During the administration of the filler, strict asepsis must be maintained. The region of the face that must undergo treatment has to be disinfected with a spirit named povidone; it is also referred to as the iodine spirit method. For the same sterile cotton gauze must be used.
Any kind of medical intervention requires it to be painless but during an enhancement procedure like a wrinkle filler, eye filler, surgery team is extra careful. Treatment outcomes are unlikely to be affected by methods to alleviate pain. It is frequently encountered when filling the nasolabial groove an infraorbital nerve block is employed. When lignocaine is injected in the infraorbital region, the local anatomy becomes distorted and may result in a suboptimal correction. The surgeon reduces the resultant distortion by employing 1 ml of lignocaine 2% administered with the help of an insulin syringe. The application of topical anesthetic cream such as EMLA can improve the skin’s hydration and the fine lines grow imperceptible which would finally lead to an imperfect correction. A suitable option in such a case is to make use of a filler which is premixed with lidocaine or any regional nerve block. With the use of ice packs, the inadequate use of EMLA in achieving anesthesia can be compensated. Long needles of 1.5 inches are used to minimize the pain induced with the number of pricks when linear threading or depot technique is employed. The surgeon, however, will definitely check for the hypersensitivity of each patient for lignocaine.
Depending upon the site where it is being deposited, the correct technique of administration has to be made use of for the fillers. If a filler that must be placed quite superficially gets injected deep, then it just diffuses into the deeper plane thus requiring larger volumes for filling the defect and can also result in faster resolution. Once, it can lead to lumpiness and blanching at the same time if denser fillers are inserted superficially. Molding is done immediately after the lumping is observed and has to be done until a level where the lump becomes flattened and the blanching effects are reversed. Ideally, it should be done immediately, but 2 weeks after the filler is inserted can also be done.
An intraoral approach is employed as an alternative to percutaneous injections for the subperiosteal or subcutaneous deposition of the fillers used for cheek augmentation. But there is no specific consensus on the method in this regard.