Spade Skin Care & More

Advanced Injectable Procedures in Los Angeles | Physician-Exclusive Care

At Spade, select aesthetic procedures are performed exclusively by our physician, Dr. Neil Vranis, a board-certified plastic surgeon. These services require advanced medical judgment, procedural expertise, and direct physician execution due to higher anatomical risk and complexity. They are not delegated to nursing staff. Our MD-only services are designed for patients seeking a higher level of safety, precision, and medical accountability.

This distinction is not a marketing claim—it’s a clinical necessity. These treatments require advanced anatomical knowledge, precise injection plane control, vascular risk assessment, and the ability to manage emergencies that may arise from even the most carefully executed technique.

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Advanced Injectable Procedures

These procedures involve complex facial anatomy and increased vascular risk and are performed exclusively by the physician.  Common treatment areas:

  • Tear trough filler
  • Non-surgical rhinoplasty
  • Temple hollowing correction
  • Advanced Midface Filler
  • Advanced jawline and chin reconstruction
  • Brazilian Butt Lift


Why physician-only:
These treatments require advanced anatomical expertise, precise injection plane control, and real-time medical decision-making.

Anatomical Knowledge: Board-certified physicians and dermatologists complete years of specialized training in applied facial anatomy, including deep dissection studies and imaging interpretation. This knowledge cannot be compressed into a weekend course.

Real-Time Decision-Making: Physicians are trained to recognize subtle signs of vascular compromise—blanching (whitening of skin), mottled discoloration, pain patterns—and can immediately discontinue injection and initiate emergency protocols.

The Advanced Injectable Consultation Process

Comprehensive Medical Evaluation (45–60 minutes)

Your advanced injectable journey begins with a thorough physician consultation. During this visit, we assess:

  • Complete medical history: Previous surgeries, allergies, bleeding disorders, medications (especially anticoagulants), and conditions affecting healing

  • Facial anatomy evaluation: Bone structure, soft tissue distribution, asymmetry, and vascular considerations

  • Aesthetic goals and expectations: What you hope to achieve, concerns about outcomes, and realistic timeline for results

  • Photography and measurements: Documenting baseline appearance for comparison and tracking results

This consultation is not a brief appointment—it is a comprehensive medical evaluation. Rushing this process increases complication risk and reduces aesthetic outcomes.

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Advanced Injectable Procedures

Tear Trough Filler
Non-surgical Rhinoplasty
Temple Hollowing Correction
Advanced Midface Filler
Advanced Jawline and Chin Reconstruction
Brazilian Butt Lift

Advanced Injectable FAQs

What are advanced injectable procedures?

Advanced injectable procedures involve the placement of injectable materials into anatomically complex or higher-risk areas of the face. These areas require a higher level of anatomical knowledge, precision, and medical judgment and are therefore performed exclusively by a physician.

The areas treated in advanced injectables contain critical blood vessels, nerves, and delicate structures. Incorrect placement can increase the risk of complications. Physician involvement helps ensure appropriate patient selection, treatment planning, and medical oversight.

All advanced injectable procedures at Spade are performed exclusively by a physician. These services are not delegated to nursing staff due to their complexity and risk profile.

Advanced injectable services include:

Tear trough filler, Non-surgical rhinoplasty, Temple hollowing correction, High-risk midface filler, Advanced jawline and chin reconstruction, Each area requires individualized evaluation and a customized treatment plan.

Tear trough filler addresses volume loss or hollowness under the eyes. Because the under-eye area has thin skin and nearby blood vessels, treatment requires careful technique and physician-level expertise.

Non-surgical rhinoplasty uses injectable materials to improve nasal contour without surgery. This procedure requires precise placement due to the nasal blood supply and is performed only after a thorough medical evaluation.

Temple hollowing correction restores volume in the temple region, which can become sunken with age. This area is considered high-risk due to nearby vascular structures, making physician-performed treatment essential.

High-risk midface filler refers to injectable treatment in areas of the midface that have a higher potential for vascular complications. These treatments require advanced anatomical understanding and careful technique.

Advanced jawline and chin reconstruction uses injectable materials to enhance or restore facial balance and structure. These treatments often involve deeper placement and structural planning, which is why they are performed by a physician.

Not all patients are candidates. A medical evaluation is required to assess facial anatomy, medical history, aesthetic goals, and risk factors. In some cases, alternative treatments or staged approaches may be recommended.

Some results may be visible immediately, while others may evolve over time depending on the product used and the treatment area. Final results can vary between individuals.

Longevity depends on the type of injectable used, the treatment area, and individual factors such as metabolism and lifestyle. During your consultation, expected duration will be discussed.

All injectable procedures carry risks. These may include swelling, bruising, asymmetry, infection, or vascular complications. Advanced injectables are limited to physician performance to reduce risk and ensure appropriate management if complications occur.

Yes. A physician consultation is required before any advanced injectable procedure. This ensures proper assessment, informed consent, and safe treatment planning.

Advanced injectable services typically require a consultation prior to scheduling treatment. Availability and next steps will be discussed after medical evaluation.

Schedule Your Consultation Today

Advanced injectable services typically require a consultation prior to scheduling treatment. Availability and next steps will be discussed after medical evaluation.

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