Couture Explains The Benefits Of Placing Fillers At Different Depths

Most people know what most fillers are, but what they don't know is what depth is the filler being placed and why? There are multiple depths and injection techniques filler can be placed and different reasons for those placements.
 
EXTON, Pa. - Aug. 24, 2015 - PRLog -- There really is no substitute for injector experience and training when discussing filler treatments. It really is a "feel" that the injector has for the level of the injection. The dermis (the layer most superficial) is more firm, the subcutaneous layer, which is mostly fat, is more "loose", the injector can get an idea of the level by the resistance on the needle. When injecting in the superficial dermis, the needle is almost visible in the skin, the deeper dermis is just above where the needle resistance lessens. Experience and training are necessary to "feel" the difference.

There are quite a few different types of placement. Linear threading is placing the full length of the needle into the middle of the wrinkle or area to be enhanced and creating a tunnel that will be filled in a continuous line as the needle is being withdrawn. This is the most frequently used technique for correction of isolated wrinkles and creases, including the lips. The serial puncture technique uses multiple injections that are placed along the length of the treated area so that it merges into a continuous line which lifts the wrinkle.Using the fan technique is when after injecting one line of filler the direction of the needle is changed and injected as before but creating a new line. This is a popular technique when utilized for augmentation of the cheeks.
The sandwich method is a layered technique using one filler in the deeper dermis and then placing another filler above it in the mid or upper dermis. This is most commonly used in deeper folds such as a deep nasolabial fold or marionette line.

The different depths of placement are in the Epidermis which is the top layer of skin where fillers for fine lines is injected. For example Restylane Silk for the smokers lines. When injecting into this layer you can see the needle under the skin. The dermis is the middle layer of the skin where the light to medium depth folds are injected. Juvederm is a prime example to be injected into a mildly to moderately indented nasolabial fold. With this depth the needle can not be seen under the skin but can be felt from the outer layer of skin. There is a need to force a bit to get the needle through at this level of depth.
The sub-dermis, also known as the subcutaneous, is the deeper layer of the skin where deeper folds are injected. Thicker fillers such as Juvederm Ultra Plus, Radiesse or Voluma, which are made of larger molecules, are better to be injected into this area to provide a better fill. The needle can move easily in all directions of this area. This is a prime example of the depth needed for doing a cheek enhancement or cheek bone highlight.

Couture offers multiple fillers and each has it's own specific purpose. Dr Gambhir not only has a comforting bedside manner but a special and unique talent to see the face as his canvas to beautify. As it is often compared, each filler is like a paintbrush, some are meant for thick lines and others are meant for the fine lines as a finishing touch.

As in all aesthetic techniques, a proper consultation with respect to achievable results is important. Come to Couture and let Dr Gambhir explain how to age gracefully.

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Couture - Anshul Gambhir, MD
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