Hyaluronic acid fillers are the treatment with the most serious complications in facial aesthetic medicine, and almost all of these are vascular in nature. That is why a hyaluronic acid course for doctors is judged by one thing above all else: how much time it devotes to vascular anatomy, the prevention of occlusion and the hyaluronidase protocol. Everything else – cannula or needle technique, injection planes and rheological properties – comes second. This guide explains how to evaluate a programme and in what order to undertake your training.
First of all: vascular anatomy and risk areas
The facial artery and its branches: the angular, supratrochlear and supraorbital arteries, the dorsal nasal artery and the superficial temporal artery. A proper course teaches their usual course, their variants and the depth at which they run in each area, and relates this to the areas of greatest risk: the glabella, nose, nasolabial fold, temporal region and lip. You should come away from the course able to explain why an injection into the dorsal nasal region can result in occlusion of the ophthalmic artery.
Prevention and management of vascular occlusion
Aspiration and its limitations, slow injection in small boluses, use of a cannula in high-risk areas, immediate recognition of signs (disproportionate pain, blanching, livedo, delayed capillary refill) and the hyaluronidase protocol, including dosage, repeat administration and follow-up. Ask whether the course includes a simulation of the protocol and whether you will be given the algorithm in writing. Also ask whether the course teaches you to have hyaluronidase to hand in the surgery before treating your first patient.
Rheology: choosing the right product for each area
Not all hyaluronic acids behave in the same way. Concentration, cross-linking, G-prime, cohesiveness and integration capacity determine where each product works best. A proper course explains these concepts independently of any particular brand and teaches you how to read the technical data sheet. If the programme focuses on just one manufacturer, ask why.
Technical drawing: plans, instruments and volumes
- Injection sites by area: supraperiosteal, deep subcutaneous, subdermal, intradermal.
- Needles versus cannulas: gauges and lengths, and when to choose each.
- Shading techniques: bolus, back-shading, fan shading, cross-hatching, and where each one is best used.
- Guideline volumes by area and how to draw up a plan based on individual sessions rather than over-correcting in a single session.
- Three-dimensional assessment of the face: proportions, bony structure, loss of volume in the fat compartments.
Practical experience with real patients
As with any injection technique, watching is not the same as practising. Check how many patients you will be treating, which areas, what the tutor-to-student ratio is, and whether the tutor provides immediate feedback. When it comes to dermal fillers, it is also advisable to start practising on lower-risk areas (chin, jawline, cheekbones using a cannula) before moving on to the lips, nasolabial folds or nose.
A sensible itinerary
- Initial phase: vascular anatomy, haemodynamics, protocol for managing complications, and practical training in low-risk areas using a cannula.
- Intermediate stage: lips, nasolabial folds, dark circles under the eyes and the area around the mouth.
- Advanced stage: rhinoplasty, temporal region, glabella and combinations with botulinum toxin and biostimulants.
- Across the board: standardised clinical photography, specific informed consent for dermal fillers, and recording of the batch and product details for each patient.
Signs of a reputable school
- Practising medical lecturers, who can be identified, presenting their own cases.
- A syllabus that sets out the number of hours allocated to anatomy, theory, practical work and the management of complications.
- Hyaluronidase protocol provided and issued in writing.
- Brand independence, or at the very least, transparency regarding commercial agreements.
- Follow-up: a way to discuss your first cases with your tutor.
Format: what to learn via video and what to learn in person
Anatomy, rheology and protocols are best learnt from a video that you can watch repeatedly. The injection requires supervised practice. That is why at the Medars training Each masterclass is available as a recording, as a recording with one month’s follow-up from the doctor delivering it, or with follow-up and a certificate; the in-person practical session is organised separately. Before purchasing any course, please also check how the health advertising in your community: sharing a result and announcing it are not governed by the same rules.
Revised training for registered doctors
The best way to learn about complications with dermal fillers is from doctors who have already treated them. A Basic Medars membership is free for life and is activated once your professional registration has been verified – no card required. From there, you can access the catalogue of masterclasses, the Lounge and verified distributors. Request access or check the memberships.
Related guides
- Botulinum toxin training for doctors: what a reputable course should include
- A Master’s degree in aesthetic medicine or a masterclass: which course to choose and when
- How to get started in aesthetic medicine as a doctor: a realistic roadmap
- Buying aesthetic medicine supplies: authorised distributors and traceability
Continue exploring Medars
- Training for doctors: masterclasses on botulinum toxin, hyaluronic acid fillers and facial contouring, delivered by practising doctors.
- Memberships: Basic is free forever, and Gold and Black are available if you want more access.
- The Lounge: clinical cases with colleagues, direct messages and clinic rooms to rent.
- The Shop: verified laboratories and distributors.
- Teach at Medars: publish your masterclass and keep 70% from each sale.
- Frequently asked questions: verification, access and memberships.