
Ensure the needle is held steady and doesn’t move. Be aware you can feel the filler pushing the needle away as you inject.Slow injections ensure control and minimise discomfort to the patient.Feel your patient’s facial anatomy as well as visually assess their facial contouring ahead of injecting.Have a final visual scan for lumps and check the patient is happy, further moulding can be done if requested.Feel over the top to the point of the lateral canthus at the front of the cheekbone. (Why you should never go to sleep on your cheek immediately after your appointment!) Using your fingers the filler can be edged forwards and backward and up and down to position correctly. The filler can be moved slightly after injecting. Next, look at the patient head-on and assess the symmetry of the face.The filler will merge and flatten (see below diagram.) Leaving the 3 injections creates the best results for volume and the most effective use of the filler. At this stage, I don’t massage the filler down as massaging can result in lost volume. Once finished remove the make-up marks on the cheeks so you can assess the patient.


The first injection is going to be at the front perpendicular to the skin.

Start towards the front of the face and work backward.Be careful going too far forward, close to the infraorbital foramen which transmits important structures to be avoided such as the infraorbital artery, vein and nerve. Equally, if the patient’s cheekbones sit rounder or further forward on their face then the injections can be placed in different positions to resculpt the cheeks. In the video example, you can see that the patient’s zygomatic arch comes back quite far and so I have assessed her and placed the injections nearer to the side of her face. Our patient here is looking to add volume and definition. Every patient’s face is different and their facial contours may determine the volume – some patients even know from the outset they want bigger cheeks – that’s for you to discuss with them during the consultation. I usually use 1ml of filler per cheek, however, if this is the patient’s first time, they may prefer to go for 0.5ml each side instead.When determining the injection site, feel the flat surface of the zygomatic arch, as well as visually assessing their facial contouring. Mark the box overlying the bony prominence (the zygomatic arch). You can use a make-up pencil to do this, drawing box shapes high on the cheek – this will be the injection site – for 3 injections on each side. Firstly start off by marking the patient symmetrically on the top of the cheekbones.
