- Blunt-tip cannulas have decreased risk of vessel damage
- Cannulas can be used for superficial to deeper corrections, depending on size and diameter used
- Flexible cannulas can be challenging to penetrate the skin
Blunt-tip cannulas represent a paradigm shift in the injection techniques used by aesthetic physicians who perform injectable filler treatments. Some of these blunt-tip cannulas also have varying flexibility, and their use can result in significantly less bruising as well as less painful procedures compared to traditional hypodermic needles.
"Blunt-tip cannulas appear to be more than just a fad, but instead, they are a natural evolution in the way aesthetic physicians perform filler treatments," says Joe Niamtu III, D.M.D., F.A.A.C.S., a cosmetic facial surgeon in Richmond, Va.
Traditional needles used in filler treatments are associated with pain, tissue damage, bruising, vessel laceration, multiple punctures and more. Blunt-tip cannulas can achieve the same results as traditional needles, but without many of the associated negative aspects. "One of the goals for all cosmetic surgeons is to improve and refine the process of delivering injectable fillers in the tissue. Though traditional needles are the current standard technique used in filler treatments, blunt-tip cannulas can help to reduce downtime through less bruising and are potentially a safer technique, as there is a decreased risk of vessel damage, which could have catastrophic sequelae," Dr. Niamtu says.
LIP VOLUMIZING When volumizing the lips, Dr. Niamtu says he often uses a 20-gauge, 4 cm or 5 cm long, nonflexible microinjection cannula (Tulip Medical), which is traditionally used for the microinjection of fat. Using the 5 cm cannula, one can inject the entire lip or nasolabial fold using a single puncture site. The technique is not only minimally traumatic, but fillers are easier to inject and there is less pain, edema and bruising resulting from the injection.
"Instead of using a sharp needle and sticking it multiple times in the lip, I make a small puncture at the corner of the lip, then feed the cannula through the entire length of the lip and inject the filler as I withdraw the cannula. The cannula allows to me to cut the treatment time in half, and because the tip is blunt, the risk of intravascular injection is significantly reduced. This is my technique of choice when volumizing the lip," Dr. Niamtu says.
OTHER BLUNT-TIP OPTIONS Other blunt-tip cannulas have been developed consisting of different sizes and varying degrees of flexibility. DermaSculpt cannulas (CosmoFrance), approved by the Food and Drug Administration (FDA) are flexible, blunt-tip, disposable microcannulas that can be used for all facial filler indications in the face. The cannulas are offered in three sizes — 30-gauge 1 inch long cannula, a 27-gauge 1.5 inch long cannula and a 25-gauge 1.5 inch long cannula. Depending on the size and diameter used, these cannulas can be used for superficial to deeper corrections and can accommodate different fillers of varying viscosities.
"One main advantage of using a flexible long cannula is that the surgeon can easily cover a much larger surface area of injection from a single point of entry, using the fanning technique," says Raphael Dewandre, chief executive officer of CosmoFrance, Miami Beach, Fla.
A patient is treated with an 18-gauge needle (left) used to make a small entrance puncture to accommodate the cannula. The cannula positioned in the mid-lip (right). The filler is injected while retracting the cannula from the lip. (Photos credit: Joe Niamtu III, D.M.D., F.A.A.C.S.)
According to Mr. Dewandre, these blunt-tip cannulas allow for a practically painless procedure (not requiring local anesthesia), and because the technique is atraumatic, there is minimal to no bleeding or bruising at the target site.