Dermal Fillers

How Are Fillers Injected?

Explore the intricate world of dermal filler injections, where science and artistry converge to rejuvenate skin and enhance natural features. Learn about the techniques and expertise involved in this transformative realm of cosmetic enhancement.

In the dynamic landscape of cosmetic enhancements, where science meets aesthetics, the realm of dermal filler injections has emerged as a shining star. A testament to modern ingenuity, these injections offer a nuanced and artful approach to revitalizing the skin and enhancing natural features. Beyond the surface, this practice embodies the fusion of medical expertise and creative finesse, guided by a deep understanding of facial anatomy and the subtleties of beauty. The journey begins with a consultation, a dialogue between the individual and their chosen practitioner. Goals are discussed, concerns are addressed, and a roadmap is charted. From there, the canvas takes shape, as treatment areas are marked and mapped, akin to an artist’s sketch before the first stroke of paint. With finesse and experience, the injector employs various techniques—linear threading, fan patterns, cross-hatching—to craft a symphony of enhancement, revealing the natural beauty that lies beneath.

This article ventures deeper into this world, we uncover the intricate techniques, the dedication of practitioners, and the radiant results that emerge, showcasing the beauty that was always there, waiting to be unveiled.

What Are Dermal Fillers?

Dermal fillers are cosmetic injectable substances used to restore volume, contour, and smoothness to the skin. They are commonly used in the field of cosmetic dermatology and aesthetic medicine to address signs of aging or to enhance certain facial features. Dermal fillers can be made from various substances, but the most common types include:

Hyaluronic Acid (HA) Fillers

Hyaluronic acid is a natural substance found in the body that helps maintain skin hydration and volume. HA fillers are popular because they are reversible and can be dissolved if desired. They are used to treat wrinkles, fine lines, and to add volume to areas like the cheeks, lips, and under-eye hollows.

Calcium Hydroxylapatite Fillers

This filler is composed of microscopic calcium particles suspended in a gel. It is often used to stimulate collagen production and is effective in treating deeper lines and wrinkles. It’s also used for adding volume to areas like the cheeks.

Poly-L-Lactic Acid Fillers

This type of filler stimulates collagen production over time, leading to gradual and natural-looking improvements. It’s often used to treat areas with severe volume loss, such as deep wrinkles and hollow cheeks.

Polymethyl Methacrylate (PMMA) Fillers

PMMA is a semi-permanent filler that contains microspheres that remain in the skin for a longer duration. It’s used to treat deeper wrinkles and can provide a more long-lasting correction.

Dermal filler injections are typically performed by trained medical professionals, such as dermatologists, plastic surgeons, or specialized nurses. The procedure involves injecting the chosen filler substance into targeted areas of the face using fine needles or cannulas. The results are usually visible immediately, although there might be some initial swelling or redness.

Preparation for the Injection Procedure

If you’re considering undergoing a dermal filler injection procedure, it’s important to be well-prepared to ensure the best possible outcome and minimize any potential risks. Here are some general steps to follow when preparing for a dermal filler injection procedure:

Consultation with a Qualified Professional

Schedule a consultation with a qualified and experienced medical professional who specializes in aesthetic procedures, such as a dermatologist or a plastic surgeon. During the consultation, discuss your goals, medical history, and any concerns you may have. The professional will assess your facial anatomy and recommend the appropriate filler type and treatment plan.

Medical History and Allergies

Provide a comprehensive medical history, including any allergies, previous aesthetic treatments, medical conditions, and medications you are currently taking. This information is essential for your safety and to determine the suitability of the procedure for you.

Pre-Treatment Guidelines

Your provider will give you specific pre-treatment guidelines to follow. These might include avoiding certain medications or supplements that can increase the risk of bleeding, such as aspirin, ibuprofen, or blood-thinning supplements. Smoking and alcohol consumption might also need to be limited.

Plan for Recovery

While most people can resume normal activities shortly after the procedure, it’s a good idea to plan for some downtime, especially if there’s noticeable swelling or bruising. Consider scheduling the procedure when you have a few days to recover if needed.

Follow Instructions

Follow the post-treatment instructions provided by your provider diligently. This might include avoiding excessive sun exposure, not touching or massaging the treated areas, and using recommended skincare products.

Be Realistic

Have realistic expectations about the outcomes of the procedure. Dermal fillers can provide noticeable improvements, but they might not achieve the same results as surgical procedures.

Ask Questions

If you have any questions or concerns about the procedure, don’t hesitate to ask your provider during your consultation or before the procedure begins.

Filler Injection Techniques and Methods

Dermal filler injection techniques and methods can vary based on the specific filler being used, the treatment area, and the desired results. Here are some common injection techniques and methods that medical professionals use during dermal filler procedures:

Linear Threading Technique

This technique involves injecting the filler along a line or wrinkle to provide smoother, more even skin. It’s often used for treating nasolabial folds (lines between the nose and mouth) and marionette lines (lines from the corners of the mouth to the chin).

Fan Technique

The fan technique involves injecting the filler in a fan-like pattern, which can be especially useful for enhancing volume in areas like the cheeks or temples. The injections are distributed in multiple directions to create a natural, even result.

Cross-Hatching Technique

Cross-hatching involves injecting the filler in a crisscross pattern. This technique is often used in areas with deeper wrinkles or to treat larger treatment areas. It helps provide thorough coverage and a more even distribution of the filler.

Serial Puncture Technique

In this technique, multiple small injections are made in a linear or clustered pattern to fill in lines, wrinkles, or hollow areas. This approach is particularly effective for treating fine lines and for subtle enhancement.

Microdroplet Technique

This technique involves injecting tiny droplets of filler evenly across a treatment area. It’s commonly used for delicate areas like the lips or under the eyes, where precise control is essential for natural-looking results.

Layering Technique

Layering involves injecting the filler in multiple layers to build up volume gradually. This technique is often used for larger areas or when a more significant volume enhancement is desired. It can also contribute to a smoother and more natural appearance.

Cannula Technique

Instead of using a needle, a blunt-tipped cannula can be used to inject the filler. This technique is often preferred for certain areas, as it can cause less trauma, bruising, and discomfort compared to traditional needles. It’s particularly popular for under-eye treatments.

Bolus Technique

This technique involves injecting the filler in a concentrated “bolus” or small mound to create a specific contour or projection. It’s often used to enhance features like the lips or to provide more pronounced volume.

Tunneling Technique

With this technique, the filler is injected in a tunnel-like manner beneath the skin’s surface. It’s useful for filling hollow areas or for adding volume to specific facial features.

Blending and Feathering

After injecting the filler, the provider might use massage or other techniques to blend and feather the product into the surrounding tissue, ensuring a smooth and natural transition.

Step-by-Step Filler Injection Process

The injection process for dermal fillers involves several steps to ensure a safe and effective procedure. Keep in mind that the specific steps can vary based on the type of filler, treatment area, and the injector’s preferences. Here’s a general step-by-step guide to the dermal filler injection process:

Consultation and Assessment

Before the procedure, you’ll have a consultation with your medical professional to discuss your goals, medical history, and any concerns. The injector will assess your facial anatomy, skin condition, and the areas to be treated. They will recommend the appropriate type of filler and treatment plan based on your individual needs.


On the day of the procedure, arrive with a clean and makeup-free face. The injector might apply a topical numbing cream to the treatment area to minimize discomfort during the procedure.

Marking and Mapping

The injector will use a marker to mark the specific injection points on your skin. They might also create a treatment plan by mapping out the areas where the filler will be injected.

Injection Technique

The injector will use sterile techniques and wear gloves to ensure hygiene. They might use a needle or a cannula (a thin, flexible tube) to inject the filler, depending on the treatment area and their preferred method.

Injection Process

The injector will insert the needle or cannula into the predetermined injection points. They will administer the filler substance in small amounts, adjusting the depth and technique based on the treatment plan.

Massage and Mold

After injecting the filler, the injector might gently massage or mold the product to ensure even distribution and a natural appearance. This step helps blend the filler with the surrounding tissue.

Assessment and Touch-Ups

The injector will assess the results and may perform any necessary touch-ups to achieve the desired outcome. They will ensure symmetry and balance in the treated areas.

Managing Pain, Discomfort, and Potential Side Effects of Filler Treatments

Managing pain, discomfort, and potential side effects after a dermal filler injection procedure is important to ensure a smooth recovery and optimal results. Here are some tips on how to manage these aspects:

Topical Numbing Cream

Many clinics offer topical numbing creams that can be applied to the treatment area before the procedure to minimize discomfort during the injections.

Local Anesthesia

For certain areas or more extensive procedures, your provider might use local anesthesia to numb the treatment area.

Cold Compress

Applying a cold compress to the treated area can help reduce swelling and alleviate discomfort.

Over-the-Counter Pain Relievers

You can ask your medical professional if it’s safe to take over-the-counter pain relievers like acetaminophen or ibuprofen to manage any post-procedure pain. However, avoid blood-thinning medications that can increase the risk of bruising.


Elevate your head slightly when sleeping to help reduce swelling.

Sun Protection

Protect your skin from the sun by using sunscreen and avoiding direct sunlight for a few days after the procedure.

Post-Injection Care and Instructions

Post-injection care is essential for optimizing the results of your dermal filler procedure and ensuring a smooth recovery. Here are some general post-injection care instructions to follow:

Keep the Area Clean

Gently cleanse the treated area with a mild, fragrance-free cleanser. Avoid using harsh scrubs or exfoliants for a few days.

Avoid Touching or Massaging

Refrain from touching or massaging the treated areas for at least 24 hours after the procedure. This helps prevent displacement of the filler.

Use Cold Compresses

Applying cold compresses or ice packs to the treated area can help reduce swelling and discomfort. Use them for short intervals and avoid direct contact with the skin.

Stay Upright

For the first few hours after the procedure, try to keep your head elevated when resting or sleeping to minimize swelling.

Avoid Blood-Thinning Substances

Steer clear of alcohol, caffeine, aspirin, ibuprofen, and other blood-thinning medications for a few days after the procedure to minimize the risk of bruising.

Be Gentle with Makeup

If you choose to wear makeup, apply it gently and avoid excessive pressure on the treated areas. Wait until any redness or swelling has subsided before applying makeup.

Sun Protection

Protect your skin from the sun by wearing a broad-spectrum sunscreen with at least SPF 30. Avoid prolonged sun exposure and tanning beds for a few days after the procedure.


Stay well-hydrated by drinking plenty of water. Proper hydration can contribute to healthy skin and facilitate the healing process.

Avoid Strenuous Activities

Refrain from intense physical activities, exercise, or activities that cause excessive sweating for at least 24 hours after the procedure.

Follow Provider’s Recommendations

Your medical professional might provide specific post-treatment guidelines based on the type of filler used and the treatment area. Follow their instructions closely.

Expected Results and Timeline

The results of dermal filler injections can vary depending on factors such as the type of filler used, the treatment area, individual skin characteristics, and the skill of the injector. Here’s a general timeline of what you can expect in terms of results after a dermal filler procedure:

Immediately After the Procedure

You will likely see some initial improvement in the treated areas immediately after the injections due to the volume added by the filler.

Mild redness, swelling, and bruising at the injection sites are common and should subside within a few days to a week.

1 Week After the Procedure

Swelling and bruising should have subsided significantly, allowing you to see more natural-looking results.

Any lumps or bumps that may have initially appeared should begin to settle as the filler integrates with your natural tissue.

2-4 Weeks After the Procedure

The filler will continue to settle and integrate with your skin, providing a more natural appearance.

You should see the full effects of the treatment as any residual swelling resolves.

Long-Term Results

The longevity of the results depends on the type of filler used. Hyaluronic acid fillers typically last anywhere from 6 to 18 months, depending on the specific product and treatment area.

Non-HA fillers like calcium hydroxylapatite and poly-L-lactic acid can last longer, sometimes up to 2 years or more.

Results will gradually fade as the body metabolizes the filler over time.


The artistry of injecting dermal fillers revolves around precision, expertise, and a deep understanding of facial anatomy. These injectable substances, ranging from hyaluronic acid to calcium hydroxylapatite, are strategically placed to restore volume, smoothen wrinkles, and enhance natural features. The technique employed varies with the treatment area, the type of filler, and the desired results.

The injection process unfolds in several key steps. After a comprehensive consultation, where goals and medical history are discussed, the targeted areas are marked and mapped. With meticulous care, the medical professional introduces the filler using fine needles or cannulas. Different injection techniques, such as linear threading, fan patterns, or layering, are employed to achieve optimal results. Once the filler is artfully placed, gentle massage may be performed to ensure even distribution.

However, the procedure’s success doesn’t end when the needle is withdrawn. Proper post-injection care is paramount. Patients are advised to avoid excessive touching, massaging, or strenuous activities, and to protect their skin from the sun. Swelling, bruising, and mild discomfort are common, but these temporary effects subside over time, revealing the true outcome of the procedure.

Marie Salbuvik
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