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Published in Dermatology

Journal Scan / Research · November 11, 2019

Soft Tissue Filler Properties Can Be Altered by a Small-Diameter Needle

Dermatologic Surgery

TAKE-HOME MESSAGE

• In this study, monophasic and biphasic hyaluronic acid (HA) fillers and calcium hydroxyapatite filler were analyzed for changes in particle size and physical properties after passing through a 30-gauge needle. Monophasic HA fillers with smaller particle sizes were associated with minor changes between particle sizes without any differences in rheological properties. Biphasic HA fillers with larger particle sizes showed remarkable changes in particle size and rheological properties. Calcium fillers only demonstrated changes in rheological properties.

• The role of injection-needle diameter in preventing complications associated with fillers remains a controversial issue. This study demonstrates that injection through small-bore needles may lead to altered physical properties and rheological equilibrium of soft tissue fillers. As these changes may potentially affect clinical performance, the authors recommend avoiding small-bore needles for filler injection.

– InYoung Kim, MD, PhD

Abstract 

BACKGROUND

Small-bore needles reduce the complications associated with soft tissue filler injection. Gel particles must be sized appropriately to pass through fine-bore needles with an acceptable extrusion force. However, most soft tissue filler particles are larger than the inner diameter of the needle. The authors hypothesized that the physical properties of these particles change as the gel passes through the needle.

OBJECTIVE

The authors aimed to investigate whether the predesigned physical and rheological properties of the filler change after passage through the small-bore needle.

METHODS AND MATERIALS

Particle sizes of 4 hyaluronic acid (HA) fillers were analyzed using a particle size analyzer. Five soft tissue fillers with different particle sizes were subjected to rheological characterization. All tests were performed using fillers with and without a 30-G needle.

RESULTS

Monophasic HA fillers with smaller particle sizes exhibited small changes between particle sizes but no differences in rheological properties. Biphasic HA fillers with larger particle sizes exhibited remarkable changes in particle size and rheological properties. Calcium fillers exhibited changes in rheological properties.

CONCLUSION

Injection through small-bore needles can alter the physical properties and rheological equilibrium of soft tissue fillers. The authors suggest avoiding small-bore needles as they may affect the rheological equilibrium and clinical performance of fillers.

Dermatologic Surgery

Soft Tissue Filler Properties Can Be Altered by a Small-Diameter Needle

Dermatol Surg 2019 Oct 11;[EPub Ahead of Print], W Lee, W Oh, HJ Moon, IS Koh, EJ Yang 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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