A Novel Needle Structure that Can Avoid Intravascular Injection of Any Filler

Huang, Hsiang; Lin, Yu‐Shan

doi:10.1097/gox.0000000000001285

Cited by 4 publications

(5 citation statements)

References 2 publications

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“…[2][3][4][5][6] In contrast, it is thought that needles deliver product more precisely and accurately despite creating more trauma to tissue. 7 However, recent studies have shown that using a needle results in less precise product placement, if precision is defined as the filler material remaining in the plane of intended implantation. 4,5 For instance, fluoroscopy X-ray analyses 5 revealed that needle-injected filler material can run retrograde along the created canal which distributes product in all fascial planes, potentially increasing risk for intra-arterial placement.…”

Section: Introductionmentioning

confidence: 99%

Subperiosteal injections during facial soft tissue filler injections—Is it possible?

Pavicic

Yankova

Schenck

et al. 2019

J of Cosmetic Dermatology

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Background It can be hypothesized that safety during soft tissue filler injection could be enhanced if the product could be positioned between the periosteum and the bone surface i.e. subperiosteal. Aim This study investigated the feasibilityof subperiosteal injections. Patients/Methods We analysed 126 injection procedures performed in seven Caucasian body donors (4 males, 3 females) with a mean age of 75.29 ± 4.95 years [range: 70 – 87] and a mean body mass index of 23.53 ± 3.96 kg/m2 [range: 16.46 – 32.23]. The injection procedures were performed in the forehead, scalp, zygomatic arch and the mandible bilaterally. Injection procedures were conducted using 25G, 27G and 30G sharp‐tip needles (TSK Laboratory, Tochigi, Japan) and at various angles from the bone surface measured with a goniometer: 90 degrees (perpendicular), 45 degrees and 10 degrees (as tangential as possible to bone surface). Results Cadaveric dissections of the injection sites showed that no product was located deep to the periosteum in any of the investigated regions. This indicates that all performed injection procedures positioned the product superficial to the periosteum (100%) with a zero‐success rate of subperiosteal injections. Conclusion In the setting of this cadaveric investigation, despite varying needle size and injection angle, subperiosteal injection could not be achieved. This indicates that the product can spread uncontrolled into more superficial layers yielding an increased risk for adverse aesthetic and vascular events.

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Section: Introductionmentioning

confidence: 99%

Subperiosteal injections during facial soft tissue filler injections—Is it possible?

Pavicic

Yankova

Schenck

et al. 2019

J of Cosmetic Dermatology

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show abstract

“…But aspiration is not 100% safe when using smaller gauge needle. 3 Using a blunt cannula is safer but not suitable in every case and cannot provide a very precise injection point if we wanted to place filler just above the bone or in different plane of our face.…”

Section: Discussionmentioning

confidence: 99%

“…We presented a new needle structure that can detect intravascular injection of filler by using the pressure difference between air pressure and intravascular blood pressure. 3 However, there were technical difficulties in making a septum inside the needle lumen in mass production. Therefore, we build a new prototype needle system without the septum that can still prevent intravascular injection by observing blood reflow because of the pressure difference between air and intravascular blood pressure.…”

Section: Introductionmentioning

confidence: 99%

Novel Double-Needle System That Can Prevent Intravascular Injection of Any Filler

Huang

Lin

2017

Plastic and Reconstructive Surgery - Global Open

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“…1,2 Although facial fillers have a low incidence of complications when administered by trained providers, vascular occlusion leading to blindness and stroke continues to be a risk. [3][4][5][6] Injection techniques and methods of filler delivery that help decrease the risk of vascular occlusion are an important growing area of study. This study aimed to demonstrate an experimental model of injecting facial fillers into a simulated bifurcated arterial system using different sized needle gauges at a constant injection pressure.…”

Section: Introductionmentioning

confidence: 99%

“…One of the most feared complications of facial fillers is intravascular occlusion of arteries. 3 The areas with the highest risk of blindness include the nose, forehead, glabellar region, and nasolabial folds due to close collateral circulation that anastamose with the ophthalmic artery. [4][5][6] One anatomic study showed that the range of supratrochlear vessel volumes from the glabella to the orbital apex ranged from 0.04 to 0.12 mL.…”

Section: Introductionmentioning

confidence: 99%

An Experimental Model Exhibiting Anterograde and Retrograde Vascular Occlusion of Facial Fillers to Avoid Vision Loss

Scott,

Khonda,

Hsu

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Facial filler injection techniques that help decrease the risk of vascular occlusion are an important growing area of study. This study demonstrates a model of injecting fillers into a simulated bifurcated arterial system, using different sized needle gauges at a constant injection pressure. Methods: Three facial fillers were injected into a bifurcated intravenous tubing with continuous irrigation at a constant pressure to simulate a vascular system. Videography was used to observe for retrograde flow through the simulated supratrochlear artery to the bifurcation point, where the filler was redirected by anterograde flow into the branch representing the ophthalmic artery. Results: Filler injection with retrograde flow to the bifurcation occurred with all the 27G needle trials. In comparison, the 30G needle trials were only able to reach the bifurcation point in three of the nine trials. The average time to the bifurcation point with subsequent ophthalmic artery anterograde flow with the 27G and 30G needles were 8.44 (95% confidence interval ±2.06) and 33.33 (95% confidence interval ±16.56) seconds, respectively. Conclusions: Larger 27G needles consistently reached retrograde flow and the bifurcation point faster than 30G needles. This study suggests thinner needles may be less likely to cause retrograde occlusion.

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A Novel Needle Structure that Can Avoid Intravascular Injection of Any Filler

Abstract: Supplemental Digital Content is available in the text.

Cited by 4 publications

References 2 publications

Subperiosteal injections during facial soft tissue filler injections—Is it possible?

Subperiosteal injections during facial soft tissue filler injections—Is it possible?

Novel Double-Needle System That Can Prevent Intravascular Injection of Any Filler

An Experimental Model Exhibiting Anterograde and Retrograde Vascular Occlusion of Facial Fillers to Avoid Vision Loss

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