The 3 secrets to precision injecting in medical aesthetics

Despite a group of aesthetic clinicians all training together in the same injection techniques, on the same day, with the same teacher, it is possible that they will all achieve different outcomes from the treatments that they deliver, and the reason is one simple word – precision.

In this blog, Dr Tim Pearce will reveal the three most important factors that will impact on the precise outcomes of your cosmetic injectable treatments – injection depth, needle position, and needle angle. He also explains how you can stabilise your body and calm your mood to become a precision injector.

Dr Tim will be discussing more medical aesthetic training tips as part of his upcoming webinar series, so if you’re looking to increase your CPD-certified learning and want to learn more skills to make you a better clinician, then step one is to register for the free webinars by Dr Tim.

What do we mean by precision injecting?

When talking about precision, as with any skill, we must not confuse this with co-ordination. For example, most people can thread a piece of cotton through the eye of a needle; this is the skill of co-ordination, it is not a skill of precision.

Precision with injecting comes from three factors – a good foundation in the primary technique (this usually comes from initial training and onwards practice), a clear image in your head of the position of your instrument – the depth and angle of your needle (including where you do not want it to be) and being in the right mindset when you are injecting.

The fundamentals of a precise injection technique lie in stability. The same skills of precision can be noted in those trained as military snipers. They can be 100% still, control their breathing, and move only their finger when required to carry out the precise shot.

How to stand when injecting fillers and toxins in four simple steps

Are you an aesthetic sniper? As aesthetic clinicians, we also need to leave all the movement and control down to the small dextrous muscles in our fingers, avoiding the use of more major muscles such as those in the forearm or shoulder, and certainly not the back or legs. All those major muscles need to be stabilised to achieve your military-level stillness and you can achieve this with four simple steps.

• Step 1 – feet firmly on the floor.
• Step 2 – rest your pelvis on the edge of the bed or treatment couch.
• Step 3 – rest your hand at the wrist level or pull your elbow in to your body so your hand is either rested on the patient or on the side of the bed or treatment couch.
• Step 4 – your fingers are now in control and your body is stabilised.

That is your body taken care of, but where is your mind?

How to be in the right mindset when injecting fillers and toxins

You cannot be a precise injector if your mind is distracted with multiple other thoughts or priorities. Examples would include concerns about running late, operational things nagging at your mind, or the details involved in engaging in small talk with your patient. Distractions like these mean that, at the moment of injection, you are not 100% focused like a sniper, and much like your body, this means your stability is compromised and will impact of your precision.

You need to learn how to zone out all the noise and distractions you may encounter in a busy clinic and concentrate on the injection you are about to deliver. This takes both practice and mental discipline, to close off all other thoughts and distractions, but it is essential.

Why attention to detail matters in medical aesthetics

Combining the fundamentals of physical and mental stability, we also need to consider the attention to detail.

Let’s think back to the act of threading a piece of cotton through the eye of a needle. To achieve this, your mind must become fixated on the detail as you attempt the task – the cotton, the needle eye, the forward movement etc. In fact, that is not all. The thin strands of fibre that fray at the end, which you may not initially see when you first view the cotton thread, can become an obstacle to successfully threading it through the eye of the needle. When this happens, you tend to refocus, increase your resolution so you can see more of the detail, and you alter your position to adapt your technique to achieve the goal. This takes threading a needle from coordination to precision.

This attention to detail also has a significant bearing on becoming a precise injector. It’s relatively simple to mimic the techniques, injection points, and approximate movements shown in a training session, but a focus on attention to detail is borne out in the tiny, and well considered adjustments made to needle depth, volume delivery, and needle angle by an experienced injector, which you need to hone yourself when replicating techniques.

Highly skilled injectors have busy, but logical minds at the point of injection, they will be sequentially going through the anatomical and aesthetic components of the treatment they are performing to ensure patient safety and optimal outcomes.

How do precise injection techniques impact on aesthetic practice?

Dr Tim notes that sometimes when he is watching videos posted on social media that aim to demonstrate injection techniques, he can see that the technique is being compromised because the practitioner may be rushing or distracted by discussion whilst they are injecting. This can lead to incorrect placement and a poor outcome for the patient. Similarly, such errors can also be attributed to an attempt to replicate a movement or needle position as part of a technique, without understanding the anatomical implications and the nuance of precision. Incorrect depth or narrow angles, such as those often seen with videos of vertical lip filler techniques, for example, can make a considerable difference, turning a safe injection into a risky injection, if the injector is not focused on precise injection points which benefit the anatomy. Be sure to read our recent blog exploring different vertical and horizontal injection techniques for lip filler treatments and the one which discusses how to choose the best needle depth for dermal filler injections.

Dr Tim explores some ways to be more precise when delivering injections to the frontalis, the tear trough, the zygoma, the orbicularis oculi, and the temple in a recent episode of the Aesthetic Mastery Show on precise injection techniques.

Ultimately, with practice, you will learn how to view your needle as more than simply a delivery tool, turning it into a sensory tool that delivers tactile feedback at you enter the differing layers of the dermis. By becoming more precise with every injection that you deliver, and learning how minor changes in depth, position, or angle impact on your outcomes, you will be able to treat more areas of the face with increased confidence.

Copying your neighbour was never a good thing when you were in a classroom at school, and it is not good practice in medical aesthetics. Simply copying the techniques that you have watched demonstrated by others – even KOLs and experienced trainers – is not the true answer to perfecting your injection techniques and becoming a precise injector. Instead, observe, review, and understand the justification for their movements and their delivery. Appreciate the precision being demonstrated and then try to reproduce that attention to detail yourself.

Aesthetics Mastery Show

Find out more about the impact of depth, position and angle of entry on your treatments. Dr Tim explains further how to stabilise your body, as well as how to calm your mind in order to get into flow. He also examines the anatomy of the lips, frontalis and orbicularis oculi, explaining how potentially harmful poor positioning, depth and angle of entry can be in those areas. Watch the full Aesthetic Mastery Show episode here:

Further resources

If you want to increase your confidence in dermal filler and botulinum toxin injections, we offer a selection of highly rated eLearning courses:

• BOTOX® Foundation Course
• Dermal Fillers Foundation Course
• Botulinum Toxin Complications Mastery
• Dermal Filler Complications Mastery

Are you still anxious about delivering cosmetic injectables safely?

If you want to learn more about mastering medical aesthetic treatments and complications or conquering the anxiety of where to place your needle, then register for the next Dr Tim webinar.

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Dr Tim Pearce eLearning

Dr Tim Pearce MBChB BSc (Hons) MRCGP founded his eLearning concept in 2016 in order to provide readily accessible BOTOX® and dermal filler online courses for fellow Medical Aesthetics practitioners. His objective was to raise standards within the industry – a principle which remains just as relevant today.

Our exclusive video-led courses are designed to build confidence, knowledge and technique at every stage, working from foundation level to advanced treatments and management of complications.

Thousands of delegates have benefited from the courses and we’re highly rated on Trustpilot. For more information or to discuss which course is right for you, please get in touch with our friendly team.