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Dermal Filler Procedure: Step-by-Step Guide

Introduction

The use of dermal fillers, particularly hyaluronic acid (HA)-based fillers, has become the predominant standard for the non-surgical treatment of ageing skin. HA fillers have surpassed collagen as the most popular cosmetic filler. Producing minimal side effects, having a reversible nature, and lacking immunogenicity, this option is preferred by practitioners and patients alike.

As with any cosmetic procedure, the outcome of this treatment largely depends on the physician’s skill and knowledge, rather than the filler itself. The demand for safe, long-lasting, and biocompatible dermal fillers continues, as a growing number of individuals prefer minimally invasive treatments for cosmetic procedures.

Pre-procedure care

It cannot be stressed enough that dermal filler injections must only be performed by trained and licensed medical professionals. Aside from having the appropriate credentials, the administrator must have a comprehensive knowledge of the process of ageing and concomitant skin conditions, the types of fillers available, and the appropriate injection techniques.

Patient Assessment

It is the responsibility of the physician to determine the appropriateness of any requested procedure. There are many factors to consider before the appropriate treatment plan can be devised for a patient. Some patients will have unrealistic expectations of their results, which should be addressed early on.

Prior to treatment:

•  Assess the patient’s psyche.

•  Obtain a thorough medical history of the patient.

• Consider the desired outcome of the patient.

•  Assess the area with the patient in an upright position.

•  Take pretreatment photographs for study.

•  And identify the injection sites using a washable marker.

Filler Selection

Reversible or temporary fillers are recommended for patients who are unfamiliar with dermal filler injections. Appropriate fillers depend on the defect to be corrected, the type of material used, and the longevity desired. HA fillers do not require allergy testing, while collagen-based fillers are of bovine origin, and as such must be pretested prior to administration.

Intra-Procedure Care

Cleansing

On the day of treatment, patients should remove any cosmetics from their face and wash it with mild soap. Patients must sit in an upright position in a comfortable chair. The area will be prepared for filler injection following strict aseptic techniques.

Anaesthetizing

The type of anesthesia required depends on the area to be treated, as well as the patient’s pain threshold. To reduce discomfort, topical anesthesia may be applied 30 to 60 minutes before the procedure. Topical anesthetics include lidocaine and tetracaine, in various combinations. There are also a wide variety of fillers pre-mixed with lidocaine.

For physicians’ injection

The physician must be aware of the right injection techniques used for each filler, and the site where they will be deposited. Unwanted effects, such as overcorrection, can be remedied by injecting the enzyme hyaluronidase (for hyaluronic acid-based fillers) into the skin.

During the procedure:

•  Adhere to the correct depth of injection.

•   Correct product label or batch number sticker on consent forms.

•   And document the procedure by indicating the filler used, quantity, and areas treated.

Common Injection MethodsIndicationTechnique
Threading MethodUsed for treating the vermillion borderInvolves depositing the product as the needle is withdrawn from the tissue.
Serial Droplet MethodFor treating glabellar lines and periorbital hollowsCommonly used for silicone injection
Fanning MethodFor nasolabial foldsThe preferred method for superior, natural, and longer lasting results. Needle is passed back and forth under the fold, depositing the filler as the needle is inserted and withdrawn.

Post-Procedure Care

After the procedure is complete, the treated area will be cleaned, and markings will be removed using alcohol, hydrogen peroxide, or a similar antiseptic solution. Ensure you follow all instructions for aftercare methods as provided by the injector.

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Did you know that, according to the American Board of Cosmetic Surgery, over a million men and women choose dermal fillers annually? The common reasons are to fill in sunken areas of the face and to get rid of wrinkles.  Due to the popularity of…

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