The education that preceded this demonstration was excellent. I can’t seem to find it on now that I’ve watched a few other videos. Can someone help me out? It’s GOLD!
Omg. That was amazing!!! You are amazing! Thank you so much for this content. For us providers (I've been a NP for 19 years, ER for most of them but an injector for 13 years) listening and watching you is like constant training for free. I've learned so much from you in the past year, please keep doing them! They are invaluable!
Dr. Tim. Thank-you for your continued dedication to the safety of (our) patients as well as the advancements of the industry. Invaluable for both newer injectors and experienced!! 💛💛🤩🤩
Great video- thanks for posting! I love Voluma in all the areas you treated Lindsey, but I really dislike Volbella in the tear troughs. Even with very little product, I think vycross draws too much water even with the lower HA concentration of volbella. I especially see it as the product breaks down it draws so much water to itself and can look worse than the original deficit. I think there are far superior products you can use like Restalyne-L that give a much better aesthetic initially and as the product degrades.
That's an interesting observation- I do see myself as quite grounded in the realities of day to day practice, not simply in the theoretical. I'll take your comment as a compliment :-)
@2:38 I would say i have not seen anyone so far injecting filler right there, its so close to the tip of her eyebrow. Is that also the temple? I thoight the temple is more on the side and lower, the soft indent which is usually the hollowed part?
It might be looking at a 2 dimensional view but it looks like Dr. Pearce's angle on the right with temporal injection is perpendicular to the temple and to the left it looks slightly angled anteriorly and superiorly? It could be a minor change to accommodate the client's anatomy/positioning but I am curious to know. TIA.
Wonderful video :) I’ve got a question ! 1) when injecting the medial cheek with the cannula, was this deep (close to bone)? I would be scared of the infra-orbital foramen, but at a more superficial plane I would also be worried about a result where the patient would smile and the cheek would move in a strange way.
It will be within the deep fat pads, not along bone. Always with a cannula medial to the midpupilary line. It’s important that you choose your product correctly for superficial work and one that is flexible so that it moves with your patient’s expression. Kind regards Mary. Clinical advisor for Dr Tim
@@DrTimPearcehow do we know that we are in the right layer in the deep fat pads? Because i ever had experience occlusion happen using canulla in this area. 😢
What is it you did or she have done to make such beautiful hollows under her cheek bones I love watching your videos and watching the anatomy and physiology. Please make them more often, I’ve just started (my 59 yr old face) my aesthetics journey.
she do not eat and burn fat from her face. Also this looks awful to me. However I have the same as I workout a lot. I would fill that gap first place if it is possible.
I was just wondering why the deep hollows beneath her cheeks were not filled. Is that a natural thing to have them? I am 72 years old. I’ve never been in the sun nor smoked or drank - these are the biggest agers around. I have never had plastic surgery; however, I do get minimal Botox and also filler around the the chin. I have large cheeks due to my Swedish heritage. I am always trying to get my dermatologist to fill my smile lines, but she says no - it looks unnatural not to have the smile lines. I have maintained my weight from young adulthood. I was a model and we are taught proper nutrition (at least we were in my days) and proper skin maintenance. What is the single most important area in my face which you feel would help to keep the youthful look? (P.S. I’m also married to a man who is 15 years younger than I am, so it’s important to me to keep looking younger, but not “plastic”.). Thank you!
I think it may make her cheeks look too round and full and diminish the definition of her cheekbones. However, your practitioner should be willing to do what you want (as long as it's safe), as it can always be dissolved if you don't like it.
Excellente présentation je vous prie de présenter vos vidéos avec traduction en français svp j'adore vos travaux mais parfois je craint mal comprendre vos recommandations. Merci pour tout ce que vous faites et bonne continuation.
Hoping you see this comment since it is an old post, but when i palpate that temporal region on myself i feel a steady pulse at the lateral aspect of my finger. Does that mean this is not a safe area to shotgun inject on me?
Placing the amount of filler needed to revolumize the face would look puffy and strange. When placed on the periosteum it achieves a more natural look. Think of how breast implants can look over vs under the muscle
Would you not recommend fat transfer in place of fillers when it comes to face... to avoid the risk every year of the potential of getting an artery or something blocked when repeating procedures. I'm assuming fat transfer generally would have substantially longer duration than fillers.
there are pros and cons to fat- it has some additional risks by virtue of the fact that much higher volumes are used, it sometimes doesn't take and the fat dies, or it grows too much- so though it can give great long lasting results it's less predictable.
Dr , isn't it anterior medial cheek is the one to treat? Do you layer into subcutaneous tissue layer? For lateral lid- cheek, isn't that there is a transverse facial artery right on that area? Also laterally u inject into lateral canthus area?
Yes we did some anterior medial projection for Lynsey using a cannula, small quantities but painted in, layering and moulding is best to really get that sculpted natural look within the hypodermis. The transverse facial artery lies inferior to the zygoma so deep onto periosteum is safer, I still aspirate for good practice and safety. Lateral lid cheek there can be branches of the zygomaticofacial artery hence why I aspirate with an unprimed needle to make it more sensitive. Yes injected at her lateral canthus as I was revolumising some mild volume loss from her lateral sub orbicularis oculi fat pad to make her transitions more smooth for the full face rejuvenation to look it’s best. Thank you for your question I hope that helps.
@@DrTimPearce tx u Dr. May I know for anterior medial cheek , a standard rheology like Restylane will do? Anterior medial cheek got thick skin so inject it into hypodermis won’t have Tyndall effect. But of there is bulge in superiormedially ( tear trough eyebag ) then if one inject filler there, isn’t that look swollen? Also it will touch onto Danker zone where angular artery become relatively superficial? Tx u.
Dr Tim, i am curious about what you would do in such a situation where a patient already has other brand of filler in her face eg Juvederm Voluma and if she requests to have eg Restylane Defyne, would you agree to that? It seems many injectors dont use a variety of brands in their clinic. Would mixing filler be a problem for you, if they are done at different time periods, say months?
I like your technical expertise. Wish you were in Houston Tx. I did a deep div in the processes.. I want you he whole face temper led under eye, and lower face: I to use use platelet rich fibrin to build collagen
Hi that was amazing but could you please tell me the plane of the cannula when you inject the medial part of cheek is it deep on the bone or in superficial fat ?
Hi. Thanks for the question. I just asked Tim. He said it's usually intermediate fat. Cannulas gravitate towards intermediate depths. You can do both but it's harder to get on the bone there. Hope that helps, Miranda
0.2 to 0.3mls each side- this is for the true tear trough which is medial, and runs to the midpapillary line. Wide variation though, and I would almost always do some treatment at the lateral lid cheek junction and the cheek, making total volume 1-2 mls for an eye refresh.
@B Real Yes, three- two deep temple arteries which tend to be more lateral and much deeper than the point I used, and one more superficial you can often feel- that's why I palpate before injecting. To identify the superficial vessels.
I'm certain that this comment won't be well received, but to be perfectly honest, the camera work is horrible(!) The entire point of the presentation is for educational purposes, right? It's such a pity that in the 21st Century, with all of the advances in technology that have been made and are available, the people responsible for video recording this event failed so miserably. 😞 I believe you to be at the top of your field, as both a practicing Medical Aesthetic Doctor and educator, who's always striving towards excellence. But, this presentation was frustrating to watch. ((The audio portion is very informative & I'm not being sarcastic.)) I'm sorry, Dr. P, I honestly don't mean to appear ungrateful or unappreciative of your efforts, nor do I mean any disrespect. I freely admit that I'm not an expert videographer, but I do know that if I were responsible for recording this event, 'I' would strive to capture the moment in such a way that would best illustrate the techniques you were demonstrating. Sorry to say, that's not at all what was captured here. Even with using zoom, it's impossible to actually *see* the depths, placements and angles used. 😩
He said he doesn't like to cause too much trauma to the face, however, from 8:49 through 10:38 and he even states at 8:58, 'I think I am usually gentle', no way! he did so much trauma to her face by doing that. I don't know, but that hole he left on this woman's cheek at 10.41 looks awfully big. I wouldn't like to have that on my face, that's for sure.
Lynsey is a naturally very slim lady and you can feel when you are sliding along the bone so looks superficial. Bevel of cannula down to ensure product doesn’t move superficially. Lynsey had no issues at review. Thank you for your comment.
She looks like she may be Irish or german... these face shapes are common in people from those backgrounds. I am indigenous American and have high enough natural cheekbones that I get this effect as well. It's very offensive when you thrust your standards of beauty on others. The world would be a very boring place if we all looked the same 😊
It's crazy how Xanaxed she is to make this look tolerable. Tim definitely has the knowledge, but skills and craftsmanship- that's a whole different story
Now this Dr. really cares about his patients and career. Fantastic procedure!
Finally someone who uses enough product to properly voluminous the temple
Right? Most doctors seem to be too conservative in that area
The education that preceded this demonstration was excellent. I can’t seem to find it on now that I’ve watched a few other videos. Can someone help me out? It’s GOLD!
Omg. That was amazing!!! You are amazing! Thank you so much for this content. For us providers (I've been a NP for 19 years, ER for most of them but an injector for 13 years) listening and watching you is like constant training for free. I've learned so much from you in the past year, please keep doing them! They are invaluable!
你也很棒
Loved this. Wish more doctors would be trained this well
Dr. Tim. Thank-you for your continued dedication to the safety of (our) patients as well as the advancements of the industry. Invaluable for both newer injectors and experienced!! 💛💛🤩🤩
Thanks for drawing the veins, would have loved to see a full face drawed with all the veins to look out for.
U can buy a red laser light (it’s like a little thicker than pen) that show where ur veins run over ur face or body. Like it was cheap .. $21 on ebay.
Thanks 🙏, I really learn a lot, the explanation was really excellent! Please, continue doing this kind of videos. 👍🏽👍🏿👍👍🏻❤️❤️💖
I love the podcasts, but especially love the demonstrations! Thank you again!!
What's the podcast?
Wow fascinating. Great explanation.
Great video- thanks for posting! I love Voluma in all the areas you treated Lindsey, but I really dislike Volbella in the tear troughs. Even with very little product, I think vycross draws too much water even with the lower HA concentration of volbella. I especially see it as the product breaks down it draws so much water to itself and can look worse than the original deficit. I think there are far superior products you can use like Restalyne-L that give a much better aesthetic initially and as the product degrades.
Hi, thank you for the video. Do you offer filler services to individuals or are you purely a trainer?
This Doctor is the Best!!!!
I appreciate “Dr. Tim’s pragmatic point of view/teachings. So curious what other subscribers think.
That's an interesting observation- I do see myself as quite grounded in the realities of day to day practice, not simply in the theoretical. I'll take your comment as a compliment :-)
@@DrTimPearce absolutely a compliment.
@2:38 I would say i have not seen anyone so far injecting filler right there, its so close to the tip of her eyebrow. Is that also the temple? I thoight the temple is more on the side and lower, the soft indent which is usually the hollowed part?
Doc, dont you think with the large area of hollowness in her cheek, sculptra would be a more economical and medically more thoughtful choice for her?
OMG!!! I want to come to you! 😮❤ I’m from LA, love your whole approach!
Who the heck down voted this Dr? He is an artist!
Thank you so much
It might be looking at a 2 dimensional view but it looks like Dr. Pearce's angle on the right with temporal injection is perpendicular to the temple and to the left it looks slightly angled anteriorly and superiorly? It could be a minor change to accommodate the client's anatomy/positioning but I am curious to know. TIA.
Amazing! Worried about the assistant who may have caused a bump
You are brilliant Dr.!!!!
Wish we could see the temple filler on the side view.
Great content. But from a billing perspective, in practice, would you bill for all those syringes you opened and only used a bit of filler?
You would have to bill as you can’t use the filler on another person as it’s now contaminated
She still has hallowness in the temples, is this a no go area for filler injection?
With that much filler, does it shift over time or migrate? Especially if you do lots of sauna.
You made this woman 20 years younger!!! Yeah you're a bad motha fuka!!!!! Brilliant! You are an artist!!!
Is it dangerous for using the sharp needle on the temple near the brows? with 90'c angle is better ?
Wondering why the assistant makes this face 😬 around 19:34 seconds in
I saw that too
Right? Very rude and unprofessional
Wonderful video :) I’ve got a question !
1) when injecting the medial cheek with the cannula, was this deep (close to bone)? I would be scared of the infra-orbital foramen, but at a more superficial plane I would also be worried about a result where the patient would smile and the cheek would move in a strange way.
It will be within the deep fat pads, not along bone. Always with a cannula medial to the midpupilary line.
It’s important that you choose your product correctly for superficial work and one that is flexible so that it moves with your patient’s expression.
Kind regards Mary. Clinical advisor for Dr Tim
@@DrTimPearcehow do we know that we are in the right layer in the deep fat pads? Because i ever had experience occlusion happen using canulla in this area. 😢
Dr Tim how much filler do you need in each site of injection? i saw your temple injection is 1cc each.
Do you ever use anything “thicker” or more viscous in the tear trough area?
What is it you did or she have done to make such beautiful hollows under her cheek bones
I love watching your videos and watching the anatomy and physiology. Please make them more often, I’ve just started (my 59 yr old face) my aesthetics journey.
she do not eat and burn fat from her face. Also this looks awful to me. However I have the same as I workout a lot. I would fill that gap first place if it is possible.
They address that in a different video.
@mightylordkuba you're incredibly rude. I like them
Wondering if the same methods, rules and results apply to lipotransfer procedure... in place of the fillers.
Absolutely
Thank you very much for this video 👏🏻
How can I inject safety at the pyriform aperture. Any pearls? How would you approach it? Thank you!
Hi this video might help - ua-cam.com/video/JOKBvaMcBdI/v-deo.html
I was just wondering why the deep hollows beneath her cheeks were not filled. Is that a natural thing to have them? I am 72 years old. I’ve never been in the sun nor smoked or drank - these are the biggest agers around. I have never had plastic surgery; however, I do get minimal Botox and also filler around the the chin. I have large cheeks due to my Swedish heritage. I am always trying to get my dermatologist to fill my smile lines, but she says no - it looks unnatural not to have the smile lines. I have maintained my weight from young adulthood. I was a model and we are taught proper nutrition (at least we were in my days) and proper skin maintenance. What is the single most important area in my face which you feel would help to keep the youthful look? (P.S. I’m also married to a man who is 15 years younger than I am, so it’s important to me to keep looking younger, but not “plastic”.). Thank you!
Thank you for that question I’m very curious as well so many things to do to take care of your face! E
I think it may make her cheeks look too round and full and diminish the definition of her cheekbones. However, your practitioner should be willing to do what you want (as long as it's safe), as it can always be dissolved if you don't like it.
An obvious oversight would be the lack of Before & After images.
Thank you !!!!!! More please !
Are the cheeks a low risk area?
Excellente présentation je vous prie de présenter vos vidéos avec traduction en français svp j'adore vos travaux mais parfois je craint mal comprendre vos recommandations. Merci pour tout ce que vous faites et bonne continuation.
Do you inject at the bone level?
What about injecting PRP. Is it effective or not.Do youinclude all these videos in foundation course.
Miranda, was there any topical or injectable anesthetic used before canalizing the zygomatic muscle?
I didn't canalize the muscle, but some 4% lidocaine topical cream only.
Are you taking patients how may I reach your office please?
I am a bit freaked out as the needle and syringe looks kind of bent @2:58 😅 Gonna prepare for my own temples to be filled 😅
HI, what is the anotomical injection point for the temple? I cant quite see in the video where you have gone in. Thanks
Looking for any obvious vessels but for most it’s about 1cm from the temple crest.
Kind regards Mary. Clinical advisor for Dr Tim
how is it injected if the patient has blepharospasm ??
Magnificent!!!
Thank you Maria
Hoping you see this comment since it is an old post, but when i palpate that temporal region on myself i feel a steady pulse at the lateral aspect of my finger. Does that mean this is not a safe area to shotgun inject on me?
That's probably and artery, connected with your eye. Definitely get a professional to help
Why did you not use a cannula for tear troughs?
Placing the amount of filler needed to revolumize the face would look puffy and strange. When placed on the periosteum it achieves a more natural look. Think of how breast implants can look over vs under the muscle
Cost of total treatment?
Would you not recommend fat transfer in place of fillers when it comes to face... to avoid the risk every year of the potential of getting an artery or something blocked when repeating procedures. I'm assuming fat transfer generally would have substantially longer duration than fillers.
there are pros and cons to fat- it has some additional risks by virtue of the fact that much higher volumes are used, it sometimes doesn't take and the fat dies, or it grows too much- so though it can give great long lasting results it's less predictable.
Dr , isn't it anterior medial cheek is the one to treat? Do you layer into subcutaneous tissue layer? For lateral lid- cheek, isn't that there is a transverse facial artery right on that area? Also laterally u inject into lateral canthus area?
Yes we did some anterior medial projection for Lynsey using a cannula, small quantities but painted in, layering and moulding is best to really get that sculpted natural look within the hypodermis.
The transverse facial artery lies inferior to the zygoma so deep onto periosteum is safer, I still aspirate for good practice and safety.
Lateral lid cheek there can be branches of the zygomaticofacial artery hence why I aspirate with an unprimed needle to make it more sensitive.
Yes injected at her lateral canthus as I was revolumising some mild volume loss from her lateral sub orbicularis oculi fat pad to make her transitions more smooth for the full face rejuvenation to look it’s best.
Thank you for your question I hope that helps.
@@DrTimPearce tx u Dr. May I know for anterior medial cheek , a standard rheology like Restylane will do? Anterior medial cheek got thick skin so inject it into hypodermis won’t have Tyndall effect. But of there is bulge in superiormedially ( tear trough eyebag ) then if one inject filler there, isn’t that look swollen? Also it will touch onto Danker zone where angular artery become relatively superficial? Tx u.
EXCELLENT!!! Thank you xx
Thank you for watching
@@DrTimPearce I really liked it!
Dr Tim, i am curious about what you would do in such a situation where a patient already has other brand of filler in her face eg Juvederm Voluma and if she requests to have eg Restylane Defyne, would you agree to that? It seems many injectors dont use a variety of brands in their clinic. Would mixing filler be a problem for you, if they are done at different time periods, say months?
Np problem as long as you know what you doing.
filling in the face is playing with FIRE
I like your technical expertise. Wish you were in Houston Tx. I did a deep div in the processes.. I want you he whole face temper led under eye, and lower face: I to use use platelet rich fibrin to build collagen
Hi please does anyone know starfill fillers? Any bad experience please tell me
After he speaks about the possibility of injecting into the brain, he then says, "the other day.....it popped into my head", lol!
Great video! Thank you
Amazing watch.
Thank you 🙏
Pleasure. Thanks for watching.
before and after pics would help
Thank you for the feedback
Hi I have swollen glands after azzelure what can I do
Unlikely due to the procedure - see your GP.
Seria meu sonho participar desse curso.
Why were the deep cheeks left like they were... just wondering
They accentuate the cheekbones. I llove the hollow look. Way better than the chipmunk or flat look.
Excellent
Great video
How do I volunteer, you can practice on me?!
We do have a models page. Let us know if you are UK based and would like to be added to our database.
Kind regards Mary. Clinical advisor for Dr Tim
Why is the left side more painful?
My theory is that one side of our brains is optimised for doing things, and the other for sensing things, but I'm not sure!
Is the syringe 💉 fake or real
Hi that was amazing but could you please tell me the plane of the cannula when you inject the medial part of cheek is it deep on the bone or in superficial fat ?
Hi. Thanks for the question. I just asked Tim. He said it's usually intermediate fat. Cannulas gravitate towards intermediate depths. You can do both but it's harder to get on the bone there. Hope that helps, Miranda
@@mirandapearcemindset thank you Miranda🌹
Pleasure Shimaa 🙏
I would rather have my own natural fat. Can you do this safely with fat?
How much filler does the average hollowed tear triugh take to fill. Thanks.
0.2 to 0.3mls each side- this is for the true tear trough which is medial, and runs to the midpapillary line. Wide variation though, and I would almost always do some treatment at the lateral lid cheek junction and the cheek, making total volume 1-2 mls for an eye refresh.
@@DrTimPearce thank you.
Thanks so much teacher
Is it me or did he go straight in like he mentioned not to do? Lol
Wow prefect doctor thank u
Best video
what would you recommend for her sub malar hollow, would you use canulla? what depth? subdermal ? Thanks
Yes always cannula here. In the hypodermis.
Dr Tim Pearce hypodermics means close to superficial skin?
What do u mean by bogginess?
Puffiness
Amazing
In the tear trough, do you inject voluma on bone then volbella superficially?
Hi Floricious. He only ever uses Volbella in tear troughs. Thanks for your question.
I can feel the pain 😓
Well, it doesn't appear that the patient can. They probably applied topical numbing cream and most fillers have lidocaine in them.
Is he using Dr. Swift's technique for Temple filler? How much did he bolus? It unsafe to bolus 0.5ml at one point or more?
Yes that is the Swift point- 0.5 is common. There's no data on what is safe. I feel comfortable doing 1 ml each side in the right cases.
@B Real Yes, three- two deep temple arteries which tend to be more lateral and much deeper than the point I used, and one more superficial you can often feel- that's why I palpate before injecting. To identify the superficial vessels.
We want to see the final result of this procedure, you cut the most important part which makes me thing there’s no good result. Disappointed!
I would have imagined the patient would have had their eye shadowed removed before the procedudeures.
She isn't wearing any eyeshadow. That is her natural skin tone.
Looks like at the tail of the brow
omg your technic leaves a lot to be desired .
What specifically concerns you about Tim's technique, Norhaina?
I am a doctor and i think it is irresponsible to teach a student how to inject so un safely in order to accommodate the camera.
What is unsafe?
I don't have time for this
@@norhainalidjamansali7183 ..empty kettles make a lot of noise.
this assistant is honestly useless, he told her to hold on a bandage and she removed it
She's not usually an assistant- she's usually the one injecting :-)
سلام ❤️👌
IN MY OPINION SHE ONDE NEED FILLERS ON HER LIPS AND ANYWHERE ELSE BECAUSE, SHE HAS A BEAUTIFUL SQUARE FACE WITH ALMOST NO WRINKLES...
I'm certain that this comment won't be well received, but to be perfectly honest, the camera work is horrible(!) The entire point of the presentation is for educational purposes, right? It's such a pity that in the 21st Century, with all of the advances in technology that have been made and are available, the people responsible for video recording this event failed so miserably. 😞 I believe you to be at the top of your field, as both a practicing Medical Aesthetic Doctor and educator, who's always striving towards excellence. But, this presentation was frustrating to watch. ((The audio portion is very informative & I'm not being sarcastic.)) I'm sorry, Dr. P, I honestly don't mean to appear ungrateful or unappreciative of your efforts, nor do I mean any disrespect. I freely admit that I'm not an expert videographer, but I do know that if I were responsible for recording this event, 'I' would strive to capture the moment in such a way that would best illustrate the techniques you were demonstrating. Sorry to say, that's not at all what was captured here. Even with using zoom, it's impossible to actually *see* the depths, placements and angles used. 😩
Sorry to frustrate you- this was our first time ever for my team to record an event. The primary intent was for the audience not really for youtube.
He said he doesn't like to cause too much trauma to the face, however, from 8:49 through 10:38 and he even states at 8:58, 'I think I am usually gentle', no way! he did so much trauma to her face by doing that. I don't know, but that hole he left on this woman's cheek at 10.41 looks awfully big. I wouldn't like to have that on my face, that's for sure.
I think is overdone.much love.
Italiano????!!!!!
I think in your TT procedure, you went too superficial.
Lynsey is a naturally very slim lady and you can feel when you are sliding along the bone so looks superficial. Bevel of cannula down to ensure product doesn’t move superficially. Lynsey had no issues at review.
Thank you for your comment.
Ahh is this your daughter? She resembles you
I think she has removed her buccal fat that's why she has hollow cheeks.
Thanks for your comment. Lindsay just has volume loss.
She looks like she may be Irish or german... these face shapes are common in people from those backgrounds. I am indigenous American and have high enough natural cheekbones that I get this effect as well. It's very offensive when you thrust your standards of beauty on others. The world would be a very boring place if we all looked the same 😊
It's crazy how Xanaxed she is to make this look tolerable. Tim definitely has the knowledge, but skills and craftsmanship- that's a whole different story
In the uk we do not hand out Xanax like in other countries, she absolutely did not have any benzos