Where are the injection points for biostimulation in the skin?

Biostimulation Injection Points in the Skin

For biostimulation procedures, inject into the intradermal layer using a 30-gauge, 4mm needle at 5mm intervals across the treatment area, creating visible papules with blanching to confirm proper depth placement. 1

Anatomical Target Layer

The intradermal layer (dermis) is the precise target for biostimulation injections, positioned just beneath the epidermis and well above the hypodermis where major blood vessels reside. 1 This superficial placement maximizes safety by avoiding deep vasculature while delivering growth factors and bioactive substances directly to dermal fibroblasts. 1

Specific Injection Technique

Needle Specifications and Approach

• Use 30-gauge needles with 4mm length for optimal intradermal delivery 1
• Insert the needle at a shallow angle with the bevel facing upward to facilitate proper papule formation 1, 2
• Each injection should create a visible wheal or papule 6-10mm in diameter 2
• Blanching during injection confirms intradermal placement and proves you are not in deeper tissue layers 1

Injection Grid Pattern

• Space injections 5mm apart across the treatment area 1
• For microbotulinum techniques, a 1cm grid pattern from forehead to cheek and jawline has demonstrated significant improvements in skin texture and pore size 3
• Inject 0.05-0.1 mL per injection site when using biostimulation solutions 4

Facial Zone-Specific Recommendations

Standard Facial Areas

• Target problem areas include: crow's feet, glabellar lines, nasolabial folds, perioral wrinkles, and overall facial rejuvenation zones 1
• Inject problem areas before microneedling when autologous platelet concentrates (APCs) are in their most liquid form 1

Periorbital Region (Under-Eye Area)

• Use even smaller gauge needles (30G) and reduce depth to 0.25mm when treating the delicate under-eye skin 1, 5
• Consider using a 22G × 2 inches (~5cm) cannula for enhanced safety around the eyes when using albumin-PRF formulations 1
• Warn patients about potential bruising and swelling, which are common in this area 1, 5

Lip Rejuvenation

• Microinjections of 0.15 mL point-by-point into lips using the same intradermal technique 1
• Focus on the vermillion border and body of the lips for color improvement and fine line reduction 1

Critical Safety Considerations

Avoiding Vascular Complications

• Formation of a papule with blanching is mandatory to confirm you are NOT in the hypodermis where major vessels like the transverse facial artery reside 1, 2
• The intradermal technique avoids placing product into deep underlying vasculature, which lies well below the dermis in the hypodermis 1
• Never inject deeper than 2.5mm to maintain the safety profile of intradermal delivery 1

Areas to Avoid

• Do not inject over tattoos or permanent makeup 1
• Avoid injection closer than 1cm above the central eyebrow to prevent complications 6
• Lateral corrugator injections should be placed at least 1cm above the bony supraorbital ridge 6

Treatment Protocol

Session Frequency

• Treatments should be spaced at least one month apart for three to four initial sessions 1
• Maintenance can be performed every 6 to 12 months thereafter 1
• For periorbital PRF specifically, minimum 21-day intervals between treatments with maintenance every 6 months 5

Pre-Treatment Preparation

• Apply compounded topical anesthesia (pharmacy-based, not over-the-counter) for at least 30 minutes prior to the procedure 1
• Ensure anesthesia is completely removed before beginning injections 1
• Keep skin well lubricated with APCs during the procedure to avoid dry tugging sensation 1

Post-Treatment Instructions

• Advise patients to avoid sunlight and heavily scented facial products for 24 hours post-procedure 1
• Typical healing time is 24-48 hours when compared to other modalities 1

Common Pitfalls to Avoid

• Injecting too deeply risks vascular complications and reduces efficacy by missing the target dermal fibroblasts 1, 2
• Failing to create visible papules suggests incorrect depth placement 1
• Using PRF beyond 20-40 minutes after preparation as it will clot in the syringe 1
• Inadequate spacing between injection points may result in uneven treatment coverage 1