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January 27, 2026
Dr Tim Pearce
It is easy to feel a bit blind, or like you are trying to find your way in the dark when your needle is beneath the skin as you inject dermal fillers.
In this blog, Dr Tim Pearce will help you to understand and use certain observations to determine the depth of your needle when injecting in facial aesthetic practice.
Do you feel anxious about causing complications? Many clinicians feel so overwhelmed with the thought of causing a vascular occlusion that it stops them growing their aesthetics business. Dr Tim is currently hosting a webinar series to help you overcome your fear of complications so that you can uplevel your knowledge, and increase your CPD-certified learning to build a successful aesthetics business. Sign up here >>
How can you tell how deep your needle is when you cannot see it?
The most important way to determine needle depth is by depth checking, notes Dr Tim. However, to test this, you must also ensure that you have good understanding of the structure of the tissues – the layers of the skin, and the types of skin you are injecting into, including the differences in the thickness of skin in different parts of the face.
For example, if you are injecting into the tear trough, there are fewer layers of skin, in this case only three layers, but more importantly, the dermis is only 0.2 millimetres thick. Therefore, it can appear that you are very superficial but in fact, you are under the dermis and not in the epidermis, because the skin is much thinner in this area. In contrast, the skin is much thicker in the chin and the glabella.
The thickness of the skin might change what you see, but using a depth check is your best guide to understanding where your needle is located, allowing you to evaluate the level of blanching as you raise your needle to gauge the specific layer.
If you want to be in the hypodermis, then as you lift the needle, you should see all the tissue lift, but not a clear line of blanching, when injecting in most areas of the face. For example, if you want to slightly inflate the volume of a superficial cheek fat pad, then as you lift the needle, it should not be clear where the needle is, you should simply see the shape of the needle and maybe some slight blanching.
When you are more superficial in your injections, it should be much clearer where the needle lies, with a decent amount of blanching. If, however, you are too superficial there will be continuous blanching, without change, and a line of white that follows the shape of your needle. Conversely, if you are deep, and on the periosteum, you should know that because you can feel that it is hard.
Dr Tim has a more expansive blog on how to choose the best injection depth for fillers to get the best results and avoid complications which covers four factors that dictate the depth of dermal filler injections and injecting into different layers of the skin including the dermis, hypodermis, the SMAS and deep fat pads, and the periosteum. Also check out how to improve needle control when injecting!
If you have any further questions about dermal fillers or injection techniques, then why not drop a comment to Dr Tim Pearce on Instagram. You can also look at some of the downloadable free resources on injection techniques available on his website.
Aesthetics Mastery Show
How to tell how deep your needle is
In this episode, Dr. Tim explains tow to tell what depth you’re at when injecting dermal fillers. Watch the full Aesthetics Mastery Show here.
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Filler Complications eLearning Courses
If you want to increase your confidence by learning how to handle complications, Dr Tim Pearce offers two comprehensive courses that are highly rated by our delegates:
Both give CPD and certificates on completion.
In addition, browse our FREE downloadable resources on complications.
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.
