Unit 8: Placement of Dermal Fillers

Placement of dermal fillers is important in order to achieve optimum results. Deep lines that are caused by volume loss are best corrected using deeper injections in the lower dermis. Fine wrinkles are better corrected using shallower injection techniques in the mid dermis. If you inject into the fat these may not have as much impact. Injections too shallow into the papillary dermis will discolour the skin (blueish tinge), this is known as the Tyndall effect.

• To ensure ease of flexibility and comfort for you and the client, hold the needle correctly with your wrist above and your thumb on the plunger of the syringe.
• Line up the needle with the point on the skin where you want the needle to terminate. Once you know this, you can choose your position of entry so the needle tip will reach the point where you want to inject filler.
• Make sure you use the correct angle of entry. This is 45 degrees for deep lines and loss of volume and 30 degrees for more superficial creases.
• After inserting the needle at the chosen angle until a third of the needle has penetrated the skin, your needle tip should now be at the correct depth.
• Change the angle of your needle slowly so that it is parallel to the surface of the skin. As you advance your depth you will remain at the desired level. Move the needle into the desired position.
• Do a depth check. Once you have established that you are at the correct depth then check for a flashback by pulling back on the syringe. If you cannot see any blood after 5 seconds, then you are then its ok to proceed.
• Inject the area as per the treatment area guidelines.
• Remove the needle and massage the area so that it is smooth.
• Check for capillary refill.

Performing a depth check:

Too Shallow: Skin blanches without lifting. If you inject here the filler will be visible as you are too superficial.

Fine Lines: If you lift the needle slightly under the skin and you can clearly see the shape of the needle as a defined line then you are at the right depth for injecting a low viscosity filler.

Deep Lines: For deeper lines or volume replacement, you should see a defned but rough shape of the needle you are at the right depth.

Too Deep: If you can only see the skin lifting in general and can’t see the shape of your needle then you are more than likely in the subcutaneous fat which is not ideal.

Injection techniques: