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09-13-19 | Posted by

In addition to the dizzying array of available hyaluronic acid injectable fillers, the means in which they are injected continue to expand as well. Although a pointy needle may be the first tool that comes to mind for injecting fillers, it’s worth getting familiar with the cannula. This alternative injection tool is a thin, flexible tube with a blunt tip that is inserted into an entry site created with a needle, and then used to place the filler. Many physicians prefer a cannula for filler injections because this tool slides through the skin more easily, potentially reducing the trauma that can lead to swelling, bruising and other issues—and Allergan/Abbvie’s Juvéderm’s Voluma XC is the latest hyaluronic acid filler to receive FDA-approval for injection via this technique.

Initially FDA approved in 2013 for the improvement of age-related volume loss in the cheek area, Voluma instantly restores youthful plumpness—with results that can last for up to two years. Voluma can be placed beneath the skin’s surface and/or directly over the bone to help lift and contour the cheeks while providing natural-looking results that can help reduce the look of sagging. In addition to replenishing facial volume, Voluma’s rejuvenating effects can also help improve the appearance of adjacent areas of the face including the nasolabial folds – doc speak for nose to corners of the mouth creases.


Boca Raton, Florida oculoplastic surgeon Dr. Steven Fagien explains, “When using Voluma to restore lost volume in the mid-face, using a cannula can help a physician whose goal is to distribute the product evenly across the treatment area with fewer needle sticks. This can minimize trauma to the skin and, in turn, reduce the potential for bruising and swelling.”

Although Voluma is formulated with lidocaine to minimize discomfort during injections, Dr. Fagien theorizes that the use of a blunt-tipped cannula could have a beneficial effect on the pain associated with treatment. “Imagine the sensation you experience when poking your skin with a needle. Then compare that to what you would feel when poking your skin with a ballpoint pen. Simply put, sharpness of the instrument can affect patient comfort.”

But Dr. Fagien is quick to clarify that Voluma’s recent FDA nod merely means that injectors now have another approved injection-technique option (although may providers have been using the cannula technique for years). “This approval does not imply that a cannula is a better, safer or more effective way to inject Voluma. The provider’s experience, knowledge of facial anatomy and ability to identify the ideal filler and injection technique for the individual patient is more important than the actual instrument used,” he emphasizes.

It’s essential to know that tenderness, swelling and bruising are possible after any injectable filler treatment—whether delivered via needle or cannula. “The choice of injection technique often comes down to the provider’s personal preference based on experience, and this newly-approved option offers yet another way to safely achieve a patient’s desired outcomes.”

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