Juvederm via cannula. Is this a commonly used technique?

I recently consulted a Doctor about filling my nasolabial folds with Juvederm. He said he uses a cannula and fills into the cheeks. Is this a commonly used technique? He said I'd need maybe 1 syringe. I don't want to end up with fat cheeks. Thank you.

Doctor Answers 14

Juvederm injection technique

Hi! Nice to see a writer from Rockland County! 
I tell patients it isn't the paint or the brush - it's the painter. I've been using cannula for years - in Europe before they were available here. They are a useful tool for some areas and in others I use needles.  
To me the first question is why your nadolabial folds? If you are young with a full face and just early etched in lines then superficial injection of belotero makes sense. However,  nasolabisl folds are generally a result of volume loss in the cheeks and lateral face. We lose specific pockets of fat as we age which had the result of making the skin deflated - it causes loss of transition and folds. If you have volume loss elsewhere and just fill the folds, you can end up with a snout or a monkey appearance.  Before you go in, try this - stand at a mirror far enough to see your full face (no magnification).  Looking straight (chin up) see what happens when you lift the skin at your temples, then the cheekbones, then the center of the cheek. See if you have a hollow coming from your eyelid by your nose down your cheek. Can you put your thumb in your temple? In front of your ear, the side of your chin? And look at yourself from the sides. Is most of your facial fat in the front? 
Be sure that your consultation involves an evaluation of your face from the front and sides with your hair pulled back and without makeup. Otherwise instead of getting a naturally youthful and refreshed appearance, you can end up just looking 'done'.
i hope this answer was helpful. If this approach makes sense to you, feel free to make a consultation appointment at my Nanuet office. 
Best wishes.


New York Dermatologist
5.0 out of 5 stars 9 reviews

Cannulas with Juvederm

Dear Minxs:

Injecting the tissues "upstream" from the nasolabial folds, for example in the cheeks, over the zygoma, temples, and jawline, replaces volume where you have lost it and indirectly smooths the nasolabial folds, providing a much more natural enhancement.  One syringe is a very small volume for this approach, and you will not end up with fat cheeks. Cannulas are employed by many physicians to minimize bruising and the risk of nerve damage or injecting into a blood vessel, and often to reduce any discomfort, but cannot successfully be used in all areas.

All the best,
Dr. Clark

Sheryl D. Clark, MD
New York Dermatologist
5.0 out of 5 stars 7 reviews

#juvederm injection with a cannula, is this normal?

Thanks for sharing your question about having Juvederm HA filler injected with a cannula.  This is quite common however I agree with my colleagues in this forum that it's definitely not necessary -- it's just an extra tool that may help depending on the specific areas to be treated.  Many board certified plastic surgeons feel comfortable either using cannulas or needles and it seems more common to use the cannula for treating under the eye area.  I hope this is helpful and wish you all the best.
Brian S. Coan, MD, FACS 

Brian Coan, MD, FACS
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 52 reviews

Juvederm via cannula. Is this a commonly used technique?

Yes this is very common and felt to slightly decrease the risk of embolism. One tube to do both cheeks is conservative, you are unlikely to end up with 'fat cheeks' with that amount. Best of luck! 

Mathew A. Plant, MD, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 21 reviews

Juvederm Injection Technique

Cannulas are commonly used for injecting fillers.  However, needles are also used effectively.  Injecting into the cheeks tend to soften the appearance of the nasolabial folds. Ask your Physician which is his/her preferred method. Swelling and bruising are not uncommon using both methods.  I hope this helps.  Good luck.

Leslie M. Sims, MD (in memoriam)
Las Vegas Ophthalmologist
5.0 out of 5 stars 4 reviews

Juvederm for Nasolabial Folds

Fillers such as Juvederm can be injected with a cannula or needle.  Both have advantages and disadvantages.  I use both cannulas and needles depending on the specific patient, filler, and facial area.  The most common area for which I use cannulas is underneath the eyes in the tear trough, where there is a higher risk of bruising.  In the nasolabial folds, I tend to use a needle but I am careful and superficial with my injections as there is an underlying blood vessel in this area.  I have also used cannulas in the nasolabial fold with good success.

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Filler with or without cannula

Dear Minx,

Nasolabial folds can easily be filled with a needle.  A cannula can be used in the cheek or eye area, but it is not necessary.  I have used cannulas in the past and found them to cause more swelling than a needle, but ultimately, your doctor will choose a method that she/he feels will give her/his best results.  

More importantly, trust your gut.  And, be careful with filler in the cheek.  It can be a short-lived solution. Too much filler in the cheeks can lead to too much filler around the mouth.  Together, beware!  You can end up looking like a "bobblehead"! 

Read more about it on my link below:

All the best,
Dr. Michelle Yagoda

Michelle R. Yagoda, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Juvederm injected with a cannula

Hello Minxs,

Cannulas are designed to minimize bruising and decrease the risk of injecting into a blood vessel.  The other option is to use a needle and when using appropriate techniques it also minimizes these risks (the manufacturer provides very small needles which are what I prefer to use).  It is not common when injecting the melolabial/nasolabial fold to also inject into the cheek right next to it.  This, in my opinion, would only serve to make the cheek heavier and the nasolabial fold more prominent.  It is common to inject over the cheek bone in addition to the nasolabial/melolabial fold but this would take more than one syringe.  If you are concerned about having cheeks that are too fat then I would hold off on the cheek injections.  

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Cannula and fillers

Some surgeons use cannulas and others use a needle. Either way is fine for injection. Best of luck with your fillers.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Juvederm injections

Many expert physicians combine cannula and needle injection techniques to optimize results. In fact we often do both of these techniques during the same visit. For example, we might consider needle technique for precise filler placement (including lip augmentation) and use cannula in the same patient for visible lines and folds, for example marionette lines. When used appropriately, regardless of needle or cannula, the likelihood of ending up with lumpiness or "fat appearance" is minimal. Remember it is the aesthetic eye of your expert injector that will ensure that you look natural and rejuvenated regardless of cannula or needle technique. 

Andrei Metelitsa, MD, FRCPC
Calgary Dermatologic Surgeon
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.