was normal and I would feel stuffy nosed for a few days. This was in august. Now I have sunken eye on right side and pain behind eye. I went back and she said she does not want to dissolve filler or even soften it a bit even though it is overfilled and there is a bump in it. She said it looks beautiful and my eye is a different problem. But what a coincidence. I am now seeing ophthalmologist, ent and trying to figure out what happened to my eye and vision. Filler is still there and I regret it so much.
You’re doing right by getting your eyes checked by ophthalmologist. Coincidence is possible. It’s highly unlikely though that filler has migrated from this region to the back of your eye.
Fingers crossed you get some answers from your doctor.
Kind regards Mary. Clinical advisor for Dr Tim
You’re doing right by getting your eyes checked by ophthalmologist. Coincidence is possible. It’s highly unlikely though that filler has migrated from this region to the back of your eye.
Fingers crossed you get some answers from your doctor.
Kind regards Mary. Clinical advisor for Dr Tim
Hello, I’ve had something similar. Filling the filler going up on the side of my nose . How is everything now for you? I hope all is well
Please give us an update
Sue her.
Can radiesse be injected into the pyriform fossa??
You're the best! Thanks for sharing!
very informative , thanks
Gosh i was taught so wrong i will have to wait to redo these till i can practice this technique ! Thank you i will keep watching you
And this is why I will never get fillers until I actually 100% know that my injector is an expert. We got people like you going around injecting other people without having the full knowledge of how to inject.
Superb video!
I was given the injection in this area and it did lift the lip a little and gave more volume to the area but it did not fill the nasolabial fold... my question is if the fold is farther away from the area injected how can it fill the nasolabial fold? thank you
Mirinda is super cute 🥰
Why can’t fillers be done with some sort of scanning device to see where the arteries and blood vessels are? I’m sure not everyone has these situated exactly in the same place. Seems just so dangerous to me when injecting filler just millimetres in the wrong place could blind you forever. I’m honestly so surprised that this industry isn’t more strictly regulated and fillers should be scan assisted.
Even if the filler doesn’t go into the artery it compress it enough to cause necrosis surely?
I have a bad nasolabial fold on one side but because my mid face is flat, I don’t have the fold starting from my nose. The crease gets worse near my mouth and towards my jowl area. Is this a less dangerous area to fill?
Some injectors actually do use a small ultrasound device while injecting those riskier areas to verify that they're in a safe zone to inject.
Do you palpate the alveolar ridge and stay just superior? Does this anatomical landmark play a role in your injection technique at all?
Hi there. Great question. Yes, you could use that - the advantage being that it's a fixed point. But on a day to day basis I'd use the alar base more often. The artery is usually superior and lateral to the nasolabial fold, but you can palpate to make sure it's not in the fold. And then the alveolar ridge would represent your inferior boundary, and the nasolabial fold, your superior boundary. Thanks for the question, Tim
Dr Tim Pearce thank you for your response! May I also ask the direction of your needle? Is it approximately a 45 degree angle to the skin, and pointing towards the contralateral oral commissure? Thank you again for your time!
Is it hard to dissolve there ?
Same question
Thank you for a great info guys. I always thought 90 degrees down on the bone was Safe.
What's the maximum amount of filler you would put in ?
Thank you x
Hi Katarina. Thanks for this great question. The max I would put in 0.3ml per side. All the best, Tim
@@DrTimPearce Hi Dr Tim, can filler injected into the piriform fossa at the nose area have a chance of migration? Thank you. x
@@wem-c9f Hi there. Yes all filler has the capacity to migrate. Kind regards Mary. Clinical advisor for Dr Tim
@@DrTimPearce Thanks so much, Mary! 💝
So this is terrifying.
(1) Assuming the injector is experienced, how common is it to have serious complications from injecting treatments?
1 in a hundred? 1 in 500? 🤔
(2) Fillers and botox are both used to treat nasolabial folds. Is the injector risk equal for both?
Depends on the most recent data that’s available but the one cited in 2021 suggested that rates of occlusion using needle is 1:6000 and 1:40,000 using cannula. This was a cohort of experienced dermatologists but with the world also involving many non experienced practitioners and non medics providing dermal filler treatments we can’t know for sure without regular data collection.
Our experience is though the more experienced the better the odds. But even the most experienced can still experience VO.
Kind regards Mary. Clinical advisor for Dr Tim
I am also wondering how many are officially reported? Are only the most serious occurrences reported? And, it seems reporting would depend on the ethics of the provider. @@DrTimPearce
What product do you prefer ?
We like the vycross range. Voluma for deep lines or volift for softer.
Kind regards Mary. Clinical advisor for Dr Tim.
Or even renuva?
What about using ultrasound to check depth?
If you have an ultrasound machine and competent at how to read the results it will be a fantastic tool. But remember it is still just a screening tool. Nothing is 100% fool proof.
Kind regards Mary. Clinical advisor for Dr Tim.
How big bolus do you inject?
Not more than 0.3 in total, in separate injections for each alar is what we recommend in one bolus.
Kind regards Mary. Clinical advisor for Dr Tim
Hello!!!! I love your videos! I am a relatively new injector…..I do own a butterfly 🦋 ultrasound probe that attaches to my phone! And am learning how to use it…..do you have any tips for me or thoughts about injecting with needle visualization?? I have tried to look some things up but can’t find much to help me
My advice would be to hone your skill with needle/ cannula first. Safety measures such as aspirating will get you further and understanding depth and safety margins. Once you are proficient you can then look at multitasking.
Ok but you can't just aspire before inject?
Always aspirate before you inject yes. It’s another safety test than helps you sleep at night!
Kind regards Mary. Clinical advisor for Dr Tim
I'm interested in getting a pyriform aperture augmentation, is it risky? Would you recommend it?
isn't piriform fossa located in the hypopharynx?😅
yes, there's one there too. Just means pear shaped hole!
@@DrTimPearce thanks for clearing my doubt. just a medical student who was actually searching for a video on piriform fossa in the hypopharynx and got totally confused🤣after watching this video
@@pungjikonia5155 Good luck with your studies! It's worth learning some of word origins, makes it easier to remember... now you know pear shaped!
Did you mean Orbicularis ORIS ? Not oculi…oculi is the muscle surrounding the eye.
Michael Jackson cameo.
You are saying the wrong muscle. You keep saying o orbicularis oculi and it’s the orbicularis oris that your talking about in this pod cast.the orbicularis oculi is around the eye.