5 Top Aesthetic Filler Injections Techniques
According to paper, Injection technique in neurotoxins and fillers: Indications, products, and outcomes by Murad Alam, MD, MBA, MSCI, and Rebecca Tung, MD (2018), fillers have diverse indications and includes correcting aging-related volume loss causing forehead horizontal creases, glabella vertical lines, temporal hollowing, re-cessed eyebrows, upper cheek atrophy, tear troughs, nasojugal folds, midface atrophy, nasolabial folds, vertical lip lines, lip thinning, preauricular fat atrophy, earlobe thinning, marionette lines, mental creases, and jawline irregularities.
Injectable fillers are important for rejuvenation of the midface by replacing lost volume and providing structural support. Multiple types are available such as various hyaluronic acid products, calcium hydroxylapatite, and a few others that are biocompatible with good duration and a variety of mechanical properties allowing intradermal, subdermal, and supraperiosteal injection.
Facial features can be reshaped with great control using these fillers. These treatments have become a mainstay of rejuvenation in the early facial aging patient. Injection technique is critical to obtaining excellent results.
Threading, fanning, cross-hatching, depot, and layering techniques must be mastered. Technical execution can only measure up to, but not exceed, the quality of the aesthetic analysis.
Fanning
The needle is inserted in a fashion similar to that used in linear technique, but immediately before the needle is withdrawn, its direction is changed and a new line is injected.
The advantages of this technique are reducing the risk of complications like erythema, edema, and vascular injuries, and providing easy access to injection sites.
Cross Hatching
Cross hatching builds on linear filling where a series of parallel tunnels of filler is injected. Then perpendicular tunnels are injected to create a cross hatching. This technique is meant for filling in broader areas.
Depot
A depot injection is a slow-release form of medication. The injection uses a liquid that releases the medication slowly, so it lasts a lot longer.
During depot injections, the needle is advanced deeply to the level of the fat pads or periosteum, and a bolus of 0.1–0.2 cm3 of filler is deposited.
Layering
The layering, or stacking, technique involves injecting filler at multiple depths to incrementally build up volume. This is particularly beneficial when treating deep creases around the nose and mouth by adding volume & creating support.
Additional, more advanced techniques can be employed once experience is gained with standard techniques.
Due to their accessibility, injectables is a democratizing force and is becoming a cultural phenomenon. And as with any medical treatment, adverse events and complications may occur. Adverse events associated with these products are typically transient and mild to moderate in severity. Serious adverse events, such as infection and intravascular occlusion, are rare. Therefore, proper patient selection, consent and counselling, preparation and impeccable injection technique are all extremely important & clinicians should always strive to accumulate as much knowledge & hands on experience as possible.
Reference
Injection technique in neurotoxins and fillers: Indications, products, and outcomes, published on Continuing Medical Education Vol 79 (Sep 2018)
Facial aesthetic injections in clinical practice: Pretreatment and post treatment consensus recommendations to minimise adverse outcomes, published by Australas J Dermatol (Aug 2020)
Injectable Filler Techniques for Facial Rejuvenation, Volumization, and Augmentation, published on Facial Plast Surg Clin North Am (Nov 2015)
Using the arcing technique to perform an injectable thread lift procedure published on Plast Surg Nurs (Apr-Jun 2009) Apr-Jun
Injection Techniques published on W&O medical esthetics GmbH (2015)
Four-point injection technique for lip augmentation published on Acta Dermatovenerol Alp Pannonica Adriat (Jun 2018)
Putting Injectable Facial Fillers to Their Best Use published on Review Of Ophthalmology (Nov 2015)
What is a depot injection? published on Mind (2022)
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