By Doctor Sandrine Sebban
We all know about hyaluronic acid injections into targeted areas in the middle of the face (under-eye shadows, nasolabial folds, marionette lines, etc.). Today, the trend is to inject into the lateral parts of the face with the aim of restoring the face’s original volumes and obtaining a result similar to that of a lift: as natural as possible and without heaviness. 
A new comprehensive concept for restoring volumes
With age, the face, in particular the sides of the face, become hollow due to the loss of several substances: fat is lost from the temples and cheekbones and migrates to the middle of the face, bone density becomes weakened which causes the skin to sag, and the facial “V” becomes inverted (the base of the triangle moves gradually from the cheekbones downwards). All of these factors contribute to the collapse of the face’s structure.
Instead of using localised, volumising hyaluronic acid injections in the middle of the face, it is better to treat the lateral parts of the face. The aim is to avoid adding product to areas which already have trouble supporting their own features. If we do this, the face simply looks heavier without the desired lifting effect.
By using lateral injections, we can recreate the natural volumes in and behind the temples, in the apple of the cheek, in the retro-zygomatic region and in the retro-mandibular region.
Nappage in a “fanned” pattern
In order to treat both sides of the face, a volumising hyaluronic acid is injected quite deeply using the nappage technique. The product is introduced via one entry point using a cannula, either between the dermis and hypodermis if the face has persistent fat and moderate hollows (EMERVEL® VOLUME GALDERMA, JUVEDERM® VOLUMA® ALLERGAN, JUVEDERM® VOLIFT ALLERGAN, ULTRA DEEP TEOSYAL®), or between the bone and the muscle if the visage shows significant skeletonisation (STYLAGE® XXL VIVACY), to achieve an even and natural-looking result at the surface.
The calibre of the cannula should be medium to large (25G or 22G) so that it can easily inject the volumising hyaluronic acid. The length of the cannula (60, 70 or 90mm) is just as important, to ensure that a large area can be covered properly from just one entry point. Located on the retro-mandibular angle, this entry point enables the cannula to reach up to the temple, the top of the cheekbone and the rear of the cheek, thus creating this volumising/firming effect in the middle part of the face.
A natural result with numerous benefits
The congruous restoration of the facial volumes also produces a lifting effect by pulling up the tissues, which brings the face into the light and erases any signs of fatigue. Thanks to the repositioning of the tail of the eyebrow and the outer canthus of the eye, the expression is opened up. The lines on the forehead are ironed out and the nasolabial fold is naturally smoothed, as are the marionette lines and the corners of the lips. The smile is rejuvenated without looking fixed. Now more even, the line of the oval of the face looks lifted while the volume of the jowls is reduced.
The ideal candidates for this treatment are women in their fifties who are starting to see more pronounced hollows on their face, but whose face has not yet collapsed too noticeably. The earlier and more regularly we act to prevent this phenomenon, the longer we will delay the need for a surgical lift.
When injected into static areas which are not often moved by the muscles, volumising hyaluronic acid can last between 15 and 18 months. HA injections can also be carried out alongside other treatments (e.g. mesotherapy, peel or fractional laser) so as to improve the quality of the skin’s texture.
The “EasyGuide” needle by SoftFil®
With its innovative, ergonomic shape and double handle for better grip, this new device enables the practitioner to easily create an entry point through which the cannula will be introduced into the skin. Very stable, it has a half sharp needle to guide the cannula, which is inserted cleanly into the skin. This unique, patented device for creating a combined gesture is ideal for the treatment of the lateral parts of the face, the chin, the hands and the décolletage. A simple but brilliant idea!
Doctor Sandrine Sebban
Doctor of Medicine specialising in Aesthetic Medicine. Trained in Paris (France) and Beverly Hills (USA). 20 years’ experience in aesthetic medicine techniques (injection of filler products, peels, mesotherapy, PRP, tensor threads, lasers, cryolipolysis). Inventor of the “Soft Filling Technique”, an innovative injection technique using micro cannulas, which led to the development of SoftFil® cannulas.
