My preferred needle is a 27 gauge 1 1/4 inch. I have high-quality 30 gauge 1 inch needles but to reach the center of the lip from the lateral, sure sometimes the 1 inch is too short. Whenever possible I use highest quality needles generally made in Japan by companies like TSK. Unfortunately TSK does not make a 30 gauge needle that’s longer than 1 inch.I typically inject lidocaine with high epinephrine concentrations in the lab prior to doing lip filler’s to make the lip filler painless and to minimize the chance of bruising. For this are use a 1 inch 30 gauge needle. I typically wait at least 10 minutes after injecting the lidocaine with epinephrine before placing the filler. My preferred filler is flume because it gives substantial volume that seems to last. I typically spend 45 minutes with patients doing lip fillers. It’s not something I prefer to have patients go through on a regular basis. Having patience be completely numb so they feel zero discomfort during injecting the filler allows me precision work with the best aesthetic outcome. The vasoconstriction from the epinephrine minimizes the chance of having any bleeding or bruising. Because of this I can inject multiple times touching up each quadrant until the final desired volume and shape has been achieved.perhaps a bit technical. Hope that helps. Best, Mats Hagstrom MD
