Hyaluronic acid

The face is not a flat surface but a dynamic arrangement of complex anatomical layers: bone structure, deep and superficial fat pads, muscles of expression and skin. Over time, bone resorption and fat loss change the highlights of the face and contribute to tissue laxity.

As a maxillofacial surgeon, Dr Afshin Yousefpour does not see hyaluronic acid as a simple “wrinkle filler” but as a tool for three-dimensional restructuring. Each injection is designed to restore volume and balance, refresh tired features and preserve the authenticity of your expressions.

The protocol, step by step.

1. Step 1

   Personalised facial assessment

   Clinical examination at rest and in motion, analysis of facial proportions, listening to your wishes and drawing up a precise treatment plan.

2. Step 2

   The treatment session

   Disinfection of the areas, marking of anatomical safety points and injection with a micro-cannula or fine needle. The gel may contain lidocaine for comfort. A session usually lasts 30 to 45 minutes.

3. Step 3

   Result and review

   The volumising effect is visible immediately. The result usually settles after 10 to 15 days; a review at the practice is offered for any small touch-ups.

Why entrust your injections to Dr Yousefpour?

• A surgical eye and anatomical command: choosing the right injection plane — on the bone, in the fat compartments or superficially — with particular attention to the facial vessels and nerves. This expertise aims to reduce risk without eliminating it.

• The architecture of the whole face: a “full-face” approach takes the entire profile into account. Restoring support to a cheekbone can, depending on the anatomy, indirectly soften the nasolabial fold.

• Gentle techniques: preferential use of flexible blunt-tipped micro-cannulas to limit bruising and discomfort. The choice between cannula and needle depends on the area; no technique rules out all vascular risk.

• Careful product selection: resorbable, biocompatible hyaluronic acid gels with rheological properties suited to each tissue.

Detailed analysis of the treatment areas

The indication and expected benefits are assessed individually. Injections do not replace surgery when a greater structural correction is needed.

• Temples and tail of the brow: filling the temporal hollow and supporting the orbital rim to soften the upper third of the face and open up the eyes.

• Cheekbones and tear trough: restoring cheek support to reduce a tired look and soften the folds.

• Hollow under-eye circles: smoothing the transition between eyelid and cheek with a suitable gel to soften shadows. Swelling and the Tyndall effect (bluish tint) remain possible side effects.

• Non-surgical rhinoplasty: correcting some asymmetries or dents and harmonising the nasal profile, sometimes in a procedure of about 15 minutes. This area carries specific vascular risks, particularly to the eye, which are explained at consultation.

• Lips and around the mouth: hydration, defining the Cupid’s bow, tailored volume and softening of vertical lip lines (“barcode lines”).

• Jawline, chin and face contour: redefining the jawline and projecting a receding chin to harmonise the profile and contours.

What does a maxillofacial surgeon bring to injections?

Maxillofacial surgery is dedicated to the anatomy of the head and neck. Dr Yousefpour operates on the deep bone, muscle and vascular structures. This knowledge contributes to an accurate assessment of the structural causes of ageing and to planning the injections, without guaranteeing that complications cannot occur.

What is the difference between hyaluronic acid and botulinum toxin (Botox)?

Hyaluronic acid is a volumising filler: it restores contour, fills hollows and hydrates the tissues. Botulinum toxin temporarily reduces the contraction of the muscles responsible for expression lines, particularly on the forehead, between the brows and at the crow’s feet. The two approaches can complement each other in an overall treatment.

Do hyaluronic acid injections hurt?

Discomfort is usually limited but varies with the area and individual sensitivity. Many gels contain lidocaine, a local anaesthetic. Blunt-tipped micro-cannulas can reduce the number of entry points and tissue trauma, without removing the risk of vascular injury.

How long do the results last?

Hyaluronic acid is resorbable and biocompatible. Results last on average 9 to 18 months, sometimes up to 24 months for some deep structural injections, such as in the chin or along the jawline. The duration depends on the area, the product and your metabolism.

What if I am not happy with the result?

In case of over-correction, asymmetry or intolerance, hyaluronidase can be used to dissolve the gel in a targeted way, after medical assessment. It can act quickly, but the correction and the need for further sessions vary; it does not guarantee that every complication is reversible.

What precautions should I take after the session?

You can usually resume normal activities after the appointment, although redness, swelling or bruising may be visible. Do not massage the treated areas vigorously for 48 hours. Avoid intense exercise, sauna, steam room and direct UV exposure for 2 to 3 days, following the practice’s personalised instructions.

Goals and course of treatment

The medical information document describes the hyaluronic acid used as a sterile, biodegradable medical device of non-animal origin. It aims to restore lost volume, redefine contours and fill skin depressions.

The result depends in particular on skin quality, lifestyle and muscle dynamics. It fades gradually over time. Treatment is performed by Dr Afshin Yousefpour, specialist in oral and maxillofacial surgery.

Contraindications and situations to report

Tell the doctor about your full medical history, previous injections and treatments. These situations may contraindicate or postpone the procedure, or call for special precautions after medical assessment.

• Pregnancy or breastfeeding.

• Active autoimmune disease, sarcoidosis or a history of chronic inflammatory reactions.

• Previous injections of permanent, non-resorbable products, such as silicone or polymers.

• Acute skin infection or local inflammation: cold sores, active acne or folliculitis.

• Recent use of anti-inflammatories, aspirin or anticoagulants. Do not stop any prescribed treatment without the agreement of the doctor who manages it.

Adverse events and complications

Even with rigorous attention to facial anatomy, injection carries risks. They are explained at the prior consultation.

• Common and transient: redness, localised swelling and slight tenderness for 24 to 72 hours; bruising at the entry points.

• Rare medium-term effects: asymmetry or palpable irregularity needing review, delayed inflammatory reactions, nodules or granulomas, reactivation of cold sores in people prone to them.

• Exceptional but severe vascular complications: accidental injection into a vessel or vascular compression that can lead to ischaemia and then skin necrosis without prompt treatment.

• Very rare eye complications: migration into the eye’s blood supply that can cause visual disturbance or blindness.

Safety measures and warning signs

The practice’s document states that Dr Yousefpour uses vascular landmarks and suitable techniques, including blunt-tipped cannulas depending on the indication, and keeps emergency equipment on site, including hyaluronidase. These measures reduce the risks without eliminating them.

Unusual sharp or throbbing pain, whitening or mottled paleness of the skin, or sudden visual disturbance require immediate medical care. In case of visual disturbance or suspected vascular complication, call the emergency services without waiting for a reply from the practice on WhatsApp. Also inform Dr Yousefpour as soon as possible.

Precautions before the session

• In the week before: report aspirin, anti-inflammatories (ibuprofen, ketoprofen), anticoagulants and high-dose omega-3, vitamin E or ginkgo biloba supplements. Any change must be decided with the doctor; never stop a prescribed treatment on your own initiative.

• The document mentions Arnica montana 9 CH three days before the session. The preventive effect of homeopathic arnica on bruising and swelling has not been demonstrated; it is not an essential precaution.

• In the 48 hours before: avoid excessive alcohol and intense sun exposure.

• On the day: ideally come without make-up on the areas to be treated. Report any history of cold sores so the doctor can assess whether antiviral prevention is needed.

Recommendations after the session

• For the first six hours: do not touch, rub or massage the injected areas. Keep your head upright and avoid bending forward for long periods.

• For 24 to 48 hours: avoid regular make-up. Using suitable make-up after a few hours should follow the practice’s instructions.

• Avoid intense exercise, cardio and heavy weight training, as well as sauna, steam room, very hot baths or showers and UV; respect the 2 to 3 days given in the general advice.

• Sleep on your back with your head slightly raised if the doctor recommends it, to limit swelling.

• For swelling or bruising: use cold compresses without pressure and without ice touching the skin directly. Ask the practice before applying a soothing cream, for example one containing arnica or vitamin K.

• Follow the hygiene and rest instructions. The warning signs described above require urgent assessment, not simply waiting for a reply to a message.

Information and informed consent

The document records the information given during the prior consultation: indications, limits, expected benefits, alternatives and risks. You must be able to ask all your questions and have enough time to reflect before deciding.

Consent is obtained at the practice after this discussion. This page sets out the medical information and instructions; it is neither a signed form nor consent given online.

Synergies and combined facial treatments

Overall care can combine restoring deep volume with treatments for skin texture and firmness. Indications, order and timing are personalised.

• Fractional microneedling radiofrequency (Morpheus8): collagen remodelling and treatment of laxity. The document generally suggests an interval of 3 to 4 weeks before or after injections; the schedule is confirmed by the doctor.

• Fractional CO2 laser: improving texture, superficial lines around the mouth and complexion, often planned in alternation with volume restoration.

• Botulinum toxin (Botox): relaxing dynamic muscle tension in the upper face, which can be combined in the same session depending on the indication.

• Biostimulators and skin boosters: improved hydration and elasticity, alongside deep volume restructuring, depending on the product chosen.