Using cannulas for dermal filler placement: why, when and how?

Soft tissue augmentation is a common, office-based procedure in which a filler is delivered into the dermis or subcutaneous tissue. The traditional delivery tool for this procedure used to be a hypodermic needle, most often supplied with the product. However, recent years have seen a major shift from using sharp needles for dermal filler injections to using blunt cannulas to deliver product in this procedure.

Similar cannulas have been used extensively for years in cosmetic surgery; predominantly for fat injections. However, these tools have been modified to make them suitable for use in dermal filler placement procedures (Niamtu, 2009). The increasing popularity of this new tool is related to a number of reasons, including:

Traditionally in this procedure, the typical injection technique included use of hypodermic needles to deliver the product sub- or intra-dermally by linear threading, fanning or bridging. Most of these techniques were relevant in the era in which dermal fillers were used as wrinkle ‘correctors’. However, in recent years, there has been a natural evolution to 3-D volumisation of the face, rather than simply filling the lines of the face. As such, the use of cannulas has increased in popularity, owing to the fact that this tool is suitable when filling a large area of the face in the subdermal or supra-periosteal plane. Regions such as tear troughs, midface, temples, forehead, cheeks and marionettes, require even ‘inflation’ by the filler, rather than the more focused approach to filling that is required to address individual rhytides.