My doctor didn't use a blunt cannula to fill my temples w/ Juvederm, but w/ needles. The side are asymmetrical. Is this normal?

If you just had your injections it is too early to be worried about symmetry issues.  The filler still needs to settle and incorporate and any small swelling from the injection may need to resolve.  Other factors such as swelling from the injection, possible small bruising, etc can cause one side or the other to look slightly different.  If the same technique was used on both sides, then what you are observing is likely due to one of the above mentioned issues which resolve.  Symmetry issues are not due to needle versus cannula.  You can do light massage, ice or just time with the advice of your injector to see what the best approach would be.  Fillers can be injected by cannula or by needle.  For areas where the filler is injected perpendicular to the skin, a needle is used as a cannula is blunt and can't pierce the skin or deeper layers.  For areas where the filler is injected in a fanning technique or parallel to the skin, a long needle or a cannula may be used.  If the cannula is used, a needle is first used to pierce the skin and then the cannula is inserted.  In the temples, sometimes a combination of techniques are used depending on how much filler is required.  For instance, the first round of injections, I may do deep injections perpendicular to the skin with a needle to fill the deeper voids.  If more volumizing is needed or blending with the forehead or mid face, then the cannula technique may also be used to blend and cross the areas deep and parallel to the skin.  These techniques are used when patients are having multiple areas and multiple syringes injected.  If you have any concerns, it is best to contact your injector for a follow up visit to review your results.  However, many patients find that a day or two after their injections any initial worries or concerns they may have had resolve before their follow up appointment.  One great thing to keep in mind if you had an HA product injected, such as Juvederm or Restylane, is that they are always reversible or meltable so there is no need to worry.   

The use of cannulas or needles is usually determined by the injector according to their technique. If this injection is recent there is always a good chance of asymmetrical swelling. Schedule an appointment with your injector at 2 weeks for a follow up and discuss any concerns at that time. 

The debate about the use of blunt cannulas versus needles during filler injections has been raging on since cannulas really started becoming popular a few years back. There is no right answer to this question. Some of the best in the business like exclusively cannulas, some of the best in the business like exclusively needles, and most people now utilize some combination of the two. I personally am very new school and fall this latter category of mixed use. I believe there are some areas that cannulas outperform needles, and vice versa. I vary my use of the two depending not only on location, but also on the type of filler being used, the depth that I am planning on injecting, and the individual patient. People will debate the safety of the two, citing that cannulas are less likely to penetrate a vessel, but on the flipside others will argue that cannulas are less precise with their filler placement. Like I said, there is no right answer, and what's most important is that your physician was using the instruments he or she was most comfortable with for your particular situation, location, and type of filler. Which exact one he or she used should not affect the final result that you get, specifically with the symmetry that you're asking about. Since you just had your injections, be patient and let the swelling subside before you make final judgments about your results.

Thank you for your
question.Some swelling may persist but the temples can be a very difficult area sometimes.  The skin in this area is very thin and any irregularities are easily seen through the skin.  This makes getting it exactly right a challenge.

To be sure, see
two or more board-certified providers in your area for a complete evaluation to
make sure you are a good candidate and that it is safe for you to have these
treatments.

I hope this helps.

It would not make any difference whether they used needles or cannulas.  Some doctors prefer one over the other, and the cannula may have a lower incidence of bruising, but the end result would be the same.  If you had the injection in the last few days, the asymmetry may even out.  If not, they can always inject a little more into one side.   

I don't believe that using a cannula is necessarily an improvement over a needle.  It very much depends on the doctors technique and as noted below, you need to wait for full healing.  I see my patients back in a month to check symmetry and see if more product is needed or some should be dissolved.  I prefer a needle for most injections to stimulate collagen and help treat multiple tissue planes except for in the upper eyelid but cannula use is excellent as well depending on the technique used and desired outcome.

Juvederm top the temporal fossa – asymmetry
No photograph is given in this patient who had Juvederm applied to the temporal fossa. It should be noted that the manufacturer of Juvederm encloses needles as part of the Juvederm package. Many injectors would change the needles depending on the application. In any case it is unlikely that the asymmetry is due to a choice of needles. It is possible that there is a hematoma or small bleed in one side which should resolve spontaneously. In addition Juvederm is hydrophilic meaning that it absorbs water and this may account for some asymmetry also. At 3 days this is probably too soon to be concerned. In any case you should return to your injector if there is still some difference at two weeks. Asymmetry can be corrected quite easily.

The type of needle used should really have no impact on asymmetry. In general, people are asymmetric. I would give it about two weeks to allow for swelling to subside and then reassess it.

The temple ares has a lot of small blood vessels. You immediate assymetry could be do to bleeding under the skin. Consult your injector.

I don't know when you were injected. If it was recent, then you could have asymmetry from swelling and/or bruising, which is VERY common. While cannulas are used by some doctors, they are not necessarily preferred by all, or in all locations. I doubt very much your asymmetry has anything to do with a cannula vs. a needle and has more to do with either swelling, or product. "This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."