ArtiCle | fACiAlAeSTHeTiCS |


Figure 5 (A) Before and (B) 6 months after treatment with 6ml Radiesse


the cannula to be used, and hold the needle between


the thumb and index finger. Pass the needle through the anaesthetised area down to the supraperisoteum. Scrape the needle as it is being withdrawn on the underside of the dermis. As a guide, this introducing needle should be 2 gauges


smaller than the size of cannula to be used, though needles the same size as the cannula may be used when confidence is gained in this technique. Once the needle has formed a channel in the tissue, take the cannula and with the non-dominant hand, stretch the skin medially. This helps to open the insertion point. Do not rest the metal of the cannula on the finger while sliding it into tissues, as this increases the risk of infection.firmly slide the cannula down to the supraperiosteum.


Occasionally, a little extra pressure may be required


to push through the fascia to reach the supraperiosteal plane. The cannula will move freely parallel to the periosteum once in place. Advance the cannula along the periosteum, following the lines and direction as marked on the skin surface. Once the cannula is inserted to full length, deposit a strand of product retrogradely, leaving approximately 0.3–0.5 ml per strand — a total of 1–3 ml per side (zygomatic arch/malar region). Do not withdraw the cannula. While still remaining in the supraperisoteal plane,


advance the cannula again at a slight angle to the first injection, all the while following the surface markings. Using the non-dominant hand the cannula may be guided and its direction monitored, ensuring product


Figure 6 (A) Before and (B) 6 months after treatment with 6ml Radiesse


32 ❚ September 2011 | prime-journal.com


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