Is constant needle motion during soft tissue filler injections a safer procedure? A theoretical mathematical model for evaluating patient safety

Abstract

BackgroundThe safety rationale behind the constant needle motion injection technique is based on the assumption that due to the constant needle motion and simultaneous soft tissue filler material administration a smaller amount of product per area may be injected into an artery if an artery within the range of the moving needle is inadvertently entered.ObjectiveTo perform mathematical calculations for determining the probability for causing intra‐arterial product administration when constantly moving the needle during facial aesthetic soft tissue filler injections.MethodsThis study was designed as a theoretical investigation into the probabilities for causing adverse events due to intravascular injection of soft tissue filler material when constantly moving a 27‐G needle during facial soft tissue filler administration.ResultsIt was revealed that with a higher number of conducted injection passes a greater soft tissue area can be covered by the needle. The odds of encountering an artery within the covered soft tissue volume and the odds of injecting any volume greater than zero into the arterial blood stream increases with the number of performed injection passes. This increase is greatest between 1 and 10 performed injection passes.ConclusionThis model demonstrates that the constant needle motion technique increases the probability of encountering an artery within the treatment area and thus increases the odds for intra‐arterial product administration. The constant needle motion technique does not increase safety but rather may increase the odds of causing intra‐arterial product administration with the respective adverse consequences for the patient.

High-dose pulsed hyaluronidase for managing nasal skin necrosis following hyaluronic acid treatment in nasolabial folds: A case report

“…It's noteworthy that even minuscule amounts of HA above zero can trigger obstructive or compressive vascular events, potentially resulting in irreversible complications for patients. 12 …”