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Natural and Lasting Beauty: Bone Touching Filler Injection

For over years now, the technique in using blunt tipped needle for filler injection was introduced into Thailand by Dr. Puttipong. At that time no doctor in Thailand mentioned this technique. Dr. Puttipong explained that for filler injection to be effective in providing the beautiful facial lift desired by patients, it is necessary to target the deep layer right on top of the bone. However, injecting filler deep into the skin is risky because a blood vessel might be hit in the process. This is why Dr. Puttipong pioneered the use of blunt tipped needles for his procedures. Today Dr. Puttipong has pioneered many more innovative procedures using both blunt tipped and sharp tipped needles for facial contouring that he calls Transforming Face Lift. The doctor has published his techniques in 2013. He later found that another team of doctors from the University of Tokyo, Japan worked on a similar procedure that targeted the treatment for those needling facial treatment as a result of accident trauma or deformities.

University of Tokyo Research

Dr. Kotaro Yoshimura and his team at the University of Tokyo studied the treatment in 63 patients. In this group 51 received the treatment for beauty purposes while 12 received the treatment for facial deformities. The team observed the patients over a period of 12 – 93 months. The doctors injected Hyaluronic Acid (HA) onto the area touching the bone. The results were observed through MRI x-rays of the treated area. Normally the Hyaluronic Acid (HA) fillers injected into the skin or fatty layer would dissolve in 10 -12 months. However, it was found that the fillers stayed on to an average of 21.6 months. It was found that 86.6% of the spots where the filler was injected retained more than 50% of the volume. In 49.5% of the cases it was found that 75% of the volume remained. Consequently the doctors reasoned that this was the result of regeneration of the new skin layer and some bone mass.



Rationale and Procedure

There are two methods in implementing the bone touching injection technique.

1. Injecting the filler under the membrane on the bone. This will stimulate the regeneration of bone mass under the membrane.

2. Injecting the filler on top of the membrane on the bone. The Hyaluronic Acid (HA) molecules will stimulate the periosteal stem cells resulting in tissue regeneration. Also it would stimulate the accumulation of calcium in the area.



These two methods of treatment in injecting Hyaluronic Acid (HA) fillers result in Semi-permanent effects even when using Non-permanent HA substances.

In the past HA injection procedures were not popular in increasing skin volume because the effects usually did not last up to a year. This is because HA dissolved quickly. Injecting fat into the skin or in severe cases, Bone Graft procedures were used. Bone graft involves cutting bone from other areas in the body and inserting it into the face. These two techniques were usually very painful requiring long recovery time.

The findings of the research led to the conclusion that injecting Hyaluronic Acid (HA) fillers directly on to the bone may result in longer lasting treatment effects. This treatment is more convenient than injecting fat or bone graft techniques. This is because the treatment can be done more easily requiring less recovery time for patients and the results can last for quite a substantial period of time.




Filler Injection for Facial Contouring

As discussed previously, the injection of Hyaluronic Acid (HA) fillers on the Periosteum membrane covering the bone on target points on the face would result in visible facial contouring and lift. The target points on the face include:

1. Eyebrow, forehead, and eyebrow ridge –especially at the end of the eyebrow near the temples

2. Along the bone around the eyes and cheek bones

3. Along the lower jaw and chin

4. Along the upper jaw above the incisors and front teeth



This procedure is effective in cases where the anomaly to be corrected is not severe. The result would be a naturally beautiful appearance that is quite enduring. This is different from the V-shape and Facial Design treatments advertised by many medical institutions. Those treatments inject botox to the jaw area to make it appear smaller, to lift the cheek, or reduce the excess fat. This will result in a slimmer face but it is only reducing the cheek or jaw area. These areas are only soft tissue thus it is not a real facial contouring procedure. No areas of the bone are targeted thus the results would not be enduring and the appearance would be unnatural. The face may seem smaller but in some cases the face may lose its proportion. Sometimes the appearance of youth may not even be seen. In extreme cases the appearance may even be strange. There have been reports that the cheeks may still sag after the injection to reduce the jaw or chin area.


The innovative technique of injecting Hyaluronic Acid (HA) fillers on to the bone membrane has quite an enduring effect. The procedure may utilize both blunt tipped and regular sharp tipped needles. This technique can be used to treat patients with facial deformities from accidents and for beauty aesthetics purposes. The procedure would help in facial contouring resulting in a beautiful and lifted youthful appearance. It is a suitable alternative to surgery in less severe cases. The results are more natural and the patient hardly needs recovery time. The patient can always return for additional treatment for the desired effect. The limitation of this procedure lies in the fact that it is necessary to consult highly skilled expert doctors only. This is because the procedure requires injecting the filler deep under the skin. As a result there is a chance of hitting a blood vessel. Therefore, it is necessary that the procedure be done by an expert doctor who can use both blunt tipped and sharp tipped needles.