The most updated facial injection technics, JBP-V-lift & Nanoneedles Kanda Aesthetic Plastic Surgery Clinic,, Shinichi Soyano M.D. I have been treating wrinkles and concaves since 1984 with Injectable materials. Those materials are collagen, hyaluronic acid, hydroxylapatite, poly-lactic acid, botulinum toxin, platelet rich plasma and own fat. 1, Fillers; I mainly use collagen and hyaluronic acid. I used to use Zyderm®1, Zyderm®2, Zyplast®, Cosmoderm®1, Cosmoderm®2, Cosmoplast®, but they are not available now. I have also been using Koken Atelocollagen Implant® 1%, 2%, 3%, and 6.5%. There are many kinds of hyaluronic acid, but I mainly use Esthelis®soft, Esthelis®basic, Juvederm®, or Hyaluronica®, while Hydroxylapatite (Radiesse®) is one of treatment options for 5 years. Before treatment, I mark the injection points with a marking pen. For reducing pain during the injection, I put anesthetic cream (Painbloc®) for 30 minutes on the injection points. 2, Needles I used to use B&D precision glide 30G® needle. Now I use JBP nanoneedle® 30G, 33G, 34G needles. JBP nanoneedle® 33G needle has the same inner diameter as B&D precision glide 30G® needle. For botulinum toxin, I use 34G needle which is 0.2mm diameter. There were some adverse reactions in this treatment. The most possible reaction is the remarkable injection marks. To avoid this reaction, I prefer finer needles. 34G needle makes only a slight injection mark. 3,V-lift V-lift is a thread containing an absorbable string inside the thread. There are 3 types of the threads. 31G with 30mm length, 29G with 40mm, 27G with 60mm. These threads are put into the face and threads are taken out. The strings are left under the sin of the face. Soon after the procedure, cheeks are lifted up. There are many discussions about the reason of the lifting effect. In the clinical cases the side treated is lifted compared to the opposite side. The color of the treated region turns red but will be normal in several hours. No serious side effect is seen unless bleeding occurs. The lifting effect lasts for 2 to 3 months and sometimes more.