Blood Aspiration Test for Cosmetic Fillers to Prevent Accidental Intravascular Injection in the Face

Abstract

The aspiration test was reliable with 53% syringes and needles tested. Fillers that have a negative aspiration test may be applied when the needle gauge is adjusted.

Sensitivity of aspiration as a safety test before injection of soft tissue fillers

“…In another recent publication, where the reliability of aspiration as a safety test with different STF materials was also examined, 60% of the tests were false negative, which is comparable to our results …”

“…16 In a recent study, where the reliability of the aspiration study was examined in a rabbit ear model, results were positive for four STF products tested with five different needle sizes. 17 However, with in vivo experiments, one can never be certain that the needle lumen is indeed intra-arterial at the moment of aspiration as hand tremors can rapidly effect needle tip position. This can lead to a true-negative result under the assumption that the needle is placed intravascularly.…”

“…In the current study, the 28-G needle (19 mm) was associated with more false-negative results than the 30-G needle ( In another recent publication, where the reliability of aspiration as a safety test with different STF materials was also examined, 60% of the tests were false negative, which is comparable to our results. 17 For optimal results and accurate product placement, anatomic knowledge is a key. In addition, the risk of intra-arterial embolisms can be reduced by adhering to the following advice:…”

Experience and Management of Intravascular Injection with Facial Fillers: Results of a Multinational Survey of Experienced Injectors

“…Prevention strategies suggested include aspiration (although a negative or positive aspiration cannot be relied upon [21]); slow low-pressure injection technique; continually moving the needle or cannula while injecting; care during injecting while patients are under any form of anesthesia; injecting small amounts at a time; observing skin changes during injection and in the immediate postinjection period (for pallor, mottling), and taking adequate notice of the underlying anatomy [18,19]. The use of widebore cannulae to inject fillers into high-risk areas may also be a safer alternative to needles.…”

A Novel Needle Structure that Can Avoid Intravascular Injection of Any Filler

“…Aspiration before injection is not completely safe because successful aspiration is achieved only with the proper gauge size for different fillers. 1,2 No method is 100% safe during the injection process, because it is difficult to determine the precise position of the tip and distinguish whether it is inside the vessels or not.…”