1. Hypodermic Tissue Building

2. Conditions Requiring Treatment  Emaciation  Concavities  Injury or Surgery

3. Equipment  Syringe  Needle: gauge

4. Precautions  1) avoid overfilling  2) hidden point of injection  3) tissue builder hardens quite quickly  4) use solvent to clean the needle  5) when filling the syringe, expel any air

5. General Procedures  1) single entry point  2) keep needle close to the surface  3) carefully direct the needle  4) fingers may be used to determine depth and position of the needle  5) inject slowly  6) apply digital pressure to the skin

6. General Procedures (cont’d)  7) direct needle to adjacent areas without removing it from the point of entry  8) repeat steps 5,6, & 7 until area is filled  9) to refill the syringe, leave the needle in place  10) pull back on the plunger when removing the needle

7. General Procedures (cont’d)  11) clean the needle and syringe using solvent  12) seal the puncture site  13) wax and cosmetize the puncture site if necessary

8. Recommended Points of Entry  Eye  Supraorbital Area  Temples  Cheeks  Lips  Hands  Neck

9. Cosmetically Conceal Small Discolorations  small, localized  opaque cosmetics  “bleach” the area then opaque cosmetics  “feather” the opaque cosmetics  use opaque cosmetics sparingly  reinstate warm color areas and shadows

10. Methods of Cosmetic Application  1) undercoat  2) cosmetize  3) powder application

11. Cosmetically Concealing Large Discolorations  Pre-embalming  Embalming  Post-embalming: surface pack surface pack cosmetize surrounding area cosmetize surrounding area slightly lighter shade of opaque cosmetic slightly lighter shade of opaque cosmetic “feather” using a clean brush “feather” using a clean brush shading and highlighting shading and highlighting reinstate warm color areas reinstate warm color areas powder powder

12. Tissue Preparation

13. Prior to Restoration  Receive written permission if major restoration to be performed.  Tissue must be firm and dry.  Embalming concerns:  Post-embalming concerns:

14. Large Cavity and Excision Restorations  1) trim away dehydrated marginal tissue  2) undercut the margin  3) chemically dry the deep tissues  4) apply liquid sealer to the deep tissues  5) use a deep filler (wound filler) to fill the cavity to within ¼ “ from the surface

15. Large Cavity and Excision Restorations (cont’d)  6) suture the margin with basketweave  7) apply wax into the cross-stitches  8) apply additional wax to contour and taper wax over the margin  9) reproduction of pores and wrinkles  10) cosmetize

16. Wax and Cosmetics  Cosmetics under: undercoat to cover discolorations  Cosmetics mixed with wax: to match the complexion color  Cosmetics over wax: usually cream cosmetic

17. Skin Texture  Pores: stipple brush gauze gauze paper towel paper towel  Furrows: shallow deep deep