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Proper Patient Positioning During Injectable Filler Treatments

Posted: 6:00 a.m. Sunday, Dec. 3, 2017

By Anita Mandal, M.D.
Question: I have gotten filler treatments in my cheek and lower eyelid hollows. Since I moved to Florida, I’ve seen 5-6 plastic surgeons/dermatologists, but no one seems to quite do it right. I notice a lot of doctors lay my face and body back in the chair when doing the fillers, but you stress the importance of sitting upright during your treatment. Is positioning really that important?

Answer: In my 22 years of using injectable fillers, patient positioning, primarily of the face and eyes, can be the key to a successful result.

As you age, have you ever noticed how your face looks better when you lie down in bed on your back? That’s because the effects of gravity are not pulling on your facial tissues as much. Your eyes may also look less hollow in this flat body position. Even your cheeks can look fuller, and your neck can appear tighter.

When doing injectable filler treatments, particularly with the longer-acting fillers, accuracy and precision are crucial. There should be no guessing involved as to where to place the filler. An expert injector should only inject in an area where they can clearly visualize the full extent of the deficiency.

When treating lower lid hollows, I always have the patient sit upright and face straight ahead with eyes centered but with a slight upward gaze. This position makes the lower lid hollows most pronounced, allowing an expert injector to adequately fill the lower lid hollows and create a natural result.

When filling cheek hollows, it is important for patients to limit all facial expressions such as smiling, squinting and talking during the actual treatment. Facial expressions during treatment can raise the cheeks, making them appear less hollow than they actually are. I also have my patients keep their jaw relaxed with their mouth very slightly open. Such positioning enables accurate filling of the hollows with a more natural result.

There are generic injectors and there are injectors with exceptional skill. It’s up to each individual patient to decide which type of injector is the most suitable choice for them, especially when having a long-term filler like Bellafill or stem cell fillers.

A careful consultation with a Board Certified Facial Plastic Surgeon is the first step.


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