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What is Hyaluronic Acid?
Hyaluronic acid treatment involves injecting a soft, easily blending substance, similar to a soft mochi, into areas where volume has been lost and shadows have appeared. This helps to sculpt the face or body.
By filling in depressions, it improves hollows and wrinkles. It also has moisture-retaining properties, helping to maintain skin elasticity and hydration.
Treatment Features
The choice of filler, layers, and injection method vary depending on the area to be treated.
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- Forehead
- For safety, we use a thick, long needle called a microcannula. Swelling or bruising may occur, so please be aware of this.
To minimize pain, the nerve above the eyebrows is anesthetized. A needle entry point is created at the hairline, from which a long microcannula is inserted to gradually inject hyaluronic acid.
We typically use Volbella. For minor depressions, 1 to 2 syringes are usually sufficient, while 5 to 6 syringes may be needed to create a rounder forehead.
For small amounts, a thin needle may be used without anesthesia.
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- Temples
- A thick microcannula is also used for this area. The entry point is typically created at the outer edge of the forehead or near the ends of the eyebrows, from which hyaluronic acid is injected using the microcannula.
For slight hollows, 1 to 2 syringes of Volbella are typically used, while 3 to 4 syringes may be needed for more significant hollows.
In some cases, T1 and T2 injections, as explained below, may also be combined. - T1、T2
- This method is used to fill hollows around the temporal bone. As we age, the temple area loses volume, which can worsen upper eyelid sagging and make the temples appear hollow. To compensate for this volume loss, a firmer filler is injected deeply above the periosteum.
One syringe of Voluma is typically used for T1 and another syringe for T2. This treatment may also help make it easier to open the eyes.
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- Upper Eyelids
- This is an area where unevenness can be noticeable. The amount of filler required depends on whether the desired result is based on the appearance of the eyes when open or when closed.
Typically, no more than 1 syringe of Volbella or Skinvive is used to achieve a natural-looking result.
In some cases, treatment around the eyes with Volnewmer may also be recommended to tighten the skin at the same time.
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- Under Eyes
- A medium-sized microcannula is used to gradually inject small amounts of hyaluronic acid into the deeper areas under the eyes.
If the filler is injected too superficially, it may cause the Tyndall effect, which creates a bluish appearance, or result in uneven lumps. Please understand that there are limitations to how much filler can safely be injected into this area.
Injecting along the outer orbital rim can also naturally improve hollowness and sagging under the eyes.
Typically, 1 syringe of Volbella is used. For patients with hollows extending from the cheeks, additional injections into the cheeks (CK3) may be recommended.
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- Tear Troughs
- For a natural-looking result, approximately 0.3 cc of Volbella is usually ideal.
Injecting more filler near the inner corner of the eye can create a more noticeable result. Placing more filler in the center can make the eyes appear rounder, while placing more toward the outer corner can create a slightly downturned appearance.
The amount of filler used can be adjusted according to the patient’s preferences.
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- Nose Bridge
- The areas between the eyebrows and at the tip of the nose carry a higher risk, so only the bridge of the nose can be enhanced. A firm filler such as Volux is used.
For a natural-looking result, approximately 0.3 cc is used, while up to 0.5 cc may be used for a more noticeable lift. Typically, 1 syringe is sufficient.
Injection methods include making several small injections with a standard needle or using a thick, long microcannula inserted from the tip of the nose.
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- Nasal Septum
- Injecting hyaluronic acid into the membranous nasal septum between the nostrils can make the nose appear slightly narrower and lift the tip of the nose.
Typically, approximately 0.3 cc of Volux is used.
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- Cheeks (CK3)
- Hyaluronic acid can be injected into the front of the cheeks or around the outer eye area to enhance the underlying bone structure. This treatment can help reduce the appearance of under-eye bags and improve the tear trough area.
Typically, 1 syringe of Voluma is used. - Cheeks (CK2)
- This treatment targets the most prominent part of the cheekbones. Although it is less commonly requested by Asian patients, it tends to be popular among Western patients.
This treatment can lift the entire cheek area.
Typically, 0.6 cc to 1 syringe of Voluma is used. - Cheeks (CK1)
- This treatment targets the area behind the cheekbones. It helps lift the entire cheek and create a more defined jawline.
Typically, 0.6 cc to 1 syringe of Voluma is used. - Cheeks (CK4)
- This treatment fills the depression below the cheekbones.
Placing filler toward the back provides a stronger lifting effect, while placing too much toward the front may contribute to sagging. Therefore, more filler is generally placed toward the back. A small amount may also be used to improve the nasolabial folds through its lifting effect.
Typically, 1 to 2 syringes of Volift are used. This method may also be used to create a more oval facial contour. - Cheeks (CK5)
- Filler is injected into the front part of the cheek. Because this area is prone to sagging, care should be taken not to overfill it.
Typically, 1 to 2 syringes of Skinvive are used.
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- Nasolabial Folds (NL1)
- This area is located near the facial artery and therefore carries a higher risk. A sharp needle is inserted deeply above the periosteum. After carefully confirming that there is no blood return, the filler is injected slowly.
Because the filler is placed deeply, various types of firm filler may be used.
Typically, approximately 0.6 cc is used. - Nasolabial Folds (NL2,3)
- Excessive filler in this area can result in an unnatural, bulky appearance around the mouth. Therefore, care should be taken not to overfill it.
The amount should generally be limited to approximately 1 syringe of Volift.
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- Lips
- The Cupid’s bow, philtrum, and center of the lips are typically injected using a sharp needle, while the remaining areas are usually treated with a microcannula.
A small amount of filler placed below the corners of the mouth can create a slightly lifted appearance.
The amount of filler required varies depending on the desired lip shape. However, because there is a limit to how much the skin can stretch at one time, we generally recommend adding 1 syringe at a time.
To achieve lips as full as Nicki Minaj’s, at least 5 syringes would be required.
Depression Below the Lower Lip (C1)
This treatment fills the depression between the chin and the lower lip. It can make the chin appear longer without making the entire face look larger.
Typically, 1 syringe of Voluma is used.
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- Chin (C1)
- This fills the depression between the chin and the lower lip, enhancing the chin’s appearance without altering the overall face size.
Typically, 1 syringe of Voluma or RHA4 is used.
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- Chin
- Volux is recommended for shaping the chin. The filler is injected into different layers using various techniques to achieve the desired shape.
The amount may range from 1 to 6 syringes, depending on the patient’s goals.
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- Jawline
- Hyaluronic acid can be used to contour the entire lower jaw. Volux is used to shape the desired areas along the jawline, from the tip of the chin to the area in front of the ears.
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- Hands
- Filler is injected between the bones on the backs of the hands to reduce their bony appearance and create a softer, more youthful look.
Typically, 1 to 2 syringes of Volbella are used.
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- Neck
- This treatment improves horizontal wrinkles on the neck. For vertical wrinkles, treatments such as Profhilo or Botox may be more effective.
Typically, 2 syringes of Skinvive are used.
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- Elbows
- Filler is injected into the bony areas of the elbows to soften deep wrinkles and rough skin.
Typically, 2 syringes of Volbella or Skinvive are used.
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- Buttocks
- Filler is used to enhance hollows beneath the buttocks.
Typically, a total of 10 to 20 syringes of Volift is used for both sides.
Yoshiko Kuno