00:00in today's video i am touching up my cheek filler using tesoro implant with lidocaine
00:11there are two different needles included in the tesoro implant packaging both of them are just
00:17fine for cheek filler or jawline filler application they both work well i'm just
00:22going to go ahead and attach the needle to the syringe by twisting it clockwise i have already
00:28double cleanse my skin and alcohol swabbed and then apply topical lidocaine for 15 minutes you can
00:35see here that i'm wiggling the syringe getting the needle down to the bone i'm going to go ahead and
00:43aspirate to make sure that the tip of the needle is not in a vein or vessel typically the periosteum or
00:50down at the bone is a safe place to inject for cheek filler having said that it is always important to
00:57implement a safety protocol which includes aspiration and having a filler dissolver on hand i always keep
01:05lipo race and some sterile saline on hand in case of a vascular occlusion here i am applying the filler
01:13in a very slow even pressure not rushing or forcing i'm injecting about 0.2 ml of filler into each point
01:24but this could be adjusted to suit your personal preference less is always a good idea when first
01:31starting out and personally i really just want to maintain a natural look and offset some of the
01:39volume loss that i've had with weight loss volume loss is a normal part of the aging process and cheek
01:46filler is probably the most impactful way to lift the face and it has such a nice impact on the lower face
01:54as well including the jaw line marionette lines and nasal labial folds with each injection point i am
02:01aspirating holding that for just a few seconds to make sure there's no blood in the syringe
02:08and then injecting with slow and even pressure taking my time not rushing and not forcing this is a thicker
02:17filler filler but you do not have to put tremendous force on the syringe just nice consistent even
02:24pressure after i've injected in the two or three spots along the zygomatic bone i like to take a look
02:32and kind of assess if there's any spots that need just a little extra little tweaking it's important to do
02:39a thorough assessment really looking at your bone structure before beginning but it's also important
02:46to really take a good look as you're creating that shape during the injection process i noticed a
02:52slight depression where there was a little shadow and wanted to just put a little more filler right
02:57in this area i definitely take my time getting the needle on the bone making sure it's steady and i'm not
03:05moving the tip of the needle around much and then aspirate every single time watching the front part of
03:13the syringe to see if there's any blood that comes into the syringe as i've said before a magnifying
03:19mirror really does come in handy and also just a sense of calm and steadiness and confidence is really important
03:28it should be noted also that i personally think that cheek filler is the first place to start with any filler
03:35treatment for facial rejuvenation as we age it can have a positive impact on so many areas of the face
03:42even the under eyes so by first starting with the cheek filler letting that settle for about a month
03:48we can really assess what other areas might need treatment the best way to lift the lower face is
03:56often by starting in the mid face so i'm moving on to the other side basically repeating everything
04:03that i've done really focusing on symmetry and also paying attention to any divots or areas that need
04:11attention our faces aren't always a hundred percent symmetrical and especially with a weight loss you may
04:19have more volume loss on one side than the other so taking a good look at that and sometimes taking photographs
04:27of yourself from a low angle under the chin and through the cheek area to really take a look and
04:34assess if there's one side that needs more attention than the other i think it's always best to err on the
04:41side of under filling the cheeks and then repeating treatment to add more volume down the road than over
04:48filling right off the bat it's always easier to add more than to try to remove filler that you don't like
04:55having said that i have a strict two to four week rule that i never dissolve filler in the first few
05:04weeks even if i think it's too much because most of the time that's just inflammation filler can look a
05:10little lumpy bumpy and inflamed and it doesn't settle in and look really nice for at least a couple of weeks
05:17so definitely give it time to integrate and don't panic i can honestly say i generally don't like my
05:25filler treatments immediately it does take me a good two weeks and it is a mistake to dissolve the filler
05:32before two to four weeks because not only are you dissolving the filler but you're also dissolving your
05:39natural hyaluronic acid in your body so it can leave you with more volume loss than you had to start
05:46with stay calm and remind yourself never dissolve for at least two to four weeks let it settle let the
05:55inflammation subside of course this is completely disregarded if you have a vascular emergency and in
06:01that event you want to inject a hyaluronidase or liporase some kind of filler dissolver in the area
06:09at the same depth to dissolve the filler and clear the vein or artery when filler is done properly and
06:16with a safety protocol in place a vascular occlusion is minimized tremendously one thing you'll notice
06:24throughout my videos is a sense of calm and confidence and patience not forcing the filler not rushing not
06:35pressing too hard the key is that slow steady pressure confidence does take time and when i first
06:43did filler there was a little nervousness but there was still that calmness and staying steady and that's
06:52important the cheeks anatomically are actually a very good place to start with filler when you're
06:59doing a filler at the bone with a needle the risk of an occlusion is pretty slight you could do this with
07:06a cannula however i feel like for the zygomatic area or the cheekbone it is better to use a needle
07:15and get down to the bone and really create that lift with a cannula you can't quite get to the
07:22bone but a lot of people do cheek filler with a cannula and it does look nice so it's a personal
07:29preference and one that you need to feel good about thank you so much for watching and sharing
07:34a piece of your day with me i will see you in my next video
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