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JULIA APAC Webinar 2026 Ep 02 Recording 260526
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JULIA APAC Webinar 2026 Ep 02 Recording 260526

Introduction to the Webinar

Welcome and Overview

  • The webinar begins with a welcome message from Teda, the moderator, inviting participants to introduce themselves.
  • The topic of discussion is "Mastering Full-Phase Restoration with the Biointeractive PD-LLA-HA Stimulator."
  • Key areas of focus include mechanism of action, clinical considerations, treatment approaches, and real-world experiences related to full-phase restoration.

Introduction of Dr. Xiangli Lin

Speaker Background

  • Dr. Xiangli Lin is introduced as a board-certified dermatologist and medical director at Xiangli Aesthetics Derm Clinic.
  • He serves as an injection trainer for the Chinese Society of Cosmetic Surgery and Anti-Aging Medicine.
  • Dr. Lin has extensive experience in regenerative aesthetics and facial rejuvenation across the Asia-Pacific region.

Presentation Begins

Product Introduction

  • Dr. Lin shares his screen to begin discussing Juviluk and Juviluk volume products used for collagen stimulation.
  • Juviluk contains HA as a gel carrier providing immediate effects and hydration; particle sizes are 25 micrometers for Juviluk and 40 micrometers for Juviluk volume.

Treatment Applications

Indications for Use

  • Juviluk is primarily used as a skin booster targeting mid dermis to improve skin elasticity, pore reduction, and quality.
  • Juviluk volume acts as a bio-stimulator placed in deeper layers for volumizing through collagen stimulation.

Particle Characteristics

Importance of Particle Size

  • Differences in particle size affect their application; smoother particles provide gentler stimulation with less inflammation during phagocytosis.
  • Spherical particles enhance controlled degradation without fragmentation, crucial for sustained collagen stimulation.

Mechanism of Action

Collagen Stimulation Process

  • After implantation, HA not only acts as a carrier but also initiates immune responses leading to collagen synthesis over time.
  • Neocollagenesis occurs within weeks post-treatment; early type 1 collagen appears by four weeks while mature fibers develop by six months.

Adipogenesis Promotion

Role in Fat Restoration

  • Upon contact with microfascial tissue after implantation into subcutaneous fat, it activates signaling pathways promoting adipocyte stem cell activation leading to adipogenesis.

This structured markdown file provides an organized overview of key points discussed during the webinar on mastering full-phase restoration techniques using specific aesthetic products. Each section highlights critical insights linked directly to timestamps for easy reference.

Overview of ACC Dilution and Injection Techniques

ACC Dilution Recommendations

  • The protocol from VAM recommends the use of ACC dilution for injections.

Cannula Specifications and Injection Areas

  • A 23-gauge, 5 cm cannula is suggested for subcutaneous injections, which involve different fat layers with distinct functions.
  • For facial areas like the malar region, entry points can be made at the zygoma or lateral area to perform fanning techniques effectively.
  • Forehead augmentation also utilizes a 23-gauge cannula; ideal injection depth is subcutaneous, specifically in deep fat below muscle for safety.

Facial Assessment Before Injection

  • Prior to any injection, a thorough facial assessment is crucial to determine volume placement based on individual needs.
  • Superficial placements enhance superficial fat thickness while deeper placements provide support and lifting effects.

Importance of Layer Knowledge in Injections

Understanding Aging Insights

  • Recognizing which layer is being injected is vital as aging affects individuals differently; reassessment before treatment is essential.

Recommended Injection Sequence

  • The most efficient injection sequence starts from the upper face, moving to mid-face and lower face while considering lateral-to-middle transitions for optimal results.

Timing and Ethnic Considerations in Treatments

Volume Injection Guidelines

  • It’s important to know how much product to inject at each point since it directly influences outcomes.
  • Different ethnicities may require varied approaches; for instance, Asians often need more volume in central facial areas due to flatter features.

Aging Process and Volume Loss Patterns

Structural Changes Over Time

  • Bone resorption begins in the mid-twenties leading to volume loss in bony structures and defect compartments.

Fat Pad Aging Trends

  • Volume loss typically starts from the malar area around mid-twenties, progressing through various facial compartments independently.

Comprehensive Approach to Facial Structure Aging

Multi-layer Consideration During Treatment

  • All layers of facial structures age simultaneously; thus treatments should consider bony support alongside muscle and fat changes.

Deep Fat Role in Projection Restoration

  • Deep fat injections are critical for restoring facial projection and achieving a slimmer appearance.

Specific Areas of Concern During Facial Assessment

Identifying Key Areas for Correction

  • Temporal hollows require attention on bone resorption over orbital areas along with temporalis muscle atrophy considerations.

Symptoms Related to Jowling and Nasolabial Folds

  • Jowling indicates muscle atrophy while nasolabial folds suggest maxillary projection loss; both require targeted interventions during treatment planning.

Strategies for Effective Product Placement

Superficial vs. Defect Pad Injections

  • Caution against over-injecting superficial fat layers as this can lead to an undesirable heavy appearance; focus should be on defect pads below SMAS that significantly impact projection.

Collagen Stimulation Techniques

  • Super paleostil injections aim to create collagen-like implants by mimicking desired shapes during product placement.

Techniques for Facial Volume Restoration

Injection Strategies for Temporal Area

  • The interfacial plane in the temporal area allows for medial entrance points, facilitating effective treatment and brow lifting by injecting into the roof.
  • Using a sharp needle to contact the bone targets preperosteal fat, ideal for restoring volume and achieving broad projection effects in aging skin.

Layered Approach to Product Placement

  • Three main layers are identified for product placement: Layer 2 (subcutaneous), Layer 4 (interfacial plane), and Layer 9 (anterior superior temporal area).
  • Efficient lifting effects can be achieved by placing products in areas with thinner muscle, such as the anterior superior temporal region.

Observations Post-Treatment

  • After treatment, improved facial proportions lead to a more oval shape and smoother contours; three months post-treatment shows significant skin quality improvement.
  • Treatment on bone and interfacial planes results in lifted brows and enhanced overall facial shape without direct jawline intervention.

Addressing Mid-Face Volume Loss

  • Key fat pads in the mid-face include lateral soothe, medial soothe, deep lateral, and medial cheek fat; short needles ensure precise placement into deep fat.
  • Correctly placed volume increases anterior projection while providing lifting effects below the ligament line.

Myomodulation Effects of Deep Fat Placement

  • Placing volume behind muscles supports them without direct injection, leading to myomodulation effects that enhance facial aesthetics.
  • Supporting muscles with volume can change their position over time, contributing to lifting effects through collagen stimulation.

Safe Volume Placement Techniques

  • The deep here from space is crucial for altering perioral proportions safely below the angular artery; this technique can also lift mouth corners.
  • Case studies show improved lower face heaviness and anterior projections after targeted volume placements around mouth corners.

Enhancing Lower Face Aesthetics

  • Injecting into deep central fat improves chin projection; strategic placements above mentellus muscle lengthen the chin effectively.

Considerations for Collagen Stimulators vs. HA

  • Unlike HA which requires concentrated placement in smaller areas, collagen stimulators should be spread evenly across larger surface areas for optimal results.

Guidelines on Injection Volumes

  • Different layers require specific volumes: superoperable austral plane needs about 0.2–0.3 cc/cm² while subcutaneous lines need approximately 0.1–0.2 cc/cm².

Soft Tissue Correction Techniques

Overview of Volume Restoration

  • The procedure involves correcting soft tissue, including deep and superficial fat, using three vials per session over three sessions for a total of nine vials.
  • Each case requires consideration of the deep fascia, bony structure, and fat layers to determine the volume needed for effective treatment. Up to four vials may be necessary depending on the areas treated.

Injection Techniques and Materials

  • For skin quality improvement, Juviluk is used; for addressing superficial and deep fat loss, Juviluk volume is preferred. The injection technique varies based on individual assessments.
  • A facial assessment is crucial before starting injections; identifying areas like temporal hollows helps in planning the treatment effectively.

Facial Proportions and Masseter Management

Assessing Facial Structure

  • The patient has a square face with a strong masseter; proper volume restoration can alter facial proportions and make the masseter less prominent through targeted injections.

Injection Points Identification

  • Marking the temporal crest is essential as efficient injection points are located laterally to it; observing deeper areas when the patient opens their mouth indicates more significant volume loss that needs correction.

Layered Injection Approach

Temporal Area Treatment

  • Injections in the temporal area should target both bone and interfacial planes to correct volume loss effectively across different layers. Proper marking of injection sites ensures accuracy during treatment.

Mid-Face Volume Considerations

  • Utilizing medial and lateral soup injections can enhance mid-face proportions while providing lifting effects that are aesthetically pleasing, especially for Asian populations who may have specific structural characteristics.

Addressing Nasal Base Support

Enhancing Mid-Facial Projection

  • Volumizing around nasal bases can improve mid-facial projection by supporting retracted maxilla structures common in Asian patients, which also aids in reducing tear trough appearance. This approach emphasizes strategic volumization rather than excessive filling techniques.

Lower Face Volume Restoration

Labial Mandibular Fat Role

  • Superficial fat in the labial mandibular region supports oral commissure aesthetics; injecting here can correct defects while improving overall facial proportions significantly. Marking differences between sides helps identify where additional support is needed during treatment sessions.

Injection Technique Details

Ensuring Safe Injection Practices

  • When injecting, it's critical to hit bone first and aspirate to avoid intravascular complications; administering 0.2 to 0.3 ml until full correction is achieved ensures effective results without overfilling any area unnecessarily.

Cannula Use for Layered Treatments

  • Transitioning from needle to cannula allows access to deeper layers (Layer 4), facilitating broader coverage while maintaining safety through careful handling of soft tissues during movement within anatomical planes.

Final Adjustments and Observations

Achieving Desired Contours

  • After multiple layer placements, noticeable slimming effects occur along with improved definition of lower facial features; this demonstrates how precise product placement enhances aesthetic outcomes significantly compared to untreated sides.

Efficient Product Utilization

  • Starting treatments from specific areas maximizes product efficiency; utilizing needles or cannulas appropriately at each injection point ensures optimal results while minimizing risks associated with improper technique.

Techniques for Facial Volume Restoration

Injection Techniques and Anatomical Considerations

  • The procedure begins with a 0.2 ml intravascular injection, followed by medial movement to place the second point, targeting soft tissue in the mid-face and corner of the mouth.
  • Attention is drawn to the infraorbital artery's location along a vertical line from the pupil's medial limbus, emphasizing safety during deep lateral cheek fat treatment.
  • The angular artery branches off laterally; proper technique involves pulling laterally to avoid it while injecting into deeper layers near bone.
  • Two to three points can be placed around the nasal ala for subtle lip shape changes, enhancing projection and averting the vermilion border.
  • Starting every line with aspiration is crucial; using a cannula can enhance precision in lifting techniques.

Treatment Areas and Results

  • Multiple boluses below the zygomatic minor are effective for treating deep lateral cheek fat, leading to noticeable lifting at the corner of the mouth.
  • Transition smoothing at the litter junction is performed while also addressing preauricular areas for enhanced jawline definition and chin shape improvement.
  • Subcutaneous injections help correct nasolabial lines and smooth out tear trough areas, indicating successful layering technique application.
  • Post-treatment observations reveal significant facial slimming on one side compared to before treatment, showcasing effective volume restoration techniques.

Long-term Outcomes and Key Messages

  • Two months post-injection shows improved facial proportions; six-month results indicate lasting effects without additional treatments in certain areas like temples.
  • Acknowledgment that improvements continue over time despite being just one session; further enhancements may still be possible with additional sessions.

Understanding Adipose Tissue Growth in Facial Treatments

Mechanisms of Fat Cell Changes

  • Emphasis on four-phase restoration not only adds volume but requires understanding anatomy, product features, injection planning, sequence, amount, and technique for natural results.

Q&A Session Insights

Adipogenesis Discussion

  • Participants inquire about volumizing effects related to adipose tissue growth—specifically whether it's due to hypertrophy (cell size increase) or hyperplasia (cell number increase).

Dr. Lin’s Explanation

  • Dr. Lin clarifies that adipogenesis primarily reflects animal models; human tissue responses may vary but involve improving fat turnover rates through old adipocyte removal and new cell creation.

Dosage Determination

  • Importance of assessing surface area when determining appropriate volumes for treatment areas like forehead and cheeks; adjustments based on patient condition are necessary.

Maximum Vials Recommendation

  • Dr. Lin suggests that typically four vials may suffice for severe volume loss cases but emphasizes individual assessment based on surface area coverage needed during treatment sessions.

Understanding GVALUV and Juvalook Treatments

Starting Dosage for Beginners

  • Dr. Lin recommends starting with two vials of GVALUV for beginners to ensure safety and observe patient responses before increasing the dosage in subsequent sessions.

Effects of Juvalook Volume

  • When injected into the subcutaneous layer, Juvalook may produce similar adipogenic effects as GVALUK volume, but differences exist based on particle size.
  • Both Juvalook and Juvalook volume stimulate collagen and elastin production; however, Juvalook has a smaller particle size leading to earlier degradation.

Collagen Stimulation Duration

  • The main difference between the two products is that Juvalook degrades faster than Juvalook volume, resulting in weaker collagen stimulation over time.

Weight Loss Medications Impact on Treatment

Contraindications with Weight Loss Medications

  • No documented contraindications or reduced efficacy concerns have been reported when using Juvalook volume alongside weight loss medications like Wigofi or Monjaro.
  • Significant fat loss or poor skin quality may necessitate more product to restore skin elasticity effectively.

Injection Techniques and Areas of Focus

Injection Location for Cheek Junction

  • Dr. Lin explains how to accurately locate injection points over the lead-cheek junction to mask sagging in the lower face.

Importance of Structural Support

  • Proper support from deeper structural layers is crucial before applying superficial volumization; this helps avoid exacerbating drooping by adding weight superficially.

Choosing Between Juvalook Products

Deep Scars Treatment Options

  • For deep scars associated with fat atrophy, such as severe rolling acne scars, Dr. Lin prefers using Juvalook volume; for deep boxcar scars, standard Juvalook suffices.

Combining Treatments for Optimal Results

  • Effective treatment often requires combining different methods (e.g., subsistence techniques), rather than relying solely on one product.

Dilution and Efficacy Concerns

Impact of Dilution on Duration

  • Diluting juvel volume does not significantly affect its duration or efficacy; results typically last around two years due to ongoing aging processes affecting collagen levels.

Post-Injection Care Practices

Facial Massage After Injection

  • Post-injection facial massage is not recommended as it can lead to uneven distribution and potential nodule formation if not done carefully.

Nodule Formation Risks

  • Nodules are primarily caused by technical errors rather than just over-volumization; ensuring even distribution during injections minimizes risks.

Combining Treatments: Mesobotox and Juvallok

Mixing Products Considerations

  • Dr. Lin advises against mixing mesobotox with Juvallok due to complications in tracking effects from each product separately.

Using Both Products Together

  • In cases where both deeper volumetric issues and skin quality problems exist, utilizing both products in a single session can be beneficial for comprehensive treatment outcomes.

Conclusion of Webinar Session

Closing Remarks

  • The webinar concludes with gratitude expressed towards participants and an invitation to submit feedback through a survey for future improvements.