For a liquid facelift, is the needle technique important?

Hello, and thank you for your question!The most important component of a fillers treatment is the practitioner administering it. A large part of my practice is using a procedure that I call Aesthetic Facial Balancing. I take filler and balance all features from top to bottom to make them work together to 'unlock' your beauty. This procedure is not just a filler intervention augmenting the cheeks and lips, but as in overall, non surgical way to shape the face in a different way to create natural appearing results.I hope this helps!Wishing you beautiful results,Dr. Rian Maercks M.D.

Thank you for your excellent question. There are many different excellent techniques to inject fillers. The most important thing to consider when considering an injector is the level of experience. A highly trained injector will know what technique to use to accomplish the look you desire with safety and efficacy. 

Thank you for your question. 
The most important technical aspect of injectables is the that the injector has experience with the procedure and understands facial anatomy and also has a good aesthetic eye. The overall result and complications are usually determined by good technical skills of the injector. I prefer to use blunt cannulas for deep work because they seem to cause less bruising, swelling and are theoretically safer to prevent intravascular injection, but when needed will use needles for superficial injections.
An in person consultation is
very important to decide your goals and see the results achieved by your provider.
Hope this helps!
Best, Dr Miotto

Thank you for your question, and I'd like to applaud you for doing your research before choosing an injector. Technique and training are EXTREMELY imperative when injecting the face. You MUST choose your injector carefully so that you get the natural enhancement you desire. There are many injection techniques and different types of fillers (HA and non-HA) to choose from. The term "aggressive" should never be used while injecting into your delicate tissues. This can cause increased bruising, swelling, nerve damage, and even occlusion of important blood vessels in your face. While injecting deep dermis with Voluma or Restylane Lyft, the filler is actually injected deep down right on top of the bone to support the tissue while replacing lost volume. I hope this helps!

You are very smart to have watched videos of different filler techniques and to ask about the importance of technique.  So many people "price shop," assuming that all fillers/injectors are basically the same.  Thinking that you're paying for the syringe of filler is like thinking that you're paying for the tube of paint when looking for a beautiful piece of art.  If you can tell that someone has had filler, then it was poorly done.  It's not about the amount of filler; an advanced physician injector can use 3 or more syringes of filler and give you an immediate beautiful, fresh, lifted result; while an inexperienced injector can make you look odd or disfigured with just one syringe: it all has to do with expertise, experience, and placement. However, every single injector, no matter how experienced and knowledgeable, has a different technique.  In my practice just outside of Washington, D.C., I perform my trademarked "Facelift In A Syringe" using various fillers (mostly hyaluronic acid) and injection techniques (needles of varying size, cannulas) for different faces and different areas.  During the consultation, many people are worried about their face looking too round or full; which is why I have my ipad full of before and after photos in hand.  I have my patients come in with a photo of themself fro 10-20 years earlier and we review together where volume loss has occurred and how to restore the youthful contours of the face.  You should leave the office looking fresh, not done.  I recommend that you consult with a board certified dermatologic surgeon experienced in facial contouring and review enough of that physician's photos that you feel very comfortable before the injection process begins.  Congratulations on realizing the importance of technique, and I hope that you find a physician with whom you can establish a long-term relationship so that you can receive age-appropriate maintenance treatments over the years to avoid a surgical procedure down the road.

 I am leery of the term “aggressive,” particularly when it comes to injecting the face with dermal fillers. The skin is filled with blood vessels and nerves, so whether you are using needles or cannulas to deliver hyaluronic-acid based dermal fillers such as Juvederm, Restylane and Belotero, or microparticle neocollagenetic fillers such as Sculptra and Radiesse, judicious placement and a light touch is essential.
Dermatologists train for many years, learning the anatomy of the face so that they know the position of blood vessels and nerves, and understand how muscles, bone and skin all interact. Depending on which filler is used, we may inject quite deeply into the skin to stimulate the maximum amount of collagen, but this should never be an “aggressive” movement. Being rough with the face could cause excessive bruising, swelling, and soreness and/or even temporary nerve damage.
You will find out which dermatologist gets beautiful results by looking at their before-and-after photos and by interviewing former patients. Be sure to consult board-certified dermatologists who have expert injection technique to receive an advanced procedure such as a liquid facelift.

Effective use of fillers is both a science and an art.  Fillers have differing properties and are best used in combination to acheive volumization, wrinkle reduction and facial contouring.  Depending on where the filler is to be placed may determine whether one uses a needle, microcannula and superficial or deep placement.  There is no "best" technique, it is a combination of experience and skill to yield best results.

Technique is key when it comes to the liquid facelift, but it is not as simple as gentle versus aggressive. Also, it's not clear to me if by aggressive you are simply referring to deep placement of filler, or if you are referring to the quality of movement itself looking aggressive. Deep placement of filler is not necessarily aggressive, and with certain fillers it is the location of choice for optimal results. Personally, whether I am injected deep or superficial, I prefer a gentle technique in order to minimize any trauma to the tissues. Aside from knowing how to inject, what fillers are chosen are equally as important. Poor filler choice, even if injected meticulously, will not yield the desired results or longevity. Basically your injector needs to know what filler options are available, what area each filler is best suited for, and how to inject the filler safely and effectively. For some patients, achieving long lasting and subtle, natural results may require 3 different types of filler for example. I think fillers are too often thought of as a product you buy, rather than a service provided, a service that requires quite a bit of knowledge. There are also very serious risks associated with fillers, so it is good you are doing your research to gain a better understanding.

Hi and thank you for sharing your question! Over the years each physician can develop a specific technique, but regardless of what you see in videos (which can be heavily edited and somewhat different from the real-world cases), it is never advisable to be "aggressive" with injections. This is specially important when using needles with sharp ends as the risk of injury to sensitive tissues increases. When using flexible micro-cannulas (my personal favorite for many types of injection), we can often move the cannula easier since the blunt tip of the cannula reduces the risk of tissue injury (and I am guessing that the videos you have seen which suggest more "aggressive" techniques are probably cannula injections), but I personally never put my guards down even when using cannulas. I hope it helps and good luck!

Thank you for sharing your excellent question.  In general regardless if needles or cannulas are used a gentle technique should be used to minimize tissue swelling and trauma.  I would focus more on the injector rather than their technique to optimize results.  Hope this helps.