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2.01: Unique concerns associated with facial anatomy


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Objectives: After lesson two you will...

Understand the minimum requirements for facial ultrasound devices
Learners will be able to list and describe key specifications that determine the efficacy of a facial ultrasound device, such as frequency range, probe type and related image resolution.
Understand the importance of the footprint of the transducer probe when performing facial ultrasound
To be able to explain various types of transducer probes and how their footprints differ and to comprehend how the size and shape of the transducer probe footprint affects ultrasound imaging of the face.
Appreciate the factors that need to be considered when choosing an ultrasound device for facial imaging
Understand the practical technical features of ultrasound devices that are pertinent to facial imaging, such as probe size, weight, and the differences between portable and non-portable devices.
Be able to make informed decisions regarding the purchase of an ultrasound device that meets your aesthetic medicine goals
Develop skills to analyze the cost-effectiveness of different ultrasound devices, relative to your clinical goals in applying facial ultrasound at the bedside. To be aware of which popular portable devices are on the market and what advantages and disadvantages they have.

Decoding Facial Ultrasound: A Deep Dive into Device Selection and Usage: Audio automatically transcribed by Sonix

Decoding Facial Ultrasound: A Deep Dive into Device Selection and Usage: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

All right, so in this next series of lessons, we're going to talk about what we need to consider when securing a ultrasound device, specifically for facial ultrasound for use within aesthetic medicine. Now you're in this course, so you're obviously interested in facial ultrasound, and because you have completed some lessons already, you should have an idea that performing facial ultrasound is somewhat unique. There are some unique features specific to performing ultrasound on the face, and we need to strongly consider these things when we think about securing an ultrasound device to use in our clinics, to use at the bedside. So the next series of talks are going to be very practical and geared towards a discussion around what we need to consider, what devices are out there, and how can you best secure device to achieve your goals. Now recall from previous lessons that we just finished that facial ultrasound is unique. It's different than ultrasound that's classically done on the abdomen of the chest. Now, obviously the anatomy of the face is very small relative to other parts of the body which are traditionally scanned. So we need to be able to have a scanner with the resolution that can differentiate these small structures on the face. We need to be able to visualize structures such as arteries, which can have the diameter of a millimeter, sometimes even less.

We need to be able to differentiate these structures from other background structures surrounding them, things such as fat and muscle. The other thing, which is quite unique for facial ultrasound, is that the anatomy of the face is relatively superficial compared to, say, the anatomy of the chest or the abdomen, where this technology has been traditionally applied. So, therefore, we only need an ultrasound device with the maximum penetration depth of about four centimeters. In reality, often will be scanning much less than that - one two centimeters is plenty for many areas on the face. This should tell you that you need a high-frequency linear probe. Any device that doesn't have a high enough frequency to give you a good resolution of these small anatomical structures must be avoided. It just won't help you. It will be challenging to learn at best, and at worst, it just won't provide you the information you need at the bedside. The instructors of Learn The Face have personally used dozens of ultrasound devices firsthand, both portable and non-portable. Based on this experience, I would say the minimum required frequency for medical aesthetics is 12MHz. So you need 12MHz at a bare minimum to perform facial ultrasound. Anything below this frequency will simply be inadequate. However, 12MHz is still very limiting.

Again, this is the bare minimum. You will not be able to visualize all the anatomy of the face with a 12MHz scanner. However, you will be able to identify the largest arteries of the face. Some of the key muscles and other core anatomy. The ideal frequency for an ultrasound probe for use in medical aesthetics is approximately 20MHz. Now, this frequency will provide sufficient penetration and resolution to visualize many important structures of the face, including most of the critical vasculature. When ultrasound transducers are above 20MHz, the depth of penetration becomes increasingly a limiting factor. Now, I want you to recall from the previous lessons that there is an inverse relationship between frequency and depth of penetration. As the frequency of your probe increases, the resolution increases, but the depth of penetration decreases. So, at ultra-high frequencies above 20MHz, the penetration is actually only a centimeter or less, and this becomes quite limiting for visualizing deeper facial anatomy anatomy. So scanners above 20MHz are often used more in an academic setting or within veterinary medicine, with very small animals where the depth of penetration is less of a limiting factor. At the time that this course was published, the highest frequency scanner that was portable was around 20MHz. Above this frequency, only high end non portable devices are available.

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