Influence of needle size and injection angle on the distribution pattern of facial soft tissue fillers.
facial anatomy
hyaluronic acid
injections
layers of the face
needles
safety
soft tissue fillers
Journal
Journal of cosmetic dermatology
ISSN: 1473-2165
Titre abrégé: J Cosmet Dermatol
Pays: England
ID NLM: 101130964
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
16
06
2019
accepted:
19
06
2019
pubmed:
10
7
2019
medline:
10
7
2019
entrez:
9
7
2019
Statut:
ppublish
Résumé
Soft tissue filler injections are performed using either sharp-tip needles or blunt-tip cannulas. Product can change planes in an uncontrolled manner during needle injections, potentially leading to unintentional intra-arterial placement. There is a paucity of data on the influence of injection angle on the dispersion patterns of soft tissue fillers. A total of 126 injection procedures were conducted in seven Caucasian body donors (four males, three females) with a mean age of 75.29 ± 4.95 years and a mean body mass index of 23.53 ± 3.96 kg/m Utilizing a 30G needle (compared to a 25G needle) reduces the superficial spread with OR 0.70 (95% CI, 0.48-0.99) and P = 0.049, whereas injecting at 90° (vs 10° with the bevel down) increases the odds for superficial spread with OR 10.0 (95% CI, 7.11-14.09) and P < 0.001. Precision during soft tissue filler injections, defined as the product remaining in the plane of intended implantation, can be enhanced by changing the needle size and the injection angle. Utilizing a 30G needle and injecting at a 10° angle with bevel facing down reduces the uncontrolled product distribution into superficial fascial layers.
Sections du résumé
BACKGROUND
BACKGROUND
Soft tissue filler injections are performed using either sharp-tip needles or blunt-tip cannulas. Product can change planes in an uncontrolled manner during needle injections, potentially leading to unintentional intra-arterial placement. There is a paucity of data on the influence of injection angle on the dispersion patterns of soft tissue fillers.
MATERIALS AND METHODS
METHODS
A total of 126 injection procedures were conducted in seven Caucasian body donors (four males, three females) with a mean age of 75.29 ± 4.95 years and a mean body mass index of 23.53 ± 3.96 kg/m
RESULTS
RESULTS
Utilizing a 30G needle (compared to a 25G needle) reduces the superficial spread with OR 0.70 (95% CI, 0.48-0.99) and P = 0.049, whereas injecting at 90° (vs 10° with the bevel down) increases the odds for superficial spread with OR 10.0 (95% CI, 7.11-14.09) and P < 0.001.
CONCLUSION
CONCLUSIONS
Precision during soft tissue filler injections, defined as the product remaining in the plane of intended implantation, can be enhanced by changing the needle size and the injection angle. Utilizing a 30G needle and injecting at a 10° angle with bevel facing down reduces the uncontrolled product distribution into superficial fascial layers.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1230-1236Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
American Society of Plastic Surgeons. 2018 National plastic surgery statistics. 2018. https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-report-2018.pdf. Published 2019. Accessed April 14, 2019.
Beleznay K, Carruthers J, Humphrey S, Carruthers A, Jones D. Update on avoiding and treating blindness from fillers: a recent review of the world literature. Aesthetic Surg J. 2019;39(6):662-674.
Beleznay K, Carruthers J, Humphrey S, Jones D. Avoiding and treating blindness from fillers. Dermatologic Surg. 2015;41(10):1097-1117.
Cotofana S, Lachman N. Arteries of the face and their relevance for minimally invasive facial procedures: an anatomical review. Plast Reconstr Surg. 2019;143(2):416-426.
Goodman GJ, Roberts S, Callan P. Experience and management of intravascular injection with facial fillers: results of a multinational survey of experienced injectors. Aesthetic Plast Surg. 2016;40(4):549-555.
Cotofana S, Schenck TL, Trevidic P, et al. Midface: clinical anatomy and regional approaches with injectable fillers. Plast Reconstr Surg. 2015;136:219S-234S.
Sykes JM, Cotofana S, Trevidic P, et al. Upper face: clinical anatomy and regional approaches with injectable fillers. Plast Reconstr Surg. 2015;136(5 Suppl):204S-218S.
Suwanchinda A, Webb KL, Rudolph C, et al. The posterior temporal supraSMAS minimally invasive lifting technique using soft-tissue fillers. J Cosmet Dermatol. 2018;17(4):617-624.
Schenck TL, Koban KC, Schlattau A, et al. Updated anatomy of the buccal space and its implications for plastic, reconstructive and aesthetic procedures. J Plast Reconstr Aesthetic Surg. 2018;71(2):162-170.
Frank K, Koban K, Targosinski S, et al. The anatomy behind adverse events in hand volumizing procedures. Plast Reconstr Surg. 2018;141(5):650e-662e.
Schenck TL, Koban KC, Schlattau A, et al. The functional anatomy of the superficial fat compartments of the face: a detailed imaging study. Plast Reconstr Surg. 2018;141(6):1351-1359.
Cotofana S, Gotkin RH, Frank K, et al. The functional anatomy of the deep facial fat compartments - a detailed imaging based investigation. Plast Reconstr Surg. 2019;143(1):53-63.
Cotofana S, Koban CK, Frank K, et al. The surface-volume-coefficient of the superficial and deep facial fat compartments - a cadaveric 3d volumetric analysis. Plast Reconstr Surg. 2019;143(6):1605-1613.
van Loghem J, Humzah D, Kerscher M. Cannula versus sharp needle for placement of soft tissue fillers: an observational cadaver study. Aesthetic Surg J. 2016;38(1):73-88.
Pavicic T, Webb KL, Frank K, Gotkin RH, Tamura B, Cotofana S. Arterial Wall penetration forces in needles versus cannulas. Plast Reconstr Surg. 2019;143(3):504e-512e.
Pavicic T, Frank K, Erlbacher K, et al. Precision in Dermal filling: a comparison between needle and cannula when using soft tissue fillers. J Drugs Dermatol. 2017;16(9):866-872.
Foissac R, Camuzard O, Piereschi S, et al. High-resolution magnetic resonance imaging of aging upper face fat compartments. Plast Reconstr Surg. 2017;139(4):829-837.
Suwanchinda A, Rudolph C, Hladik C, et al. The layered anatomy of the jawline. J Cosmet Dermatol. 2018;17(4):625-631.