• #2-4. Pathogenesis of Blindness Caused by HA Fillers


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    The needle tip or cannula tip must be located in the blood vessel.


    The needle is so easy to penetrate the blood vessels that it may not beeasy for the needle to be located exactly in the blood vessel. On the other hand, the large-diameter cannula is difficult to penetrate the blood vessel wall, but once it penetrates the wall, the cannula tip may be more exactly located in the blood vessel than the needle because the cannula is difficult to penetrate the opposite wall. 


    The needle or cannula must fill the blood vessel.


    Let us assume that, during a nose filler procedure with a 30G needle, the needle penetrates the dorsal nasal artery and then the filler material enters the blood vessel. If the diameter of the blood vessel is 1mm, the needle cannot fill the blood vessel (the diameter of the needle is 0.32mm). Even if the filler is injected, it may move to both sides of the blood vessel as the pressure is difficult to be completely delivered to the blood vessel wall.


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    This is because the fillers move where the pressure is the lowest. In this case, the volume of the filler that is injected through the needle and moves towards the ophthalmic artery may be less that the volume originally intended to be injected. This is because the filler may move to both sides. 


    On the other hand, if, during a nose filler procedure with a 23G cannula, the cannula tip penetrates the blood vessel and is in the dorsal nasal artery, it can fill the blood vessel. If the filler is injected at this time, the filler will move to one side of the cannula tip, and a larger volume of filler than originally intended may be injected. This is because the pressure in the blood vessel is lower than that of the tissue. 


    -To be continued   

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