Hyaluronic Acid Fillers: Layers, Ligaments and Technique
A full physician workshop on hyaluronic acid fillers: what the gel does in the skin, facial layers and ligaments, cannula versus needle, and aftercare.
This is the full recording of a hyaluronic acid filler workshop held on 4 August 2026 at Dr. Sinan Akyürek’s clinic in Istanbul for a group of visiting physicians. The working language is English. The session runs from the theory of why a face ages through to live treatment, and the participants’ questions are left in where they were asked.
The first part covers what hyaluronic acid does in the skin, what cross-linking changes in the behaviour of a gel, and how the layers of the face — skin, fat pads, retaining ligaments and bone — shift over the years. The second part is hands-on: temple, cheekbone and jawline injections, the landmarks used at each point, aspiration and slow delivery, needle versus cannula, and why a small amount placed deep can do more than volume placed at the surface.
It is meant for physicians who already inject and want to follow another practitioner’s reasoning: why one point is chosen over another, where the limits of the technique are, and when a step is deliberately left undone because it does not fit the patient’s life. This is educational content for physicians, not medical advice; no treatment plan can be taken from a recording without an examination.
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What the video covers
- 0:03 Meeting the room: specialties, experience and today's plan
- 5:30 Why the face ages: collagen, bone and gravity
- 10:35 Two gel forms: cross-linking, lift and softness
- 15:52 Needle choice, injection depth and the massage question
- 21:03 Planning the face: which point lifts which area
- 26:43 Temple injection: landmarks, aspiration and slow delivery
- 32:00 Lifting the skin before injecting under the ligament
- 37:09 Cheekbone and jawline: landmarks around the artery
- 42:55 Where to enter, how much, and when to stop
Terms in this workshop
- temporal
- The temple region. In this recording it covers the temporal crest Dr. Sinan palpates as a landmark, the temporal muscle that relaxes when the patient opens her mouth, and the temporal artery he keeps under his finger while injecting.
- jawline
- The outline of the lower jaw, from the chin back to the mandibular angle. In this workshop it is the area supported at the angle and along the mandible to sharpen the lower face.
- masseter
- The chewing muscle at the side of the jaw. Dr. Sinan asks the patient to bite so that the muscle contracts and its front border becomes visible as an injection landmark.
- retaining ligament
- The fibrous bands that hold the skin down to the bone. Dr. Sinan explains that they loosen as collagen is lost, and that lifting the skin and placing a small amount of filler underneath works like a support so the tissue does not drop straight back.
- cross-linking
- The linking of hyaluronic acid chains that slows down how fast the gel is broken down in the skin. In the recording it is described as what improves the durability of the gel and, depending on how it is balanced, whether the gel lifts or stays soft.
- aspiration
- Pulling back on the syringe before injecting to check whether the needle tip is inside a vessel. Dr. Sinan counts to ten while aspirating and points out that the result can be falsely negative, so slow injection still matters.