Sensitivity of aspiration as a safety test before injection of soft tissue fillers

Loghem, Jani Aj Van; Fouché, James J; Thuis, Job

doi:10.1111/jocd.12437

Cited by 46 publications

(37 citation statements)

References 16 publications

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“…Possible false negative aspirations raise suspicion of the reliability of this maneuver and hinder the establishment of a universal guideline to promote safety in filler injections [3,[6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…During filler injections when the needle has been primed, the filler that fills the needle may prevent the influx of blood into the syringe upon aspiration. Studies have indicated that blood aspiration patterns during filler injections can vary depending on the filler characteristics and size of the needle or cannula used [6][7][8][9]. This lack of uniformity makes it difficult for researchers to recommend a standardized aspiration protocol which can be generalized to all different fillers.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Blood Aspiration Patterns during Pre-injection Tests of Injectable Fillers

Kim

Hong²,

et al. 2020

Korean Association For Laser Dernatology And Trichology

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Background and Objectives Clinicians have yet to reach a consensus on whether blood aspiration tests are reliable when administering filler injections. Better understanding of the characteristics and patterns of blood aspiration tests for filler injections is important in reducing false negative results. In this study, we sought to outline the characteristics of blood aspiration tests for different types of fillers with different gauges of needles and cannulas. Materials and Methods Four biphasic hyaluronic acid fillers and ten monophasic hyaluronic acid fillers of four brands and two collagen stimulators were tested. Aspiration tests were performed with needles and cannulas of different gauges. The time before blood was seen in the needle hub and the vacuum space patterns generated were analyzed. Results Different aspiration patterns were observed with different fillers, depending on the viscosity of the product and the sizes of the needle and cannula used. Conclusion When factors influencing aspiration are considered, including the characteristics of fillers and the size of injection tools, aspiration tests with proper maneuver can be helpful to increase injection safety.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Analysis of Blood Aspiration Patterns during Pre-injection Tests of Injectable Fillers

Kim

Hong²,

et al. 2020

Korean Association For Laser Dernatology And Trichology

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“…The anatomy of the upper face predisposes it to a higher vascular complication risk, and it is important to be aware of the danger zones when treating patients. As aspiration is unreliable as a safety test for determining intravascular placement of the needle, a cannula is preferred for injection of CaHA combined with slow injection of small amounts of product . In the 70 patients included in this study, there were no incidence of vascular compromise with CaHA.…”

Section: Discussionmentioning

confidence: 99%

Use of calcium hydroxylapatite in the upper third of the face: Retrospective analysis of techniques, dilutions and adverse events

Loghem¹

2018

J of Cosmetic Dermatology

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Calcium hydroxylapatite (CaHA) is a commonly used soft tissue filler for aesthetic facial improvement, in particular for the lower and mid-face. The golden standard for upper facial filler indications is hyaluronic acid (HA) injection. In this report we investigate the safety, efficacy and complication rates after injections of CaHA to the upper third of the face using a variety of different techniques. This was a retrospective analysis performed on patients who had received CaHA in 2016 and 2017 at various dilutions in the upper third of the face (frontal area, eyebrows and temporal hollows) using a number of injection techniques and both blunt-tipped cannulas as well as sharp needles. Records of adverse events and side effects were studied. Seventy patients had been injected with CaHA in the upper third of the face. There were 36 treatments to the frontal area, most with a cannula in the subgaleal space with standard dilution of CaHA (16.7% lidocaine containing epinephrine). There were 13 treatments to the brow, mostly with a cannula and multilevel technique, and 66 treatments to the temporal hollows, mostly with a cannula in the interfascial space with standard CaHA dilution. No serious complications were recorded. CaHA was effective and well-tolerated for a range of upper-face indications. More (prospective) research is required to further determine the value of CaHA treatments in these areas.

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“…Nonetheless, aspiration tests can produce false negatives, wherein, even though the needle tip is located inside a vessel, blood is not detectable during aspiration. While this is thought to be affected by filler rheology, needle diameter, aspiration time, and negative pressure [16,17], aspiration tests with filler appear to be more dependent of conditions inside the needle. Accordingly, we have performed in vivo tests with rabbits and found that all aspiration tests with HA filler were positive when the needle was first primed with normal saline (Fig.…”

Section: As) Aspiration With Proper Techniquementioning

confidence: 99%

ABCs in the Prevention of Filler-induced Ocular Complications

Lee¹,

Moon

Kim³

et al. 2020

Korean Association For Laser Dernatology And Trichology

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Sensitivity of aspiration as a safety test before injection of soft tissue fillers

Cited by 46 publications

References 16 publications

Analysis of Blood Aspiration Patterns during Pre-injection Tests of Injectable Fillers

Analysis of Blood Aspiration Patterns during Pre-injection Tests of Injectable Fillers

Use of calcium hydroxylapatite in the upper third of the face: Retrospective analysis of techniques, dilutions and adverse events

ABCs in the Prevention of Filler-induced Ocular Complications

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