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

Question

Instead he used a regular needle. Also the two sides seem asymmetrical. Is this normal just after being injected?

David Shafer, MD, FACS · Answer

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.

Martin Jugenburg, MD · Answer

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.

Cameron Chesnut, MD, FAAD, FACMS · Answer

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.

J. Jason Wendel, MD, FACS · Answer

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.

John J. Martin, Jr., MD · Answer

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.

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

Answers (10)

Answer: Uneven Temples after Juvederm Injection

Answer: Uneven Temples after Juvederm Injection

Answer: Temple injections

Answer: Temple injections

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Everything you need to know about Juvederm

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

Answers (10)

Answer: Uneven Temples after Juvederm Injection

Answer: Uneven Temples after Juvederm Injection

Answer: Temple injections

Answer: Temple injections

Browse related questions

Recommended reading

Everything you need to know about Juvederm

Our mission is to create a world where every investment in modern beauty is Worth It.