Dr. Shervin Naderi demonstrates a non-surgical brow lift using filler placement, bone contact confirmation, and retrograde injection. Neuromodulators alone can't reverse existing lines; combining Botox with strategic volume restoration and blending across the forehead creates a smooth result. Safety requires blunt cannulas, vascular awareness, and a holistic approach tailored to each patient's anatomy.
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Okay. Hey everybody, we're gonna talk about one of my favorite topics, which is how do we rejuvenate the upper face? The upper face is a combination of a lot of things. It's the descent of the brows that gets heavy, it's the excess of the upper eyelids that gets heavy, and then muscles fall in, we lose volume, we lose bone, and then you create these lines. Now, people that have started Botox from a young age will likely not develop these deep furrows, but if you've not been doing consistent Botox, Then these furrows develop. If we did Botox, we're actually going to prevent the movement of the corrugator, which creates those lines, but the lines that have already formed are not going to go away. They're going to be there. So we need to do something more. Just Botox by itself is not going to treat this. So an endo-style brow lift will put things in a better position. Fat injections to replace lost volume is important. Those are all important things, but we can deal with fillers as well to a certain extent. A lot of people are afraid of putting fillers in this area, justly so. It's justified. Please don't go if you're a new injector. Please don't go doing that because risk of vascular occlusion in here is much higher. You have to have proper technique, and I'm going to show that technique. So we're going to go back. I'm going to lay you back. Chair is going to go back like this. Now we're going to do some neuromodulators, and on her I'm going to use Daxify. We're going to use Daxify. She's out of town. I want something that lasts a little bit longer and kicks in a little bit sooner. So we're going to use Daxi, Daxify, but Botox and Dysport are fantastic as well. We offer all three. Each one's a little bit different, but they're more similar than they're different. When I'm putting in the filler, I'm going to do that first because I don't want the Botox, Dysport, Daxify, whatever to create any swelling. So we're going to do that first, and then we'll do the neuromodulator. Everybody's out there calling it tox. I'm gonna call it neuromodulator. Now, she's already been prepped, but we're gonna double prep, making sure— when I do fillers, I want the area perfectly spick and span. I don't want any makeup, lotion, sunscreen, anything in that area. Now, what's the proper technique? Why are people scared? Everybody's trying to thread fillers. Thread fillers. You're gonna thread it right into the vasculature, so that's the wrong technique. If you look at the blood vessels, the way they come up, the safe way is to go perpendicular to them. If you go this way, you're gonna go right into the blood vessel, potentially incannulate it, even if you use a blunt cannula. If you go this way, that's not going to happen. And I'm going down. You ready? Mm-hmm. I'm gonna go down to the bone. I'm on the bone. I feel the bone. Now I'm filling and pulling back. So the filling is— if you come closer, you'll see a little better. The needle goes into the skin, touches bone, confirms bone, and then I lift up all the way to the skin surface, and it fills it in immediately. Now, in addition to this volumization, the thing that's going to help also is some type of resurfacing. So if we did a little microneedling, lasers, something else to improve the skin quality, that matters as well. Again, the right technique down to the bone. Feels the bone, comes up. I'm injecting only on my way out, which is called retrograde. I'm not injecting anterograde. It's retrograde injections. This is very important. I have made a lot of videos, taught a lot of injectors and doctors out there talking about the benefits of anterograde injection, because what happens with anterograde injection, sometimes you push little blood vessels out of the way. In this situation, must be retrograde. You want to confirm you're on top of the bone. There is no blood vessels. I do brow lifts all the time. There is no blood vessel that is sitting on top of the bone in that area. Why? Because we see it. So when you go there and you confirm that you're in a safe place, and I know I'm on top of the bone— sometimes you may have to change your needle halfway through because the needle dulls out from hitting the bone so much— lifts up, and already it's getting brighter. Now sometimes you can actually Follow it through. So she has a brow ridge, and she's actually weaker here. So I can continue the injections and do again. These are the same type of injections; they're on top of the bone. See how she's frowning? We're going to take care of that with Adaxi. So the injections can smooth out the area. So she has a very strong brow ridge, a glabella. And by blending it into the forehead, we don't want to create a fat forehead, but we want to soften the glabella. Get on top of the bone, little minor tiny pokes, smooth it out. And look, look at this area, much more smooth transmission from glabella to forehead. That dent is gone. And you can chase these little things as much as the patient allows you as far as comfort. So Just simple, immediate. There's no Botox yet, the Daxxi hasn't kicked in, we haven't even done the Daxxi yet, but it's better already. So that is the technique, and you'll see a beautiful result right there. Sometimes you have to do the radix of the nose as well to basically blend it, so it's almost like getting a little non-surgical rhinoplasty. But look at how things bunch up here. This is all corrected by doing an endo brow lift. When we get older, things bunch up, things get thick here. The root of the nose looks better. If she came in for rhinoplasty, this area thickness yet doesn't get improved with the rhinoplasty. That thickness actually gets improved with an endo style brow lift by reducing this stuff that has descended here. You actually create slimness to the nose. So these are all interrelated things, and when you go To an expert, somebody who can do everything will tell you about everything, all the options. So it's a complete package when you can offer everything. If you have just a hammer in your toolbox, you're going to want every single thing that walks into your office to be a nail, but there aren't. Sometimes screws walk in. You have to have a screwdriver. All right, so hold a little pressure for me there, Yasi. Looks really good. A little pressure right there. Now we're going to go to Daxify.
