How successful are microdroplet techniques of Restylane and Juvederm? (NOT silicone)

Dear Ilsa,I understand you completely. I had similar feeling when I was going to hire my nurse injector. But I fell really good about having her there. Let me explain:I teach filler injection to other physicians and I have to say there is an art to injections. Filler injections are not just a science based field, are plays a great role in this field. So, there are some doctors that I believe should never inject and there are some of the nurses that I believe can be as good of an injectors as a doctor, if they really take their time and do the foot work of understand the anatomy of the face and learn the techniques from the experts and work with an expert injector that can oversee their work. As long as they have these criterias, I believe they could be great injectors. My nurse injector has been doing injections for over 10 years. She is very familiar with facial anatomy and she understands the pitfalls of many fillers for different areas of the face. I have 100% trust in her and that is why I trust her. We have reviews of different scenarios in the office, as well as, seminars and webinars all the time together so we can make sure we are up to date with all the new products and techniques. She never does her injections without me approving and she is constantly in communication with me. I believe the doctor/nurse relationship should be this way. If there is any problem with any patient, she immediately have access to me and patient can talk to me with her concerns.  I believe as long as you have this relationship with your nurse and doctor injector, you should be safe and fine.  

The HA fillers do not develop collagen like other permanent fillers, so microdroplet technique will only help give the skin a better appearance for a short time but will not help contour or fill lines this way.  I suggest someone who uses cannulas for contouring and it limits complications.  Best, Dr. Emer.

Although skin boosters, particularly the product known as Restylane Skin Boosters, are not available in the U.S., I have routinely been using them in my Israel satellite facility, where a far greater number of regulatory agency approved fillers and volumizers are available. Skin boosters can be injected in multiple microdroplets, as you mentioned, or can be instilled in a radial fan-like fashion under the entire area or both methods may be combined if necessary. Typically two to three treatment sessions are required to achieve maximal hydration, plumping and smoothing. With the introduction of Restylane Silk into the U.S. I have begun injecting this product in a similar fashion to that described above in my Upper East Side Manhattan office, and, as an aside, I personally perform ALL injection procedures in both my offices.

I do all of the injections in my office.  Regarding the dermatologists or plastic surgeons who have nurse injectors, there is supervision by the specialists who can ensure the quality of the nurse's technique and give back-up if there are any adverse reactions.

There are special variations of the popular fillers with lower viscosity whose purpose is to plump the skin.  The skin looks thicker, more vibrant.  Some physicians say they do it first before doing volumization because the need for filler decreases. The US doesn't have these type of fillers yet. Using a micro droplet device it is possible to mimic these fillers with the current available fillers which are diluted.  I just don't think they will be long lasting using this technique but don't know for sure.