Placement of dermal filler to maximise the effect on lines is relatively simple – deep lines caused by volume loss are corrected best with deeper injections in the lower dermis. Fine creases are corrected best with a shallower injection in the mid dermis.
Injections in fat may not have as much impact, and injections in the papillary dermis (very superficial) will discolour the skin.
Syringe. If there is any blood, do not inject and repeat the process.
Too shallow: If the skin is blanched without lifting, DO NOT INJECT- you are too superficial, and filler will be visible.
Fine lines: If you lift the needle and can clearly see the shape of the needle as a defined line (which may blanch- but only on
Lifting) you are in the right depth for a low viscosity filler to treat a fine line.
Deep lines: If you lift and see a rough shape of the needle but it very defined you are about right for a deeper line or
Too deep: If all you see is the skin lifting generally, you are likely deep in subcutaneous fat which is not optimal.
When is it useful and Technique
Fine lines or superficial creases on top of deep lines. 30 degree entry, superficial (just deeper than the bevel) 0.025 to 0.05ml dose.
Can be used for medium lines and volume loss.
Deeper lines require a 45 degree angle of entry to ~1/3 of the needle, then stop and change angle to 0 degrees and advance to desired depth. Can be placed at 90 degrees or parallel and directly under the line.
Advanced technique useful if you wish to keep needle tips away from important structures. Limited control of flow of filler.
Insert needle at 45 degrees, when needle point is in desired location check flash back and then inject slowly, closely monitoring direction of filler flow.
Reduces pain, as only one initial hole is made in the skin. Useful for the top of the NLF and the marionette line- for volume replacement which is in a more even plane. Inject at 45 degrees, until 1/3 of the needle is in the skin, then change to being parallel (0 degrees) with the skin and advance, flashback and then retrograde linear thread in each direction you want to fill.
For stubborn widely spread fine lines. For lines under continuous pressure from tissues resting from above (like deeper nasolabial folds)This technique is superficial, 30 degree angle of entry usually starting with an injection directly under the line that makes little improvement. Further injections are placed at 90 degrees to the line, in rows.
Bruising is more likely as so many injections are required.
Before every procedure we do on every client we always complete the disclaimer information and consent forms. We also will make a plan on our facial planner which will be kept with the patient’s records. This was taught to you as a beginner starting your career and should be instilled in you now as a n aesthetic practitioner.