What Determines the Needle Size in Restylane?

Question

Has the size of the needle changed over the years to improve the injection process of fillers like Restylane, or is it more in the technique?

Kenneth D. Steinsapir, MD · Answer

This needle has an oversized internal bore relative to the diameter of the needle which helps the injector place the material. This works extremely well with both Perlane and Restylane. This treatments are generally very comfortable with the local anesthetic that is now mixed with these fillers.

Jessica J. Krant, MD, MPH · Answer

Generally, the needle size of the fillers has stayed the same (smaller needle for the thinner fillers, bigger needle for the thicker ones), but there has been some advancement in the details of the needle engineering and design that are intended to handle the fillers for a smoother delivery and more reliable performance. However, of course with more experience over years of use, techniques have also advanced over the years. The result is that fully educated, well trained physician injectors in the four core facial cosmetic specialties (board certified dermatologists, plastic surgeons, oculoplastic surgeons, and ENT/facial plastic surgeons) are getting better and better at achieving great results with fewer side effects. If you go to the right doctor.

Donna Bilu Martin, MD · Answer

The needle is included in the package of restylane. Regarding the question of technique, fillers in the past were used primarily to fill the nasolabial folds. However, aging and volume loss doesn't just happen in one area. Since then, most dermatologists and plastic surgeons now look at the face as a whole to assess where volume is needed, rather than just trying to fill one wrinkle or fold. Areas like the temples, cheeks, tear troughs, marionette lines, chin, lips, and jawline can all be treated to achieve a more natural, balanced result. Note that all these areas are treated off-label, meaning the FDA has not approved the filler for these areas. The most important thing is to see a board-certified physician experienced in these treatments.

Ted Brezel, MD · Answer

Restylane and Juvederm come pre-packaged with suggested needles that the physician can attach prior to injection. However it is up to the physician's discretion to use them or any needle of their liking. Several years ago Medicis he company that distributes Restylane made a change to the needle that is provided. The change involved the use of a needle with a larger internal bore (internal diameter) without a corespondent increase in the outer diameter. The advantage was that improved the flow characteristic of the filler. The fact that the external diameter didn't change means that there is no corresponding increase to the discomfort for the patient.

Enrique Etxeberria, MD · Answer

Yes they have changed. Nowadays, needle diameter and length are minimal, comparing with diameter and lenghts of ten years ago. In the other hand, current fillers, like Restylane or Juvederm, are mixed with an anesthetic (Lidocaine); this fact makes a big difference when applying the filler. As you say, there are many technical facts that alter a "paiful experience" to an "almost insignificant experience" as:

	
		Selective nerve blocking - with local anesthesia (if necessary)
	
		Preparing infiltration area with topic anesthetics (gel/ointment/cream) [f.e. EMLA] 20 minutes prior to infiltration process.
	
		Good infiltration technique (no all fillers are infiltrated in different facial areas in the same manner: deep, strenght, needle-skin angle,...)
	
		Your doctor can choose the filler "pre-mixed" with anesthetics.
	
		Injection (infiltration) speed.


	A lot of small details make the difference.

Steven Wallach, MD · Answer

The restylane syringes come with a specific needle from the compnay whichis small enough to limit discomfort but large enough to allow the product to flow easily.

Michael McCracken, MD · Answer

Restylane comes with a needle in the package, and Restylane did change the needle a year or two ago.  However, the injector can put any size needle they want onto a syringe of Restylane (or any other product).  I recently began doing the majority of my injections with a cannula rather than a needle. 

	I firmly believe that the experience of your injector and their technique are much more crucial to your outcome than the size of the needle they use.

	If your injector is blaming your results on a needle, I would recommend looking for another injector.

John Whitt, MD (retired) · Answer

Restylane comes pre-packaged with the needle recommended for injection. It is a small needle which both minimizes the discomfort associated with injection and also helps in the placement of small volumes when this is desired.

Francis R. Palmer, III, MD (retired) · Answer

Restylane, Juvederm, Radiesse and Perlane all come with standard needle sizes that work very well.  We use these for injecting these soft tissue fillers.

Mitchell Schwartz, MD - Account Suspended · Answer

The use of a larger internal bore needle as well as Restylane being premixed with lidocaine has greatly improved the level of discomfort felt with these injections. However, the degree of discomfort and bruising from filler injections may also be affected by injection techniques such as fan like injections, higher injection volumes, and more rapid injection times.

What Determines the Needle Size in Restylane?

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