PMC6955121_01
CT scan showing left displaced malar fracture. Blue dots point areas where HA was injected deep to the bone.
CRIS2019-1360741.001.jpg
PMC6955121_01_CRIS2019-1360741.001.jpg
fig1
Only few weeks later, the patient noted facial asymmetry and a complete fracture of the zygomatic arch emerged after CT scan evaluation (Figure 1).
Preinjection marking.
CRIS2019-1360741.002.jpg
PMC6955121_01_CRIS2019-1360741.002.jpg
fig2
After a careful evaluation of the CT scan, we decided to inject sovra-periosteally in the injured area: 1 mL of VYC-20L (Juvederm Voluma with Lidocaine, Allergan plc, Dublin, Ireland) deep to the bone, 0.2 mL in the medial area, and 0.4 mL in two points in the lateral area (Figure 2); then, we used a cannula to restore the right malar projection injecting 1 mL of VYC-17L (Juvederm Volift with Lidocaine, Allergan plc, Dublin, Ireland) in the subcutaneous layer.
Preinjection and 2- and 5-month postinjection frontal view results.
CRIS2019-1360741.003.jpg
PMC6955121_01_CRIS2019-1360741.003.jpg
fig3
The patient was followed up for 1 year showing stable results for the first 8 months (Figures 3 and 4); at the 12-month follow-up, a touch-up was suggested due to partial resorption of the filler (Figure 5).
Preinjection and 2- and 5-month postinjection three-quarter left view results.
CRIS2019-1360741.004.jpg
PMC6955121_01_CRIS2019-1360741.004.jpg
fig4
The patient was followed up for 1 year showing stable results for the first 8 months (Figures 3 and 4); at the 12-month follow-up, a touch-up was suggested due to partial resorption of the filler (Figure 5).
Frontal and three-quarter left view results at the 12-month follow-up.
CRIS2019-1360741.005.jpg
PMC6955121_01_CRIS2019-1360741.005.jpg
fig5
The patient was followed up for 1 year showing stable results for the first 8 months (Figures 3 and 4); at the 12-month follow-up, a touch-up was suggested due to partial resorption of the filler (Figure 5).