Aesthetic Surgery of the Face and Neck
Core concepts
Understand facial aging in layers (skin, fat compartments, SMAS, bone), rhytidectomy planes (subcutaneous, SMAS, deep plane), neck rejuvenation (platysmaplasty, submental lipectomy), and the aesthetic units of the face. Know filler and neuromodulator anatomy and danger zones.
Traps in questions
- Confusing the superficial musculoaponeurotic system plane with the subperiosteal plane; each has distinct indications and risks.
- Missing vascular occlusion after filler injection; questions may test blanching and pain requiring hyaluronidase.
- Forgetting that the marginal mandibular and temporal branches are at risk during rhytidectomy and filler placement.
- Assuming more aggressive dissection always gives better results; nerve injury risk rises.
Rule of thumb
Blanching with pain after hyaluronic acid filler means stop, aspirate, and inject hyaluronidase along the vascular territory.
Worked example
A patient develops livedo reticularis and pain over the glabella after filler. The question asks the immediate step. The rule: this is vascular compromise; inject hyaluronidase promptly and consider warm compresses. Waiting to observe is the wrong answer.