Using a needle versus cannula: the advantages and disadvantages

MISS RUMI KISYOVA DR ALEX KARKHI

Non-surgical youth restoration is becoming more and more popular among men and women who wish to reverse the signs of ageing without operative procedures and with minimal downtime. Facial ageing occurs due to loss of volume of the facial fat compartments and bony skeleton degeneration. The application of dermal fillers and neurotoxins can significantly restore facial appearance. Despite being relatively simple and straightforward when done by a fully qualified practitioner, the procedure is still associated with significant complications such as Tyndall effect, necrosis, blindness or even stroke (DeLorenzi, 2013; King, 2016; Ansari et al, 2018).

The dermal filler can be injected using different size needles or blunt cannulas, depending on the area treated, the desired effect and the experience of the person performing the procedure. Generally, a cannula is considered safer as it lacks the sharpness of the needle. There are many reported incidents of skin necrosis or vascular occlusion when using needles, as they can penetrate blood vessels easily (Jewell, 2018). However, needles still have areas of application, especially when precision in volume augmentation is needed. In these situations, the sharp needle has created an advantage over the cannula. It can be appreciated that the needle acts like a microscalpel, and the risks of vascular penetration, vascular occlusion, bleeding and haematoma, nerve or muscle injury, periosteal microtrauma, etc, are much higher. Taking this into consideration, the needle can still be used effectively for filler delivery, injecting the product as a slow, continuous bolus in the supra-periosteal layer and doing regular aspirations to check for vascular injury.