Rates of Vascular Occlusion Associated With Using Needles vs Cannulas for Filler Injection

Area of Science:

• Dermatology
• Aesthetic Medicine
• Plastic Surgery

Background:

• Soft-tissue augmentation using dermal fillers is a common cosmetic procedure.
• Vascular occlusion is a potential complication of filler injections, leading to tissue damage.
• Needles and microcannulas are the primary delivery tools for injectable fillers.

Purpose of the Study:

• To compare the incidence of vascular occlusion events between needle and microcannula injections.
• To assess the risk factors and severity of filler-associated vascular occlusions.

Main Methods:

• Retrospective cohort study involving 370 board-certified dermatologists.
• Data collected on 1.7 million syringes of US Food and Drug Administration-approved fillers.
• Comparison of occlusion rates based on injection technique (needle vs. microcannula) and practitioner experience.

Main Results:

• Microcannula injections were associated with a significantly lower risk of occlusion (1 per 40,882) compared to needle injections (1 per 6,410).
• Injections performed by experienced practitioners (over 5 years) showed a reduced occlusion risk.
• The majority of occlusion events (85%) had no long-term sequelae; nasolabial folds and lips were most affected.

Conclusions:

• Microcannula use in soft-tissue filler injections is associated with a substantially lower risk of vascular occlusion than needle use.
• The overall risk of occlusion is low, and most events are minor and resolve without permanent damage.
• Practitioner experience and injection frequency correlate with decreased occlusion risk.