Top 14 filler treatment techniques

Dermal filler can be placed using different injection patterns, depths and delivery methods. Techniques such as linear threading, fanning, cross-hatching and blanching describe ways a practitioner can position filler within tissue, while terms such as MD Codes or BAP refer to broader treatment approaches or specific protocols.

There is no single filler injection technique that is automatically best for every person or treatment area. The choice depends on factors such as your anatomy, the area being treated, the product being used, the intended change and the practitioner's assessment.

If you are still researching the treatment itself, read the main guide to dermal fillers.

How do dermal filler injection techniques differ?

The difference is not simply where the needle enters the skin. A practitioner may vary several parts of treatment.

These include:

• the pattern in which filler is placed;

• how superficially or deeply it is placed;

• whether a needle, cannula or combination is used;

• the quantity placed at individual points;

• the properties of the filler product;

• the anatomy being treated;

• and the intended treatment goal.

Two practitioners treating the same facial area may therefore use different techniques or combine several techniques.

A technique should not be considered separately from anatomy and product selection. A particular injection pattern does not guarantee a particular cosmetic result and does not remove the possibility of side effects or complications.

Common dermal filler injection techniques

The following terms describe some of the main ways filler may be deposited. They are technical descriptions rather than promises about the final result.

1. Blanching

Blanching is a very superficial injection technique in which small amounts of filler are placed close to the surface of the skin. It may be considered for selected fine superficial lines rather than for creating substantial structural volume.

Because the product is placed superficially, precise depth and product selection matter. Temporary redness, swelling or bruising can occur after injections. If hyaluronic acid filler is positioned too superficially, product visibility or a blue-grey discolouration known as the Tyndall effect can also occur.

Main distinction: very superficial, small-volume placement.

2. Linear threading

With linear threading, filler is deposited along a line as the needle or cannula moves through or out of the tissue. This allows product to be distributed along a defined path rather than concentrated at one point.

A practitioner may use linear threading when treating a line, fold or contour, although whether it is appropriate depends on the anatomical reason for the concern being treated.

Main distinction: filler is distributed along a single linear path.

3. Fanning

Fanning uses several linear passes that spread out from an entry area, creating a fan-like pattern. This enables filler to be distributed across a broader treatment area without each line necessarily requiring a completely separate entry point.

Fanning describes the distribution pattern. It does not by itself determine the depth, amount of filler or final result.

Main distinction: several lines radiate across an area in a fan pattern.

4. Cross-hatching

Cross-hatching uses intersecting lines of filler placement. One set of lines is crossed by another, producing a grid-like distribution across the treatment area.

It may be considered when a practitioner wants to distribute product across a broader region rather than along one isolated line.

Main distinction: intersecting linear placements form a grid pattern.

5. Microdroplet placement

Microdroplet techniques involve placing very small amounts of product at multiple individual points rather than depositing a larger amount in one location.

The term describes the small-volume, point-by-point nature of placement. The product, depth and spacing can vary according to the treatment being performed.

Main distinction: multiple small deposits rather than one larger deposit.

6. Depot or bolus placement

A depot or bolus technique places a more concentrated amount of product at a selected anatomical point rather than spreading it along a long line.

The planned depth and amount depend on the treatment area, product and anatomical assessment. This is therefore not simply the opposite of linear threading; each method has different potential applications.

Main distinction: a defined amount is concentrated at a particular point.

Is a needle or cannula an injection technique?

Not exactly. A needle and a cannula are delivery tools.

A needle has a sharp tip, while a cannula used for filler treatment is generally a blunt-ended flexible instrument introduced through an entry point. A practitioner may perform some injection patterns with either tool depending on the area and treatment plan.

The choice of needle or cannula does not make treatment risk-free. Technique, anatomical knowledge, injection depth, product choice and treatment planning all remain important.

Named filler techniques and treatment approaches

Not every name used in aesthetic medicine describes a basic injection pattern. Some refer to a specific treatment philosophy, facial planning system, product protocol or technique developed by an individual practitioner.

Understanding that distinction can make treatment terminology less confusing.

Fern Pattern Technique

The Fern Pattern Technique is a named hyaluronic acid injection approach associated with Dr Tom van Eijk. Filler is placed using a branching pattern resembling the structure of a fern.

It should be understood as a specific named approach rather than a general term for all superficial filler injections.

MD Codes

MD Codes, developed by Dr Mauricio de Maio, are a structured system for assessing and planning facial filler treatment. The methodology divides facial areas into defined anatomical treatment units and considers factors including the target area, intended effect and method of product placement.

MD Codes are therefore broader than a single injection pattern.

They should also not be described as simply "seven fixed injection points". A 7-point treatment approach may use selected facial points, but this is not the complete definition of MD Codes.

Tipping Point Approach

The Tipping Point Approach is a named facial treatment-planning concept associated with Dr Helga van den Elzen. It centres treatment planning around selected points that may influence facial support or balance.

It is better understood as an assessment and treatment approach than as a universal filler-deposition technique such as fanning or linear threading.

BAP technique

BAP stands for Bio Aesthetic Points. The term is commonly associated with the facial injection protocol used for Profhilo, involving defined injection points on each side of the face.

BAP should not be presented as another generic volumising dermal filler technique. Profhilo has a different treatment purpose from conventional facial volume replacement.

Hyperdilute Radiesse

Hyperdilute Radiesse refers to a particular preparation and application of calcium hydroxylapatite rather than a general filler injection pattern.

It is therefore more accurate to regard it as a product-specific treatment protocol rather than placing it in the same category as fanning or cross-hatching.

More about filler technique terminology

Which dermal filler injection technique is best?

There is no single dermal filler injection technique that is best for every treatment. Fanning, linear threading, cross-hatching, superficial placement and point-based techniques are tools that can be used differently depending on the anatomy, product and treatment objective.

A named technique should therefore not be the only reason to choose a practitioner.

During a consultation, useful questions include:

• Why is this technique being considered for this area?

• What filler product is being proposed?

• What change is realistically expected?

• What are the main limitations?

• What side effects and complications should you understand?

• What follow-up is available if you have concerns?

A practitioner can assess whether filler treatment and the proposed technique may be appropriate for your individual circumstances. Choosing not to proceed remains an option.

Does practitioner experience with the technique matter?

Relevant experience matters because filler treatment involves more than following a named injection pattern. The practitioner needs to assess anatomy, select an appropriate product and placement approach, recognise when treatment should not proceed and manage concerns after treatment.

Rather than looking only for someone who advertises a particular branded technique, compare the information available about their professional background, experience with the treatment area, consultation process and aftercare.

Compare clinics for dermal filler treatment

The injection technique is one part of a wider treatment decision. When comparing clinics, consider the practitioner, consultation process, proposed filler product, treatment plan, aftercare and how clearly possible limitations and risks are explained.

Compare available clinic information before deciding whether you want to request a consultation.

Frequently asked questions about dermal filler injection techniques