SAFETY IN DERMAL FILLER INJECTION: ASPIRATION OR CONSTANT NEEDLE MOVING?

A. Lanciani^1†, S.R. Tari^‡1, S. Benedicenti³, S.A. Gehrke^4‡, D. Amuso¹ and A. Scarano¹

¹Department of Innovative Technologies in Medicine and Dentistry, University of Chieti–Pescara, Chieti, Italy;
²Faculty of Oral and Dental Medicine, Ahram Canadian University, Egypt;
³Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy;
⁴Department of Research, Bioface/PgO/UCAM, Montevideo, Uruguay, Department of Biotechnology, Universidad    Católica de Murcia (UCAM), Murcia, Spain

^†These authors contributed equally to this work as co-first Authors
^‡These authors contributed equally to this work as co-last Authors

Correspondence to:
Antonio Scarano, DDS, MD
Department of Innovative Technologies in Medicine and Dentistry,
University of Chieti-Pescara,
Via Dei Vestini 31,
66100 Chieti, Italy
e-mail: ascarano@unich.it

Received: 12 January  2024 Accepted: 22 February 2024

ISSN 2975-1276 [online] Copyright 2024 © by BIOLIFE This publication and/or article is for individual use only and may not be further reproduced without written permission from the copyright holder. Unauthorized reproduction may result in financial and other penalties. Disclosure: all authors report no conflicts of interest relevant to this article.

ABSTRACT

Although dermal filler injections are extensively used worldwide, no consensus within the scientific literature determines precise guidelines for reducing the risk of vascular occlusion. This narrative review aims to distinguish whether the risk-reduction maneuvers proposed by the various authors are derived from anecdotal knowledge or based on scientific evidence. To pursue the objectives of the present study, a PubMed search was used using the search string (“aspiration” OR “needle movement” OR “needle motion”) AND “filler.” Articles were selected based on inclusion criteria. Twenty-five studies were chosen from 58 studies published between 1980 and 2023. Four opinion categories were compiled: 12 studies against retro-aspiration, 1 study in favor of retro-aspiration, 4 articles partially in favor of retro-aspiration, and 8 articles determined that further research is needed. The review shows no clear guidelines on vascular occlusion prevention techniques. This is due to inadequate study designs that reflect clinical reality. Therefore, further research is needed, focusing on realistic study designs applicable to everyday clinical practice.

KEYWORDS: dermal fillers, injections, aspiration, needle motion