Placement of Dermal Fillers

Placement of Dermal Fillers

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Placement of Dermal Fillers

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

The steps to a perfect dermal injection – for theoretical use only – advanced techniques are better demonstrated during your practical learning.

  1. Hold the needle correctly, wrist above, thumb on the plunger. This position enables greatest

flexibility and means you have stability while the needle is in the face, thus giving greater control.

  1. Ensure correct placement by lining up the end of the needle with the point on the skin where you want the

needle to terminate. Choose your position of entry & anticipate where needle tip will reach too as an end point.

  1. Use the correct angle of entry- 45 degrees for deeper lines and volume loss, 30 degrees for

superficial creases.

  1. Insert the needle at the chosen angle until around 1/3 of the need has penetrated. Then STOP.

Your needle tip should now be at the correct depth.

  1. Slowly change the angle until your needle is parallel with the surface of the skin. Now when you advance your depth will be maintained at the correct level.
  2. Advanced the needle to the desired position, then stop.
  3. Do a depth check. Once you are at the correct depth, check for a flashback (aspiration) by pulling back on the

syringe between 3-10 seconds, depending on where you are working.  If there is any blood, do not inject and repeat the process.

  1. If no flashback, proceed to inject as per area-specific guide
  2. Withdraw and massage to be smooth, check capillary refill present.

How to do a depth check:

 

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

volume replacement.

Too deep: If all you see is the skin lifting generally, you are likely deep in subcutaneous fat which is not optimal.

Injection Techniques

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