Why You Should Review Injecting Techniques

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Injectables are one of the many popular non-cosmetic procedures. Around 45% of the aesthetic/cosmetic procedures done in 2015 in the US was injectable procedures. It ranks high as an alternative to cosmetic surgery, and it is expected to rise in the coming years. These procedures have received praise by many patients. However, there is a constant need for reminder on injecting dermal fillers and botulinum toxin on patients. It is all in the [method of] injection, declares all practitioners. Additionally, some studies and researchers have emphasized the importance of administering procedures.

Some patients have reported that they have issues with fillers, which have caused adverse side effects like disfiguration of the face and vision loss. These side effects should serve as reminders to practitioners.

In the latest study by Scheuer, Sieber, Pezeshk, Campbell, Gassman, and Rohrich (2017) the authors present how to minimize problems in administering soft tissue filler injections. The authors suggest to inject slowly with small doses. In addition, a serial puncture technique is best in high risk areas. They cover six regions, which are considered danger zones.

Even with experience, physicians and certified injectors could still make mistakes in administering these injections. Thus, physicians must remember these safety concerns and administering of injections.

 Brow and Glabellar Region

  • Digital injection must be applied.
  • The authors recommend that intradermal injections must be done for this area.
  • Blindness and tissue loss are common serious side effects in this region.

Temporal

  • The measures of the danger zones in this area are 2.5 mm lateral and 3.0 mm superior to the peak of the brow (Scheuer, Sieber, Pezeshk, et al., 2017).
  • Deep and superficial injections can be done in this area,
  • The adverse side effect when injecting in this area is blindness.

Infraorbital

  • Practitioners should refrain from injecting deeply
  • Authors suggest to inject laterally and pushed medially
  • Tissue necrosis is an adverse side effect in this region

Lips/Commissure

  • On the commissure, the linear crosshatching method in injecting is safe.
  • Injections done in either lips must be done superficially with around 3mm deep.
  • Tissue necrosis is a serious side effect in these regions.

Nasolabial Fold

  • Intradermal injections can be administered as well injected in the preperiosteal plane.
  • Injections on the deep and superficial subcutaneous and dermal areas in the nasolabial fold are safe
  • On the alar base, only intradermal injections should be administered.

Nose

  • Fillers should be injected deeply and greater than 3mm.
  • As suggested by the authors, any injections done on the tip and dorsum should be in the preperichondrial and preperiosteal planes.
  • Tissue necrosis and visual loss are some of the adverse side effects.

To learn more about the injection techniques, you can watch the video provided by the authors here: http://journals.lww.com/plasreconsurg/Pages/videogallery.aspx?videoId=972&autoPlay=true