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[Music] here is a great case of using dermal fillers to fill in a nasolabial fold as well as an oral commissure so let's go ahead patient has been cleaned off very well and now you're going to see some of the av tips and tricks as to how to do this successfully so first of all you must know your anatomy that's first and foremost you must have training in this and you are going to look for the mid dermal plane to place these thermal fillers these are hyaluronic acid dermal fillers and you want to be in the right plane that is so crucial to get number one the best effect but also for safety and you're going to see right before your eyes this fill up and using the ap safe injection perfection protocol here and you can see here's one of the little tips that we've used all the time is keep testing that fold and you're going to see as we fill it up first of all you see exactly where the fold is but as you pinch it you go ahead and fill up that area and we're going to come back again and do a little bit more uh trying to fold it and you'll see the resistance of a dermal filler in that area here and that's what we keep going ahead and doing is testing that area and you can see just with that little bit of hyaluronic acid based filler we are going to start seeing this start to fill up just beautifully safety is key you must know the anatomy you must keep that of that um that needle moving at all times you've got to do some aspiration you've got to go ahead and only give a little bit of filler at one time but here is the big key the big key and here you can see we're testing that fold again it doesn't take much filler oh definitely have the patient go into different motions so you can see how the filler integrates with the tissue and moves around there so one one of the big keys though is to make sure that you are always watching the tissue here watch that tissue to make sure because if you are uh if you would get any kind of vascular compression or vascular occlusion or a vent then that tissue will change color here here we are now doing the oral commissure let's put pick up the corner of that lip to make it nice and straight as you see on the other side and that's exactly what we're doing here and again it doesn't take a lot of filler this is mid-thermal injection we are going to go actually perpendicular as you can see to the oral commissure to the fold that is developing and that is going to turn this frown upside down by adding some filler on the sides of the lips to...