Deep injections are near the periosteum, and very superficial injections are near the dermis, with intermediate injections somewhere in between. Dr Tim further explains that if you are looking at different aspects of the face, the difference in millimetres will be significant.
Deep injections are defined in this article as approxi- mately 6–10-mm deep, sometimes on or near periosteum. Medium depth injections are described in this article as ap- proximately 2–5-mm deep, placed under the skin, passing the overlaying muscle (if there is one) and into the targeted muscle.
Insert the IM needle to a depth of at least one inch into the muscle at a 90 degree angle with one quick and firm motion (FIGURE 7). After inserting the needle into the muscle, keep the skin pulled tight and firmly push the plunger down slowly and completely to finish the injection.
[7] Injection too superficial or too deep can lead to inadvertent injection of the wrong muscle, potentially causing an opposite effect from the desired outcome. The muscles of facial expression are innervated by terminal branches of the facial nerve.
Botox must be injected into the superficial layers of the skin in some areas, while in others, it needs to be injected deeply. One example is the masseter muscle near the mouth. If a practitioner doesn't inject this muscle deeply enough, patients can end up with an uneven or unbalanced smile.
Even if the masseter muscle is reached, failure to inject deeply enough can leave the lower parts of the muscle moving as normal while the top part is relaxed, creating a 'chipmunk' appearance. Practitioners should aim to inject at the site where the muscle meets the bone, using a longer ½” needle for best results.
The Tyndall effect happens when too much hyaluronic acid filler is placed too superficially. Light that shines on your skin may then develop a bluish discoloration. This effect can happen when too much is asked of filler, and it is injected just under the skin's surface to break or smooth out lines.
The majority of effective Botox treatments are administered from the cheekbones upward. Injecting outside these zones or into the wrong facial structures can result in a “frozen” look or, worse, impaired facial function.
Around the Mouth/Lip Area
Injecting botulinum toxins into the mouth area can cause a loss of emotional expression and asymmetry, as well as drooping as a results. While it is possible to inject Botox (botulinum toxin) in the muscles around the mouth, it's highly recommended that you avoid injections in this muscles.
Place the syringe at a 90-degree angle to the shot site. The needle should stand straight up from the skin. Quickly jab the needle all the way into the skin.
The key danger zones of botox include the areas around the eyes and mouth, specifically involving the orbicularis oculi muscle, the facial artery, and the temporal artery. Think of these zones like a “no-go zone” on a map—trespassing can lead to hazardous results.
Common indicators that Botox may have gone bad include drooping eyelids, uneven results, excessive bruising, or prolonged swelling beyond the expected recovery period. Difficulty swallowing or breathing could also signal that the toxin has spread to unintended areas.
Bruising is common after Botox, but sometimes a hematoma can develop. This happens when a blood vessel is injured during the injection, leading to swelling, tenderness, and discoloration. Most hematomas are mild and go away on their own, but proper care can help speed up healing and reduce discomfort.
Your skin can be very sensitive after your procedure and you may find retinol irritating. It is best to avoid anything that might promote inflammation while the area heals. Avoid using anything that might promote inflammation while the area heals.
“Pillow face” occurs when too much filler is injected into areas like the cheeks, nasolabial folds (the lines from your nose to the corners of your mouth), lips, and under-eye area. This repeated overfilling can result in a bloated, round appearance that looks far from natural.
As with any medical procedure, there are risks involved with the use of dermal fillers. Most side effects associated with dermal fillers, such as swelling and bruising occur shortly after injection and many resolve in a few days to weeks. In some cases, side effects may emerge weeks, months, or years later.
Traditionally, we want to aim for our injection depth to be in the deep dermal or immediate subdermal plane, at the junction of the dermis and the hypodermis.