Hypodermic needles have been the delivery system of choice for many clinical drugs and medications, but they have their fair share of drawbacks. While their efficiency at directly feeding liquid treatments to the body are well-backed by science and research, using them for repeated and short-term injections can be disadvantageous to patients and medical practitioners alike.
So is there an alternative for a hypodermic needle? For procedures that require multiple treatments, dermatologists have access to one tool that works as a much better delivery system: the blunt-tip cannula.
As far as structure is concerned, hypodermic needles are relatively simple to use and understand. The needle itself is made of stainless steel tubing, with a pointed end to ensure maximum penetration into the skin. This needle is attached to a syringe or other delivery system to feed liquid treatments or drugs under the dermal layer.
The complications come after the injection has been made. Because hypodermic needles penetrate the skin, they can often cause blood vessels and arteries to burst if they breach or scratch too deeply. The deeper the injection, the more likely the dermatologist or doctor can hit a major artery, potentially causing several complications.
This problem is most apparent in dermal filler injections or other cosmetic treatments that require multiple entry sites and sessions. The skin can only handle so much trauma without bruising or marking, which can affect the results of cosmetic procedures like Botox. It can also require post-operative aftercare, which can negatively affect a patient’s quality of life.
All traditional injections run into this issue, which is why scientists have created alternative delivery systems that look to minimize pain while retaining the efficient delivery system expected of hypodermic needles.
These alternatives include MIT’s Lorentz-Force Actuator, which uses magnets and wire to propel both liquids and solids into the skin. However, these solutions still need further testing and development before they hit the market, though most clinical trials have delivered promising results.
Other scientists are also looking for ways to replace the hypodermic needle, with clinical trials for microneedles (a group of small needles that go over a patch of skin), and transdermal patches that make the drug seep into your skin. MIT in particular has experimented with manufacturing processes that can make these alternatives easier to build, like 4-D printing.
But outside of MIT and most research institutions, dermatologists can use one effective alternative to the hypodermic needle: blunt-tip cannulas. Using blunt-tip cannulas provides several advantages over traditional hypodermic needles, and can result in more efficient treatment and delivery of clinical or cosmetic drugs.
Blunt tip cannulas have one major difference compared to traditional hypodermic needles: a blunt and rounded tip. While this means that blunt-tip cannulas have no penetrating power, they make up for this drawback by being more versatile once they actually get under the skin.
Here’s a brief table outlining the major differences between the two:
|Traditional Hypodermic Needles||Blunt-Tip Cannulas|
|Sharp tip designed to pierce||Blunt tip, designed to push|
|Requires multiple entry points for different patches of skin||Needs only one entry point per patch of skin|
|Usually rigid||Can be flexible|
|Can be used for clinical and cosmetic procedures||Usually used for cosmetic procedures|
Blunt-tip cannulas have found widespread success with clinical trials and cosmetic treatments, particularly with dermal fillers like Botox and surgeries like liposuction. While they’re a relatively small player in the market for drug delivery systems, their efficacy and versatility have made them the alternative of choice to traditional hypodermic needle use.
There are several advantages that come with using blunt-tip cannulas:
Patients are less likely to experience painful trauma to their skin since cannulas push, not pierce through the skin. Most instances of pain often occur because of the needle piercing a blood vessel or a nerve cluster – but with cannulas, painless application of drugs is possible.
Blunt-tip cannulas are easy to integrate with other medical devices like syringes and medical tubing. This makes it relatively easy for medical and cosmetic practices to use cannulas if their patients ask for them.
Patients may also be more accommodating of the design of the blunt-tip cannula. Traditional hypodermic needles have been long associated with pain and patient anxiety, which are factors that may interfere with successful treatment. Knowing that a relatively easy, efficient, and painless approach may help patients cope better with surgical or cosmetic procedures.
Using cannulas also makes it possible to treat large patches of skin with a single injection. With traditional hypodermic needles, dermatologists would need to make multiple injections depending on how large the patch of skin they had to treat. Repeated injections on different patches of skin were more likely to cause bruising, which may require extensive postoperative aftercare.
For dermatologists and doctors, this also cuts down the possibility of the patient moving during the procedure. A patient may involuntarily twitch or spasm during the procedure, which can be dangerous when general anesthesia is not always an option. Using blunt-tip cannulas are also a great way to avoid needlestick injuries.
With all that said, there are still situations where using a traditional hypodermic needle is more helpful. For single-entry injection sites such as insulin injections or vaccinations, hypodermic needles are still the delivery system of choice for their efficient action and fast delivery.
Hypodermic needles excel at delivering drugs into the system with speed, which can be crucial for medications like muscle relaxants. Cosmetic procedures that target fine lines or wrinkles may also benefit from hypodermic needle use, since the speed of the results is often the best advantage of these treatments.
It will ultimately fall upon the dermatologist or doctor to decide if using an alternative to the hypodermic needle is the best option. While it is a mainstay of many cosmetic and clinical procedures, an alternative approach can offer advantages that can work to improve the patient experience.
At FACE Medical Supply, we pride ourselves on providing high-quality medical tools like hypodermic needles, cannulas, and syringes at competitive prices. Visit our store page today to find out more information about our stocks and products.
Sculptra (or New-Fill) has steadily gained popularity among dermal fillers to fill in areas in the face with longer-lasting results. However, it still suffers from the usual drawbacks of injectable fillers: the post-operative aftercare required after the procedure and the tools used in the treatment itself.
So how can the use of cannulas or needles affect Sculptra treatments? Overall, cannulas may offer more advantages because Sculptra works better with more filler. Needles are still a viable alternative, but with less versatility than cannulas.
Post-operative issues like bruising, bleeding, swelling, scarring, or inflammation are common complaints of patients that have used dermal fillers. While these conditions will usually go away with a few days of extended rest, these issues can still affect overall patient satisfaction with the procedure.
This issue occurs primarily because of the usual method used to apply injectable fillers. Traditional needle fillers are still the medical tool of choice used by most dermatologists and cosmetic practices with injecting dermal fillers in the body.
While they have a proven history of efficacy, they have some inevitable drawbacks because of how they work. This has made alternative tools such as blunt-tip cannulas rise in popularity with using injectable dermal fillers.
Ultimately, the choice of using a needle or a cannula will depend on the dermatologist’s experience with either tool and the patient’s comfort levels with the procedure. However, there are certain situations where Sculptra application is easier when using needle or cannula on the injection area.
Using cannulas for Sculptra treatments gives a few advantages to dermatologists, but the most significant is that it makes the application of dermal fillers easier in the deep dermis or subcutaneous layers.
Depending on the amount of Sculptra needed with each treatment, cannulas can provide better entry points, wider treatment area, and more consistent flow with filler application. It also allows them to treat larger areas of the body since the cannulas can be maneuvered from one entry point.
Patients who undergo Sculptra treatments via cannula may find the procedure less painful, as the cannula tip is designed to push, not penetrate the skin. This allows it to nudge aside major blood vessels and arteries, decreasing the risk of puncturing them during filler application. Since only one entry point is required, the patient experiences less pain because there’s only one area of active trauma in the body that they need to recover from.
Dermatologists are more likely to be trained with using needles for dermal fillers like Sculptra, and it’s this familiarity with the tool that can make needle treatments more viable. Familiarity with the application tool is crucial when using injectables since it allows the dermatologist to apply the filler without making mistakes. If the injector has more skill with using needles than cannulas, it’s safer for them to use the tool that they already know.
For patients, Sculptra treatments that use needles may give them better results with their filler area. Because of the relatively short length of the needle compared to a cannula, dermatologists find it easier to control the needle during filler injection. This allows them to deliver smaller amounts of filler on fine lines and wrinkles, especially in areas with thin or sensitive skin.
Depending on the overall treatment plan, the amount of filler required, and the skill of the dermatologist, using both cannulas and needles with Sculptra treatments is highly feasible. In fact, using both tools can greatly improve the results from Sculptra treatments, especially if there’s a wide area of treatment.
One thing to keep in mind when using both tools is to allow ample time for the body to heal between sessions. Under no circumstances should dermatologists encourage simultaneous use of cannulas or needles, since the patient’s skin may not handle the trauma from multiple injection areas.
Dermatologists will also need to keep in mind the pain tolerance of the patient and their overall experience with using dermal fillers, as each procedure can feel vastly different for the patient.
Sculptra treatments can be done with cannulas or needles, with the best option left up to the dermatologist and their discussion with their patients. Cannulas are excellent choices if the patient is looking for a relatively painless procedure and the treatment area needs a considerable amount of filler. Needles are a better option if the dermatologist has more experience with them and they’re dealing with a smaller filler area.
At FACE Medical Supply, we stock high-quality medical tools like cannulas and needles at affordable prices. This way, cosmetic practices can feel secure by offering alternatives with their services without having to worry about sourcing or their overall expenses. Contact us today to learn what products we stock and how to order from us.
Injectables like dermal fillers are effective at restoring lost volume to the skin, but they can cause complications if the procedure isn’t done correctly. Dermatologists need to consider the tools they use, their experience with the procedure, and the filler they’re using before they start any filler treatment.
So does Restylane produce better results when a cannula or needle is used? Both tools can produce excellent results, though they need to be tailored to the area that needs filler. Dermatologists also need to consider the type of Restylane they need to apply.
Unlike most dermal fillers, Restylane has different varieties that are specialized to treat specific areas of the face. The various Restylane dermal fillers all share similar mechanisms of action to remove wrinkles and reduce the signs of aging, but their formulas may differ slightly depending on which area of the body they’re injected.
Here is a table summarizing their differences:
|Restylane–L||Restylane Lyft||Restylane Defyne and Refyne||Restylane Silk and Kysse|
|General dermal filler product, designed for use anywhere on the face||Best used to fill out cheeks and other areas that need plenty of filler||Mainly used to lift and reduce the appearance of folds on the face||Designed specifically to fill out the lips|
|Can contain lidocaine (a topical numbing agent)||Contains larger particles of filler to occupy more area||Defyne retains shape; Refyne adjusts to folds||Smallest hyaluronic acid particles used for precision filling|
Restylane works by introducing hyaluronic acid to the skin, restoring volume and improving water retention. Skin health relies heavily on the moisture levels found in the dermal layers since the water helps the skin cells retain their structure. It’s a crucial compound that speeds up wound healing, and can even help manage skin conditions like eczema.
Because of the differing facial anatomies dermatologists may encounter with their patients, they must adjust their dermal filler injections to minimize scarring or bruising. Depending on the patient’s needs and the specific area that needs to be treated, there are situations where specifically using cannulas or needles may be the best option.
Blunt-tipped cannulas are a popular alternative to using hypodermic needles, as the unique properties of the needle tube and the tip reduce trauma to the skin during injection. Since the blunt tip pushes away at the dermal layer, dermatologists can avoid puncturing large blood vessels and arteries.
The primary advantage of using cannulas for Restylane injections is that dermatologists have better access to the subdermal layers of the skin, allowing more filler to be injected. It also reduces the number of entry points that need to be made in a single area, which can significantly reduce post-operative bruising and scarring.
However, cannulas are incompatible with filler areas that are closer to the surface of the skin, since the blunt tip has less control over filler distribution compared to hypodermic needles.
Traditional dermal filler injections use hypodermic needles for inserting filler, as the penetrative design of the tip and the relatively short needle tubing allows for swift and efficient application of filler. Dermatologists are more likely to be familiar with using needles to apply dermal fillers, so there’s less chance for error with treatment.
The advantage of using needles for Restylane is the greater control that the small needle provides. Since cannula needles are longer, it's difficult to gauge the exact amount of filler to push from the syringe to the injection site. The short and rigid needle tubing allows for greater precision with filler application, especially around areas like the lips and eyes.
Needles are less effective when the filler area is located deep within the skin, since the risk of puncturing a blood vessel increases with subdermal injection sites. While an experienced dermatologist can navigate around major blood vessels, bruising, swelling, and bleeding is often unavoidable.
Restylane can be applied with either cannulas or needles, though patients and dermatologists can use either depending on the type of Restylane used and the area that needs filling. Cannulas are a better choice overall if a lot of filler is required, while needles are the best option if the area is full of fine lines and wrinkles.
FACE Medical Supply is a proud supplier of high-quality yet affordable medical devices like cannulas and needles to cosmetic practices around the country. For more information on our stocks and the other products we offer, visit our product pages.
According to a 2017 Statista survey, around 34% of Americans have two to three body piercings. These piercings are often performed with a hollow point-needle, where the jewelry is inserted into the needles and into the skin as the injection is made. However, needles are not the only way to inject piercings: cannulas are also an effective method.
So what’s the difference between using a cannula or a needle for piercings? Needles provide a direct link between the jewelry and the skin, while cannulas have a much better connection between the tissue when injecting piercing. It’s also which part of the world the procedure is done.
A cannula piercing needle (or a piercing catheter) is a piercing needle that’s sheathed in plastic tubing. After the piercing has been made in the skin, the plastic tubing remains and the piercing/jewelry is inserted into the hole. The “cannula” in this setup doesn’t refer to the needle – rather, it refers to the plastic sheathing that surrounds it.
The primary benefit to using a piercing catheter is that it provides a suitable channel to insert the piercing without aggravating the entry wound already made by the injection. This can allow larger piercings or settings to be inserted into the skin.
Hollow needles have been the tool of choice for inserting piercings of any size, primarily because of the laser-cut precision of the tubing and the variety of gauges available. After the initial injection is made, jewelry of the corresponding size is inserted into the hole for insertion.
Hollow needles are readily accessible, and it’s more likely that piercers have training with them rather than using cannulas. However, the risk of using needles comes down to the skill of the piercer: if the jewelry isn’t inserted soon after the injection is made, the hole may close or shrink, requiring another injection to be made again.
Here is a table summarizing the major differences between the two tools:
|Primarily used in European piercings (most notably around the U.K.)||Primarily used with American piercings|
|Short bevel, only sharp on 1 edge||Long bevel, sharp on all 3 axes|
|Shallow penetration of the skin||Deep penetration of the skin|
Cannula needles are more commonly used for piercing outside the United States since it’s not classified as a medical device. In the US, only medically qualified personnel (doctors, nurses, and dermatologists) can use cannula piercing needles. Since they have the experience and training required, cannula piercings are much more accessible for patients compared to commercial piercing establishments.
Patients that would want to consider their tendency to bruise and bleed, as cannulas will naturally cause a larger entry point. While this allows for better jewelry connection, it’s not suited for working on delicate parts of the body like the ears.
Needles are the better choice if the patient is concerned about pain, as the sharp bevels make a smoother entry point and therefore make the entire procedure less painless. However, patients should also choose a piercer with experience, as it’s easier to lose the connection between the blade and the skin mid-transfer of the piercing.
It will ultimately fall on the dermatologist and the patient to discuss the method used for their piercings. The essential factor is to have access to high-quality cannulas or hollow needles, as substandard products can jeopardize the piercing process and wound the skin.
At FACE Medical Supply, we offer medical tools like piercing catheters and hollow needles at affordable prices. Combined with our passion for excellent customer service, this enables cosmetic practices to add piercing services without having to worry about supply.
Read more: Applying Restylane: Cannula vs Needle
Dermal fillers are one of the most common minimally invasive cosmetic procedures performed in the United States. According to the American Society of Plastic Surgeons, there were 16.3 million of these procedures performed in 2019, a 2% increase compared to the previous year. We perform most of these procedures with the traditional sharp tip needle, but more dermatologists are advocating for using blunt-tip cannulas instead.
Why use a blunt cannula for dermal fillers? Research shows it’s less invasive to use and addresses several key shortcomings that come with using sharp tip needles. With the proper use and training, it has the potential to be an effective tool in any cosmetic surgeon’s kit.
Blunt-tip cannulas are closely related to sharp tip needles, but with a few major differences. Here’s a table showing some of the most important ones:
|Blunt-Tip Cannula||Sharp Tip Needle|
|Needle flexibility||Usually flexible and pliable||Rigid, though some flexible variants exists|
|Incisions needed||Only one initial incision to cover a filler site||Multiple incisions needed per application|
|Needle length||Longer than most sharp-tip needles||Varies depending on the gauge|
|Risk of complications||Low||Moderate|
In particular, three key characteristics of a blunt-tip cannula make it perfect for dermal filler use:
By design, the blunt tip of the cannula has no penetrating power. This allows easier movement around blood vessels since it’s less likely to pierce right through them. The tip design allows surgeons to “nudge” or navigate around blood vessels, avoiding any operative trauma that needs to be addressed post-op.
Dermal filler sites are often around tight clusters of blood vessels, so traditional needle treatment will inevitably leave some sort of scarring. Further compounding this issue is that needles require multiple entry points even across a localized injection site, which increases the likelihood of scarring.
Sharp-tip needles need to have rigid tubing to pierce the skin. Combined with multiple entry points and the delicate skin of some filler sites, this process can be quite painful for patients. Cannulas avoid this issue by having a flexible tube that can branch out from a single incision site, which reduces the number of entry points in a dermal filler site.
Aside from reducing the amount of scarring, surgeons also have the freedom to maneuver the cannula from the entry point to other areas. Because of the flexible tubing, it becomes possible for a surgeon to reach a larger area from a single entry point, allowing them to reach more delicate areas by making incisions at adjacent sites.
Cannula needles are longer than traditional needles on average, mainly because the flexible tubing and blunt tip are conducive for such a design. Longer needles mean continuous flow of filler to injection sites, which are crucial for achieving the best results. This is especially crucial for some filler sites that need a smooth application of dermal filler like the jawline.
This also allows surgeons to get more mileage out of using localized anesthesia, since the reach of a cannula doesn’t require multiple entry points. Surgeons can expand the entire treatment area to include other sites that would normally be inaccessible without making a direct entry point or be too much for a patient’s pain threshold.
Compared to needles, it’s easier for a surgeon to gauge if they’re about to hit a blood vessel or a nerve cluster. Precision injection is important with deep dermal treatment, since it becomes harder to avoid arterial walls and other major vessels of the skin. This minimizes the risk of serious complications like venous occlusion.
Cannulas are also a great solution for filling areas that are right next to the bone, since there’s less chance that the upper skin layer will be damaged on injection. Since the blunt end can push its way past soft tissue, surgeons can inject areas with the precise amount of fill that they need.
Most surgeons will have different preferences about the exact sites where cannulas work best. However, there are five areas that all of them agree is suitable with blunt cannula application:
Jaw sculpting requires a lot of finesse to get the contouring right. What makes cannula so ideal for this area is that the fewer incisions mean that there’s less chance of swelling, which can reduce the amount of filler that actually needs to be put in place. It’s also a relatively painless area to inject.
It also prevents any damage to the areas that are right next to your jawbone. This vastly improves patient experience, especially for first-timers. Because of the flexibility afforded by using cannulas, a surgeon can make pinpoint adjustments to the amount of filler required without worrying about hitting any critical facial nerves.
As one area susceptible to swelling and tenderness, cheek fillers are highly compatible with blunt cannulas. Because of their wide area and soft tissue, the surgeon must apply enough filler as evenly as possible for the best results. The blunt cannula’s maneuverability and characteristic of pushing instead of piercing through the skin makes for smoother filler distribution.
The cheeks are also next to many common filler sites, which make it one of the best places to make the initial incision. Surgeons can easily reach more delicate areas like underneath the eyes without worrying about accidentally injecting filler into an artery.
Tenderness is another common complaint that patients experience with traditional needle fillers, especially around the lip area. The number of nerve endings and blood vessels found on and around the lips requires delicate work from the surgeon, which isn’t always possible with the design of a sharp-tip needle.
But when cannulas are used, surgeons can reach the lip area even without a direct incision on the site. A cannula can efficiently navigate the soft tissue with little difficulty for better results. This efficacy also means they use less filler per insertion.
Using cannulas can make precision injection possible, but it doesn’t remove the possibility of pain and discomfort in your patient. If they express concerns about the pain of the procedure, you can suggest using general anesthesia to alleviate their worries.
However, the single incision cut required by most cannula treatments means that it’s enough to use a local anesthesia to make the procedure painless. It’s up to the doctor to set the expectations of the patient if the procedure is painless or not, but they can assure them that the process is less painful than using needle treatment.
Blunt tip cannulas are ideal for dermal filler because they’re a less invasive method of application. This reduces the post-operative recovery time a patient needs, gives a surgeon more confidence in accessing and maneuvering around delicate areas, and allows for more efficient filler distribution.
FACE Medical Supplies has years of experience with alternatives for cosmetic surgery such as cannulas. We offer cannulas and needles for cosmetic practices at affordable prices and hold ourselves to a high standard of product quality and customer service.
Read more: Blunt Needle: Everything You Need to Know
When there's a market where patients are less willing to undergo considerable downtime and do not want a significant surgical procedure, the demand for soft-tissue fillers increases. According to data from the American Society for Aesthetic Plastic Surgery (ASAPS), more than 2.1 million hyaluronic acid filler treatments were performed in 2015. That makes hyaluronic acid filler treatments the second most popular nonsurgical cosmetic procedure performed in the United States after neuromodulators; the latter is frequently performed in concert with soft-tissue filler injections.
Physicians have advanced beyond filling rhytides at the forefront of aesthetic medicine developments and are now targeting specific facial sites for deep volumetric augmentation. Evidence for significant volume loss in specific deep fat compartments and facial bones during the aging process is well documented in the medical literature. The aging process occurs in all anatomical layers of the face and rejuvenation should therefore not be limited to dermal signs of aging.
Injection of fillers at strategic target sites can reconstruct youthful anatomy and thereby provide the patient with a natural result. As the relatively new field of aesthetic medicine develops, practitioners are using filler products and techniques with established safety profiles to reduce complications and to increase patient satisfaction. To provide natural-looking results, the physician must have a thorough knowledge of the anatomical changes taking place during the aging process and be able to place fillers in the specific target areas that have lost volume. The practitioner should also be aware of the key anatomical features of each injection site and choose an injection technique that is safe and effective.
The facial arterial system, in particular, represents a danger zone for filler injections, as the intra-arterial injection can potentially lead to widespread necrosis and even blindness. Blindness can occur by injection in an artery in proximity to the orbit and requires rapid specialist intervention. Minimizing the risk of intra-arterial injection of fillers is therefore of paramount importance.
Technological developments include the introduction of the blunt-tipped, or non-traumatic cannula as an alternative to the sharp needle. With a sharp needle, the placement of the needle tip is considered very precise. It is therefore assumed that positioning the tip at the periosteum is relatively easy and will result in precise placement of filler products.
However, the final placement of the filler at this level cannot be guaranteed.
Treatment with non-traumatic cannulae results in significantly fewer bruises and lower pain scores and is gaining in popularity. However, non-traumatic cannulae are more difficult to maneuver to the periosteal level and cannula techniques are therefore wrongly regarded as less precise than those using a needle. Placing the tip of a sharp needle on the periosteum is often thought to be a safe technique to avoid intra-vascular embolization for two main reasons.
First, there are very few arteries running over the periosteum, making it almost an avascular area. Second, it is assumed that a needle with an artery in its trajectory, will completely pierce the artery and exit the other side, avoiding injection of product in the lumen of the artery.
In this cadaver dissection study, our aim was to determine the final position of the injected product using sharp needle vs non-traumatic cannula techniques in a split-face approach. A secondary aim was to study the safety profiles of both injection techniques, related to adjacent arterial danger zones.
Dermal fillers improve volume loss or enhance facial features. Their use is increasing at a rate of 10% or more per year worldwide. Adverse events are usually minor and consist of bruising, swelling, asymmetries, and nodularity. More significant complications are fortunately rare and include infection, granuloma, skin necrosis, and blindness. This blog will concentrate on techniques to minimize the risks of having a vascular event.
There are 2 ways a blood vessel can become occluded. If an artery is entered and filler is injected within the lumen (Intraluminal), the filler will travel down the vessel until it gets lodged. At this point, the filler stops the flow of blood to areas that are dependant on this blood supply.
Smaller pieces of the filler can break off and flow into areas far from the initial injection and into the very small arterioles. There are theories that an inflammatory response/cascade exacerbates the injury to the skin and dependent structures. This is Dr. Weiner's opinion on the etiology of the majority of vascular occlusion cases.
A second way a vessel can occlude is if there is external compression of the vessel by filler. This is plausible in areas of compartmentalization, such as in the nasal tip. If the pressure within the nasal tip exceeds the pressure within an artery, the flow will stop. Unfortunately in this area, vascularity is so poor that peripheral flow doesn't occur.
External compression is not a major problem in most areas of the face in Dr. Weiner's opinion. Most vessels can be ligated during surgery and there is no resultant skin necrosis – proving that peripheral flow can make up for an externally compressed vessel.
The worst cases of vascular occlusion result in blindness. This is the result of a filler embolus that travels through an anastomosis between the external and internal carotid systems. The filler backs up into the central retinal artery which feeds the retina. Blood flow is blocked to the retina and blindness ensues.
In most cases, early recognition of a vascular event can be reversed with hyaluronidase if a hyaluronic acid filler was used. Minimal or no sequelae are seen if action is taken within the first 4-6 hours. Unfortunately, even immediate action for blindness related to a filler complication has little or no success.
There have been about 100 reported cases of blindness from fillers, with most of the cases coming out of Asia. This is certainly underreported though. The areas of most risks for blindness are injections in: glabella, nose, periocular, and NLF. Fat is the most common filler causing blindness, but all fillers have been implicated. Any area of the face is at risk for vascular occlusion/necrosis.
Ninety-eight cases of vision changes from filler were identified. The sites that were high risk for complications were the glabella (38.8%), nasal region (25.5%), nasolabial fold (13.3%), and forehead (12.2%). Autologous fat (47.9%) was the most common filler type to cause this complication, followed by hyaluronic acid (23.5%). The most common symptoms were immediate vision loss and pain. Most cases of vision loss did not recover. Central nervous system complications were seen in 23.5% of the cases. No treatments were found to be consistently successful in treating blindness.
Techniques for optimizing safety during dermal filler administration:
The bottom line is that complications can occur with dermal fillers, even during a routine procedure. Use of larger gauge microcannulas greater than 25 gauge may minimize the risk of vascular complications but does not make it zero. Many measures can be taken to minimize risks. Choosing an experienced injector will result in safer and better outcomes.
In a recent study conducted by The People's Republic of China, multiple doctors tested various types of microcannulas to measure their differences and effectiveness. Let's dive into what the study talked about and how they came to the conclusions that they did.
Soft-tissue augmentation is a mainstay of cosmetic enhancement for the face and has grown immensely in popularity. The American Society for Aesthetic Plastic Surgery has a long list of used filler types. They are calcium hydroxyapatite, collagen, fat, hyaluronic acid, polylactic acid, and polymethylmethacrylate microspheres. That's a long list of choices, but of all these unique types of fillers, hyaluronic acid is used the most.
Why? Because of its hygroscopic properties, biocompatibility, and reversibility, hyaluronic acid is viewed as the most common dermal filler with which to restore volume loss.
Hyaluronic acid injection complications are local injection-related side effects that manifest as edema, pain, bruising, erythema, itching, and ecchymosis; the most concerning difficulty is vascular occlusion. It doesn't sound too appealing at first. However, blunt-tipped can provide some reassurance.
Hyaluronic acid gels can be injected using sharp needles or blunt microcannulas. Studies have shown that the blunt microcannula with a side port presented improvements in mitigating pain and adverse effects, which has a degree of correction similar to a needle.
Some scholars state that the use of the microcannula is ideal for deeper nasolabial fold and lip augmentation and in areas requiring a larger filler volume, such as the mid-face and jowl regions.
It's clear that micro cannulas have superior results compared to sharp-tipped needles, but which microcannulas work the best?
Microcannulas' use is limited by the injection area and the physician's choice, but the differences between microcannulas constructed by different manufacturers have not been carefully investigated.
This study was designed to compare the microstructures and properties of different microcannulas by several trials and provide guidance for clinical application.
The study chose nine types of microcannulas that are widely used internationally. These microcannulas are available in gauges ranging from 18 to 30; the 23-, 25-, and 27-gauge. All microcannulas have a blunt tip with a precision laser-cut lateral side port for filler extrusion and a plastic pedestal that fits on any Luer lock syringe.
The physician may choose a different gauge or length because of the requirements of injection, including the technique being used and the area being filled.
In this study, all microcannulas are 25-gauge.
Scanning Electron Microscopic Images of the Microcannulas.
The microcannulas were sectioned and mounted onto a stub. A scanning electron microscope was used to obtain a high-definition image of the blunt tip, side injection port, and inner surface through each microcannula's side port. For each microcannula, three new microcannula tips were measured.
The microcannulas had various tip shapes. The microcannula's hole was oval (microcannulas 1, 3, 4, 5, 6, and 7), pointed rounded (microcannulas 8 and 9), or a unique form (similar to the rounded trapezoidal structure) (microcannula 2).
The ports of the Microcannulas were mainly oval, but the lengths were different, and some ports were three times larger than the others. There were two port edge forms; some (microcannulas 1, 2, 3, 4, 5, 6, and 7) were smooth, and others (microcannulas 3, 8, and 9) were rough. The edge form depends mainly on the technical process, and the laser cutting generally results in a smooth shape.10 For the inner surface, most microcannulas (1, 2, 3, 4, 5, 6, 7, and 8) had inner surfaces with a cord-like structure; only microcannula 9 had an oval structure inner surface, and the difference demonstrated that they had different surface processes.
The inner surfaces of some microcannulas (2 and 8) had visible impurity, and the exterior of microcannula 7 had a stripe-like structure.
Only microcannulas 1 and 9 met the requirement concerning carbon composition; the other microcannulas had a higher composition with a significant difference. For other elements, all microcannulas met the American Society for Testing and Materials requirement; microcannula 9 was the only one that fits the American Society for Testing and Materials composition standards for all elements.
The elastic moduli of microcannulas 2 and 7 are smaller than those of other microcannulas. The yield strength was analyzed; the yield strength of microcannula 9 was the highest. There was a significant difference in the mechanical properties among the microcannulas.
Microcannula 1 had the highest speed compared with other microcannulas, and microcannula 9 was the slowest one in the test. The difference in the time spent between microcannula two and microcannula 9 was more than 7-fold.
The result of the injection force test showed that some microcannulas could easily puncture the aorta with a higher force; it was difficult for microcannula 4 to puncture the aorta.
Compared with the traditional sharp needle, there is a definite advantage for blunt microcannulas to reduce patient discomfort, bleeding, and bruising, attributable to its rounded tip.
In the electron microscopy results, there are nine types of microcannulas, which are mainly oval, pointed, or rounded, and microcannula 2 exhibits a unique form. From the point of stress, it is microcannulas 2, and 7 show significant differences with others.
It was more comfortable for the sharper microcannulas to penetrate the tissue, and the patient may feel more comfortable. By contrast, when blunt microcannulas meet dense tissue, such as ligaments and fascia, there will be a certain degree of discomfort from the tissue shift caused by the resistance. However, a blunter microcannula has a lower probability of piercing the vessels and is therefore safer.
This issue is further investigated in the vessel piercing test. The results show that the tips of microcannulas 2, 8, and 9 are sharper, and the others are blunter.
For microcannulas 2 and 8, the carbon content is higher than the American Society for Testing and Materials standard level, and the carburizing treatment of the microcannula surface is mainly considered. Carburizing treatment is a chemical heat treatment process in which the steel is put into the carburizing medium to be heated and preserved, making the carbon atoms enter the surface.
Generally, the surface carbon content increases with increases in the carbon atmosphere concentration, diffusion time, and diffusion temperature, whereas the internal carbon content is less affected. As the carbon content increases, the hardness and wear resistance of the material is often higher, as is the brittleness. The plasticity and toughness are worse, which may lead to a fracture in bending and stretching deformation. Microcannula 9 is the only one that fully conforms to American Society for Testing and Materials standards.
It is essential for physicians to feel the injection during the operation; therefore, the study designed an injection speed experiment that was aimed at determining the time of each microcannula injection, and the volume of hyaluronic acid under constant pressure indirectly reflected the smoothness of the operative process. Smoothness is related to the inner diameter and the smoothness of the inner wall.
From a fluid mechanics standpoint, all other things being equal, the time spent for the liquid to pass through a microcannula depends on the larger area of the inner section and the side port section. When the inner part is larger than the side port section, the outflow of liquid is restricted by the side port, and the inner diameter makes no difference and vice versa.
For microcannulas 1, 2, 3, 5, 7, 8, and 9, the inner section is larger than the side port section, and, along with the reason for differences in smoothness, the result of injection speed can be explained. When changing between different microcannulas, physicians should be fully aware of the smoothness of different microcannulas. They should first adapt to the actual injection handle and then inject to avoid making the injection volume too large or too small. Although injection technology of hyaluronic acid has become increasingly mature, complications are frequent.
One of the most serious is the microcannula piercing the blood vessels, which can lead to vascular embolization. There have been many cases of embolism reported in the literature that have resulted in skin necrosis and blindness. A competent physician must, as much as possible, reduce the risk of vascular embolism to zero. On the one hand, we should be familiar with the anatomical structure of different injection areas to avoid blood vessels during the injection.
On the other hand, it is also imperative to choose a suitable injection tool. A few studies have shown that the microcannula with a blunt tip is better for avoiding punctured blood vessels than a sharp tip. The results showed that microcannula 4 struggled the most to penetrate the blood vessels, and the relative safety was high.
If you're a doctor who wants to purchase microcannulas, then explore FACE Medical Supply's store for all our available microcannulas. We carry multiple sizes to suit whatever your needs are.
Reference for Summary
Comparison of Microstructure and Properties of Different Microcannulas for Hyaluronic Acid Injection. Plast Reconstr Surg. .
Many spas, cosmetic offices, and doctors offer dermal filler injection services to their patients. Each and everyone has their unique way of performing these procedures. Many of these offices, however, rely primarily on sharp tip dermal fillers. Many more are beginning to realize the many advantages of blunt tip Microcannula treatment. Even though the Microcannula technique is safer, effective, and less painful, doctors still use sharp-tipped needles.
In this article, we dive into the advantages and disadvantages of both Sharp Tipped needles and Microcannula technique. We want to give you a clear understanding of why so many practitioners are switching over and why patients love them for it. Sharp tipped needles aren't all that bad, however, with a few advantages still.
The Microcannula technique has reconstructed the cosmetic industry and offered doctors with a novel, innovative way of providing facial fillers injections. The approach allows physicians to slip the blunt tip cannula under the patient's skin sleekly and without tearing the epidermis. Patients looking to enhance their appearance can now do so without having to endure a painful procedure that has nasty side effects connected with sharp-tipped needles.
Essentially, microcannula is a modernized variant of the traditional hypodermic needles used to administer injection treatments. Rather than having a sharpened tip, this technique utilizes a dull end that makes an injection procedure much more pleasant. It has a bendable shaft, allowing it to move quickly compared to a traditional needle's stiffness that restricts it.
Microcannula (Blunt Tipped Needle)
At the source of the filler injection using Microcannula, your Doctor creates a minute entry point in your skin using a precise, sharp needle. This is a vital step since the Microcannula has a blunt tip and is incapable of penetrating the skin by itself. The insertion location is minimal and does not cause substantial pain or bleeding.
Then the Doctor skillfully inserts the Microcannula into the small opening and glides it under your skin to reach the sections of filler injection. The Microcannula then slides within the spaces connecting the tissue. It can be moved under the skin without any injuries to tissue. Patients typically do not feel much pain, if any, as the Doctor guides it under their skin.
Sharp Tipped Needle (Hypodermic Needle)
Sharp tip needles use a skinny, short, sharp needle to inject dermal fillers. Multiple injection points are required when using needles, which can increase the risk of hitting a vein. If a vein is hit with a needle, there's a higher chance of bruising after the procedure.
Using the Visual Analog Scale for pain assessment during the injections was quite different. The pain was described as 3 (mild) for injections with the microcannula. Patient discomfort is reduced to the level where topical anesthesia alone consistently suffices even for injection of the lips, and local nerve blocks are not necessary.
That pain level increased to 6 (moderate) for injections with the hypodermic needle. Bruising and ecchymosis were more marked following the use of the hypodermic needle.
Microcannula and Hypodermic needles scored pretty close to each other. Overall, the Global Aesthetic Improvements Scale (GAIS) results were excellent (55%), moderate (35%), and somewhat improved (10%) one month after the procedure, decreasing to 23%, 44%, and 33%, respectively, at the six-month evaluation. There were no significant differences in the GAIS score between the microcannula and the hypodermic needle. However, pain during the recovery can be higher after the use of sharp-tipped needles.
Utilizing Microcannula for filler injection offers numerous advantages over hypodermic needles, such as:
Advantages of Sharp Tipped Needle
Although the cannula method of injecting dermal fillers offers many benefits, there are still cases when sharp needles can be the right choice. When a minimal amount of filler for touchups are injected in small places like the cupid's bow of the upper lip or the temples, a needle is still the best option.
This study goes on to describe the potential of adverse effects. Of the 666 filler procedures using the microcannula technique, three treatments (0.5%) produced adverse events on the day of service, and during the two-week follow up 32 procedures (4.8%) produced adverse effects. In total, only 5.4% of treatments produced adverse events.
Cannulas may not be ideal for filling acne scars or injecting extremely fine lines located on the skin's superficial surface. Microcannulas, since they are blunt-tipped, cannot make their entry point, requiring the use of a sharp needle to start an entry point.
A risk concerning the sharp needle is not just penetrating the blood vessel but shooting the filler into it, leading to vascular occlusion. That can result in much more severe complications. Again, there are specific standards that practitioners take to ensure that this doesn't happen; however, it is something that must be acknowledged when using a needle.
Greater Pain. Using a sharp needle will create a lot of tissue, tearing only always. This tearing will cause pain for the patient and create a more unpleasant experience.
More Bruising. The needle won't slide easily and will cut veins and tear the tissue causing more bleeding, which will lead to bruising that takes a while to disappear.
Less Predictable. It's difficult for practitioners to know exactly what the damage the needle will cause.
There are many benefits to using microcannulas in sensitive invasive procedures. Here are a few examples of where microcannulas becomes invaluable to Doctors.
Technique matters greatly for evading vascular compression, but blunt tips make the probabilities of it happening much less possible. To stop unnecessary extrusion force when injecting fillers through blunt microcannulas that are invariably longer than the typical 13 mm to 19 mm sharp needles, a larger gauge is selected.
The risk of penetrating a blood vessel with a correctly used blunt microcannula is significantly reduced. Chances of ecchymosis, which may be recorded in regions such as the nasojugal fold, the upper eyelid, and the pre-jowl sulcus.
It has been suggested that a blunt microcannula multiple times through an area may stimulate collagenases. This theory is persuasive by extrapolation from the collagenases observed with repeated back-and-forth passage of cannulas during liposculpture.
If you're a doctor who wants to purchase microcannulas, then stop by FACEMed's Store for all our available microcannulas. We carry multiple sizes to suit whatever your needs are.
As many cosmetic doctors and patients can attest, swapping the sharp needle for a blunt tip microcannula improves the outcomes of a procedure. The wide variety of microcannula choices has allowed doctors to perform both cosmetic and more invasive procedures harmlessly. The Microcannula technique is available in five different sizes. At FACE Medical Supply, you can find 18, 22, 25, 27, and 30 gauge microcannulas at various lengths. We sell high-quality microcannulas that will perform any filler injection task you need. The results show that microcannula injections are the future.
These microcannulas can be safely employed with a variety of cosmetic methods and fillers of any type and viscosity, including Lip augmentation, soft augmentation of the facial filling, plumping cheeks, wrinkle-reducing, plumping cheeks, reducing saggy skin and bags under the eye.
L;, Fulton J;Caperton C;Weinkle S;Dewandre. "Filler Injections With the Blunt-Tip Microcannula." Journal of Drugs in Dermatology : JDD, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/23135654/.
Loghem, van, et al. "Cannula Versus Sharp Needle for Placement of Soft Tissue Fillers: An Observational Cadaver Study." OUP Academic, Oxford University Press, 15 Dec. 2016, academic.oup.com/asj/article/38/1/73/2698769#110268380.
Simply put? The clinical benefits. Benefits from blunt microcannulas include elimination or near elimination of the risks of accidental intravascular injection. An intravascular injection is an injury to vital neurovascular structures within the areas of injection. Many researchers agree that a blunt microcannula of 27 gauge or above is unlikely to puncture blood vessels or nerves if it is used with proper technique. A Microcannula will push tissue aside as it traverses the path of least resistance through the tissue. So what other benefits do Microcannulas have?
Technique matters for avoiding vascular compression, but blunt tips make the chances of it happen far less likely. To prevent excessive extrusion force when injecting fillers through blunt microcannulas that are invariably longer than the typical 13 mm to 19 mm sharp needles, a larger gauge is selected.
In general, a microcannula of 27-gauge or larger diameter is used in place of a 30-gauge sharp needle, and a microcannula of 25 gauge or larger diameter in place of a 27-gauge sharp needle. The decreased extrusion force facilitates the increased flow of filler products that can cause the deposition of inappropriately large filler boluses if the injector is unused to the small volume micro-threading technique that is best suited to microcannulas.
The decreased or eliminated the risk of piercing a blood vessel with an appropriately used blunt microcannula compared to sharp needles results in a significantly reduced risk of ecchymosis, which may be particularly noted in regions such as the nasojugal fold, the upper eyelid, and the pre-jowl sulcus. In the researcher's experience, ecchymosis with blunt microcannulas is minimal and, for many patients, nonexistent.
If ecchymosis does occur, it may be at the insertion site of the sharp pilot needle, or in areas of increased tissue resistance if the microcannula is applied with inappropriate force. Increased tissue resistance may be due to fibrosis, in patients who have previously had face-lifting surgery or multiple injection sessions with collagen-stimulating volumizers such as PLLA. These situations may be considered relative contraindications to the use of blunt microcannulas.
According to researchers, the tolerability of blunt microcannulas is equal to or greater than that of sharp needles. Patient discomfort is reduced to the level where topical anesthesia alone consistently suffices even for injection of the lips, and local nerve blocks are not necessary. There may be some discomfort during the injection, especially if a microcannula is passed multiple times through a zone of tissue fibrosis. Some patients dislike the noise of a blunt microcannula passing through tissue, and we recommend forewarning patients of this and playing music to provide auditory distraction during the injection procedure.
It has been suggested that the back-and-forth passage of a blunt microcannula multiple times through an area may stimulate collagenesis. This theory is persuasive by extrapolation from the collagenesis observed with repeated back-and-forth passage of cannulas during liposculpture. However, the researchers note that collagenesis induced by liposculpture typically results from a much larger number of "tunneling" passes through the tissue than would be performed when injecting alloplastic fillers with microcannulas.
If you're a doctor who wants to purchase microcannulas, then stop by FACEMed's Store for all our available microcannulas. We carry multiple sizes to suit whatever your needs are.
Regardless of what the Doctor is using the utmost care should always be taken to ensure safety for the patient.
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A huge reason people avoid getting facial fillers is the fear that the needles used to inject the treatment will be too uncomfortable. Luckily we have microcannula. To make injection treatments less painful, physicians have devised a technique that takes the complexities out of facial filler procedures.
Essentially, microcannula is an updated version of the traditional hypodermic needles used to administer injection treatments. Rather than having a sharp tip, this method uses a blunt end that makes your injection treatment much more comfortable. It's has a flexible shaft, allowing it to move quickly compared to the stiffness of a traditional needle.
At the FaceMed store, you can find 18,22,25,27, and 30 size gauge microcannulas at various lengths. We sell high-quality microcannulas that will perform any filler injection task you need. The results show that microcannula injections are the future.
Maybe you have decided to get fillers, and now the question is what sort of fillers do you need. As the mid-face ages, it begins to sag because the skin gets a little looser, and the tissue has less support. This would be a sign that you're the right candidate for facial fillers to lift the sag and create a more youthful, renewed look. What's next? You make your appointment and then schedule your procedure.
The physician first makes a small entry point in your skin using a fine needle. This is a crucial step since the Microcannula has a blunt tip and is unable to pierce into the skin on its own. The entry spot is very shallow and does not cause much pain or bleeding for patients.
Then the doctor carefully inserts the Microcannula through the little opening they created with a sharp needle.
The doctor then guides it under your skin to the sites of the intended injection. Along the way, the Microcannula gently slides through the between the tissues. The needle can be moved under the skin without causing any damage to the tissues and the patient most often do not feel any pain, only pressure, as the doctor moves it under their skin.
If a doctor was to fill under a patient's eyes, they make a small hole either next to the lip or over the cheekbone and move the needle in and up your cheek, under the skin. I know, it sounds scary, but because the one hole is the only site of injection, it closes within two hours and hurts less because it's anesthetized.
The microcannula technique has grown into becoming an increasingly attractive method for doctors injecting cosmetic fillers. Prior studies have demonstrated that the microcannula technique allows the filler to be injected with less pain, swelling, and virtually no bruising. This study examined 247 patients who have undergone any dermal filler injections using the microcannula technique from 2011 to 2016. This study assesses the recurrence of adverse events connected with injections.
The study goes on to describe the potential of adverse effects. Of the 666 filler procedures using the microcannula technique, three treatments (0.5%) produced adverse events on the day of service, and during the two-week follow up 32 procedures (4.8%) produced adverse effects. In total, only 5.4% of treatments produced adverse events. These were on smaller needles, such as the 22 gauge.
None of the procedures using the 30-gauge microcannula produced adverse events at the 2-week follow-up. The data support that the microcannula technique is a safe and effective alternative to stiff rigid needles for the injection of filler to minimize everyday adverse events.
At the Face Medical Supply store, you can find 18,22,25,27, and 30 size gauge microcannula's at various lengths. We sell high-quality microcannulas that will perform any filler injection task you need. The results show that microcannula injections are the future.
Conventional needles are stiff and pierce deep within the skin. Microcannula, however, is flexible and possesses a blunt tip. Instead of piercing through the tissues, a cannula opens up a path between the skin. This method allows for less damage to occur to the inner tissue, which reduces bruises and pain.
Due to its flexibility, the microcannula can perform filler injections in multiple locations from a single point of entry. Many areas regularly treated with fillers are cheeks, marionette lines, lips, temples, hands, nose, nasolabial folds, and the prejowl regions.
Microcannula for filler injection offers numerous advantages over conventional needles, such as:
These results create comfort for clients allowing them to take the risk to go in for an injection. It also increases the chance of repeat customers since they will recover faster and notice much less pain at your location specifically.
During filler injection using Microcannula, the first step is to create a small entry point in your skin using a fine needle. Creating an entrance is an essential step because the Microcannula possesses a blunt tip and is not able to pierce into the skin on its own. Since the entrance point is tiny, it does not cause much pain or bleeding. The microcannula is then carefully inserted into the tiny opening and guided underneath your skin to reach the sections for filler injection.
The fantastic quality is that as the Microcannula slides through the spaces between the tissues, the blunt tip can be moved under the skin without causing any injuries to the tissues. The patient often does not feel any major pain, mostly pressure, as the doctor moves it under their skin.
Lip augmentation has developed momentum in recent years and has rapidly become one of the most popular bodily enhanced sites. Proper lip augmentation is often about looking at the dimensions of a patient's face to determine which shape best complements the rest of their facial features.
Each practitioner will have a unique treatment approach to achieve the desired results. However, each will either use a hard needle or a microcannula for injection. This leaves the question: Which is better to inject with a needle or cannula? The cannula is definitely what many doctors prefer and here's why.
Similar to needles, micro cannulas have a hollow bore, allowing the filler to pass through into the tissue. The difference is instead of a sharp tip like needles, cannulas have a blunt end. The method entails dulling the skin with ice, then injecting a small amount of local anesthetic beneath the skin with a tiny needle. When the skin around the lip is numb, a needle pierces the skin, and then the cannula is threaded into the puncture site providing access for filler placement.
There are many benefits of using a blunt-tipped cannula for lip enhancement, including:
The choice to use a microcannula depends on the preference of the doctor. Although needles are easy to use, they are more likely to cause bruising or transfer filler substance into a blood vessel where they are not wanted.
The accuracy of micro cannula is one of the most sought after abilities for facial injections. The Microcannula's allow there to just be one small point of entry for the needle. The flexibility of the microcannula then allows it to travel to various locations where the filler can be injected. This allows for minimal tissue damage and almost no pain.
Regardless of what the Doctor is using the utmost care should always be taken to ensure safety for the patient. For example, the tear trough region under the eye is more likely to bruise with a needle. Although not foolproof, microcannulas significantly reduce the risk of bruising and unintended injection into a vessel. Cannulas can also reduce trauma, discomfort, and swelling.
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