I was told that I'll have less bruising if fillers are injected with a microcannula vs. sharp needle. Is this true? Do all doctors use these?
Is It Better to Have Fillers Injected with a Microcannula?
Doctor Answers 20
Microcannulas are the future of fillers
Microcannulas are without a doubt the future of injectable fillers. I started using the microcannula several years ago and now perform over 95% of all of my facial injections with microcannulas. I can perform traditional treatment areas such as nasolabial folds, cheeks, melomental troughs (marionette lines), lips, and prejowl sulci. I have also successfully used the microcannula for nasal augmentation ("liquid rhinoplasty"), temple injections, rejuvenation of the hands, and scar treatment. The increased safety, patient comfort, and accuracy of using the microcannula for injectable fillers will soon make it the standard of care.
Each has its own merit.
Because of the rounded tip, I feel more confident in the safety of my injections as well. It is hard to pierce through vessels or muscle with the round tip. This greatly reduces the chances of bruising. I have injected patients on blood thinners with very little to no bruising.
However, cannulas are not ideal for the "finishing touch," or the very fine lines on the surface of the skin. I will often use a needle to "erase" these lines and also break up acne scars. You can't accomplish this without a sharp tip. Also for certain procedures such as defining the border of the lip, you can't use a cannula so close to the surface of the skin - it just can't go there with a round tip!
My patients love the comfort of the cannula. In fact, some come requesting cannula now. It is getting more popular. Please remember it is not right for every situation, and your doctor should be able to offer both to you and explain how each would be best for your needs.
Blunt Cannulas for fillers for wrinkles reduces bruising
The blunt cannula allows blood vessels to be ‘pushed aside’ as the cannula traverses the tissue under the skin instead of piercing the blood vessels as with traditional needles used by most practitioners. This has truly decreased bruising in my practice by 90% especially when using filler under eyes or in the lips. Only a few practitioners use cannulas.
In addition, the blunt cannula technique has allowed me to use the traditional fillers for wrinkles in the nose as part of his nonsurgical rhinoplasty that is also performed only by a few. The fear of using fillers around the eyes and in the nose has always centered around penetrating vessels with the filler material and ‘clogging’ the vessel causing a lack of blood flow to the area that can cause skin death or even blindness. Though this can still happen, gentle movement of a blunt cannula through the tissue in these areas minimize such concerns.
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Microcannula versus needle for fillers
Let me start by saying that I believe that the microcannula can revolutionize the future of filler delivery. I switched to using microcannulas exclusively in my practice well over a year ago and have been very pleased with the results. My patients have been benefiting from less pain, less bruising , less swelling and less risk of complications. I have personally performed several thousand injections and I have never had a significant complication using the traditional needle technique. That being said, when the microcannula was commericially available and FDA approved, I evaluated whether this device would benefit my patients. Nothing in the way of results is compromised (in fact many argue it delivers a smoother result) and there is everything is to gain for the patient. The microcannulas do cost your doctor extra money since they dont come with the filler and that is the only downside, but in my practice this does not translate to the patient. I look at it as a small investment in achieving a better outcome . I doubt this financial issue is what is holding back doctors from switching over, but rather the lack of experience with this new approach to fillers. Something new in the cosmetic world can either be great or just a fad. I believe this concept of filling with microcannulas (not new to many of us who have done fat transfers for years) will be here to stay. My prediction is that one day the majority of the experienced injectors will all be talking about the old days when we used to use sharp needles and wonder why it took so long for so many to switch. You can see one of my videos filmed in 2011 below .
Microcannula, injection without using needles, is great for filling those lines and wrinkles with Restylane or Juvederm;
Let me give you a great example, today one of my patients, who bruises so easily and as well is on aspirin, was in and leaving for europe and a great holiday tomorrow, asking, "I need some filler. but is there anyway I can lessen the chance of bruising" So we talked about it, and I said there was still some risk, but maybe a lot less, if we use a microcannula, a needless needle, so we did, I used a 30 gauge, microcannula, to fill the marionette lines and wow, not only was this so much more comfortable, but so far no bruising, and better yet a great result!
Microcannulas Decrease Bruising and Discomfort with Filler Injection
Microcannulas are an emerging trend in filler placement. Unlike the needle, which has traditionally been used to place fillers, the microcannula has a blunt tip. Without a sharp end, the microcannula is less likely to penetrate a blood vessel thus reducing the risk of bruising. Most patients also find less discomfort with microcannulas. The downside to using microcannulas is that the placement of filler tends to take slightly longer than with a traditional needle -- we have found that most patients feel this to be a worthwhile tradeoff.
Fillers results are injector dependant.
Microcanulas are blunt needles with the hole slightly off the tip. Their use is to decrease the chances of injecting int a blood vesse, which can cause major complications.
Microcanulas are better.
Injecting fillers with a microcannula
Microcannulae have recently become more popular in the U.S. for injection of fillers. Some of the more experienced injectors (specifically dermatologists and plastic surgeons) are using these now, but most injectors are still using regular needles. There is a learning curve with these devices and advanced training is strongly recommended. The microcannula is most useful for areas such as the cheeks, temples, and tear troughs. Because they have a blunt tip, a regular needle must be used to create an opening in the skin through which the cannula can be inserted. Generally, there are fewer puncture sites and less bruising with microcannula use; however, there are certain areas that need to be injected with regular needles to get the best results. I often will use a combination of these techniques in my filler patients to get the optimal results with the least bruising and swelling.
Microcannula and needles
The flip side is that I still use 30g sharp needles for certain points where I have to lay filler on bone- cheekbones and temples are classic examples.
Both micro needles an microcannulas have their place in filling. The most important aspects of filling is the skill, technique, safety and eye of the injector. This gives the best results.
Dr Davin S. Lim
Laser and Aesthetic Dermatologist
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.