1. Purpose

Standardise female‑specific dermal filler planning and injection technique to achieve soft, natural, and proportionally feminine outcomes while meeting Australian regulatory and patient‑safety requirements.^{1 2 4 6}

2. Scope

For licensed injectors at Newcastle Cosmetic Doctor. Covers assessment, female facial anatomy, product rheology, region‑specific technique, ultrasound‑assisted injections, complication management, documentation, advertising rules, and device traceability.^{1 2 7}

3. Female Anatomical Principles

Compared to male faces, women generally exhibit greater anterior malar projection (more defined malar apex), narrower bigonial width, smoother jaw transitions, and slightly narrower, more tapered chin shape. Restore a gentle midface S‑curve and avoid creating width/edges that masculinise.^{5 11}

4. Pre‑Treatment Assessment (Female‑specific)

• Photographs: AP/oblique/profile; dynamic expressions; lip rest vs smile.
• Key goals: soft anterior midface projection (no lateral over‑widening), refined jaw taper, delicate chin shape, natural lip hydration/definition without over‑eversion.
• Dental/occlusion & bruxism: treat or refer if dentofacial disharmony predominates before filler attempts.
• Skin & oedema tendency: choose lower hydrophilicity gels where swelling risk is high; plan staging.
• Consent & expectations: follow Ahpra non‑surgical guidelines; ensure advertising compliance; set staged plans to reduce overfilling.

Governance and IPC standards apply to all cases.^{1 4 6}

5. Product Rheology & Injection Depth

Select rheology by task: high‑G′ cohesive gels for structural support (malar anchor, chin base), medium G′ for contour, and lower G′/softer gels for superficial blending. Avoid over‑volumising with highly hydrophilic gels in midface/periorbita; ultrasound can confirm plane and avoid vessels.^{13 15 16}

6. Region‑Specific Technique (Female)

6.1 Midface / Cheek (restore anterior projection)

Goal: gentle anterior malar projection and smooth S‑curve; avoid lateral over‑widening that masculinises. Technique: deep supraperiosteal microbolus at malar anchor points with small subcutaneous threads to blend.^{5 11}

6.2 Temple (hollow correction — caution)

Goal: correct concavity without bulk. Technique: deep (deep temporal fat/supraperiosteal) microbolus with optional superficial blending; consider ultrasound mapping of STA/DTFA before injection.¹⁶

6.3 Jawline (refine, don’t masculinise)

Goal: smooth, continuous mandibular border with subtle angle; avoid sharp gonial hypertrophy. Technique: subcutaneous retrograde threads to straighten the border; minimal supraperiosteal bolus if angle definition is weak.^{15 13}

6.4 Chin (refined, tapered projection)

Goal: modest projection with narrower base; maintain soft pogonion and labiomental angle. Technique: supraperiosteal central/paramedian microbolus with light subcutaneous blending.¹²

6.5 Lips (definition, hydration; restrained volume)

Aim for gentle upper‑lip eversion and lower‑lip slight fullness; avoid extreme ratios and shelfing. Technique: micro‑threads/submucosal microbolus; prioritise border definition and philtral column support where appropriate.^{9 10}

6.6 Tear Trough / Periorbita (high caution)

Conservative volumes; consider lateral midface support first. Prefer cannula or ultrasound guidance; choose low‑swelling gels; avoid continuous superficial threads.¹⁶

6.7 Nose (Non‑surgical rhinoplasty — advanced only)

Goal: subtle dorsal alignment/tip support. High‑risk zone—use ultrasound mapping; micro‑aliquots; avoid high‑pressure static bolus; have ocular pathway ready.^{17 18}

7. Dosing Guide by Region (Female) — indicative ranges

8. Safety & Risk Mitigation

• Ultrasound: map vessels in high‑risk zones; consider real‑time guidance for temple, periorbita, nose.
• Technique: small aliquots, slow/low pressure, correct plane; keep device in motion for threads; avoid large static bolus.
• Aspiration: unreliable; do not use as a safety guarantee—rely on anatomy, plane, pressure control, and ultrasound.
• Cannula can reduce some risks but is not fail‑safe; small‑gauge cannulas can behave like needles.
• Any visual symptom: stop, call 000, urgent ophthalmology transfer; follow RANZCO pre‑hospital steps.
• Anaphylaxis kit open and ready; rehearse drills; follow ASCIA protocol.

Key sources: ^{16 19 20 8 7}

9. Regulatory Compliance (Australia 2025)

• Ahpra non‑surgical cosmetic procedure guidelines (2025) for practice and advertising (including age safeguards).
• TGA advertising: no public promotion of S4 prescription‑only injectables; use compliant language in all materials.
• Device traceability: use ARTG‑included devices; capture UDI where available; maintain batch/lot/expiry records.
• Facility standards: RACGP IPC and NSQHS (governance, medication safety, infection prevention).
• Documentation: consent, injection map/planes, product details, ultrasound screenshots (if used), adverse event reporting to TGA (IRIS/MDIR) where indicated.

Authorities: ^{1 2 4 6 7 21 22}

10. Complication Management (Fast Reference)

• Cutaneous vascular occlusion: stop; warm compress, massage; high‑dose pulsed hyaluronidase flooding across the ischaemic field; repeat to reperfusion; document & report significant events.
• Ocular symptoms: cease; call 000; urgent ophthalmology transfer; follow RANZCO pre‑hospital guidance; bring hyaluronidase with the patient; do not delay transfer.
• Anaphylaxis: adrenaline 1:1000 IM 0.5 mL; lay flat; high‑flow O₂; monitor; transfer to ED (ASCIA 2024).
• Infection: adhere to RACGP IPC; consider culture/antibiotics; review and document.

Guidance: ^{8 7 4 1}

11. Audit & Training

• Quarterly: technique vs outcomes (region, product, dose, complications).
• Annual: ultrasound mapping/injection refresh; anaphylaxis and ocular drills; VO simulation; document CPD aligned with Ahpra expectations.

Sources

1. Ahpra (2025) Performing non‑surgical cosmetic procedures — Guidelines hub., viewed 05 November 2025, https://www.ahpra.gov.au/Resources/Cosmetic-surgery-hub/Cosmetic-procedure-guidelines.aspx ↩
2. TGA (2025) Advertising health services & cosmetic injections — FAQ., viewed 05 November 2025, https://www.tga.gov.au/products/regulations-all-products/advertising/specialised-advertising-issues-and-topics/advertising-health-services-and-cosmetic-injections-frequently-asked-questions-and-answers ↩
3. Ahpra (2025) Advertising guidelines for higher‑risk non‑surgical cosmetic procedures., viewed 05 November 2025, https://www.ahpra.gov.au/Resources/Cosmetic-surgery-hub/Cosmetic-procedure-advertising-guidelines.aspx ↩
4. RACGP (2024) Infection prevention & control guidelines (primary care)., viewed 05 November 2025, https://www.racgp.org.au/running-a-practice/practice-standards/racgp-infection-prevention-and-control-guidelines ↩
5. Bannister JJ et al. (2022) Sex differences in adult facial 3D morphology. Facial Plast Surg Aesthet Med., viewed 05 November 2025, https://www.liebertpub.com/doi/full/10.1089/fpsam.2021.0301 ↩
6. ACSQHC (2021, updated 2024) NSQHS Standards (2nd ed.)., viewed 05 November 2025, https://www.safetyandquality.gov.au/sites/default/files/2021-05/national_safety_and_quality_health_service_nsqhs_standards_second_edition_-_updated_may_2021.pdf ↩
7. NHMRC/ACSQHC (2024) Australian Guidelines for the Prevention and Control of Infection in Healthcare., viewed 05 November 2025, https://www.safetyandquality.gov.au/sites/default/files/2024-01/australian_guidelines_for_the_prevention_and_control_of_infection_in_healthcare_current_version_v11.22_9_january_2024.pdf ↩
8. RANZCO (2024) Filler Blindness Guidelines — pre‑hospital pathway., viewed 05 November 2025, https://ranzco.edu/wp-content/uploads/2024/06/RANZCO-Filler-Blindness-Guidelines_2024.pdf ↩
9. Kar M (2018) Is it possible to define the ideal lips? J Cutan Aesthet Surg., viewed 05 November 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC5952987/ ↩
10. de Queiroz Hernandez PM et al. (2023) Lip attractiveness varies with ratios. Sci Rep., viewed 05 November 2025, https://www.nature.com/articles/s41598-023-31332-1 ↩
11. Matthews HS et al. (2023) Data‑driven sexual dimorphism of faces. PLoS Comput Biol., viewed 05 November 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC10335371/ ↩
12. Chen B et al. (2022) Chin augmentation with hyaluronic acid: injection technique. Plast Reconstr Surg Glob Open., viewed 05 November 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC9241653/ ↩
13. Moradi A et al. (2023) CaHA best‑practice guidelines; midface/jaw rationale. Aesthet Surg J Open Forum., viewed 05 November 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC10120162/ ↩
14. Go BC et al. (2023) Injectable fillers for jawline and chin. Dermatol Pract Concept., viewed 05 November 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC10296042/ ↩
15. Vasconcelos‑Berg R et al. (2024—2025) High‑frequency ultrasound — best practices for filler use. Diagnostics., viewed 05 November 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC11353849/ ↩
16. Jung JY et al. (2025) Recommendations on ultrasound‑guided HA injections. J Cosmet Dermatol., viewed 05 November 2025, https://onlinelibrary.wiley.com/doi/full/10.1111/jocd.16759 ↩
17. Bravo BSF et al. (2024) Nasal filling guided by ultrasound. J Cosmet Dermatol., viewed 05 November 2025, https://onlinelibrary.wiley.com/doi/10.1111/jocd.16430 ↩
18. FDA (2025) Executive Summary: Dermal fillers risks and imaging guidance mentions., viewed 05 November 2025, https://www.fda.gov/media/188185/download ↩
19. Goodman GJ (2021—2022) Aspiration before tissue filler is unreliable. Aesthet Surg J., viewed 05 November 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC8670299/ ↩
20. Goodman GJ et al. (2020) Neither positive nor negative aspiration should be relied upon. Aesthet Surg J., viewed 05 November 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC7954536/ ↩
21. TGA (2025) Unique Device Identification (UDI) — compliance guidance., viewed 05 November 2025, https://www.tga.gov.au/resources/guidance/complying-unique-device-identification-requirements-medical-devices ↩
22. TGA (2024) ARTG / device inclusion & traceability hub., viewed 05 November 2025, https://www.tga.gov.au/therapeutic-goods-administration-tga ↩