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Skilled Manipulation of Tools and Sufficient Procedure Duration

 

The cannula is not a tool which cannot penetrate blood vessels. It should be considered to be a tool which is less likely to pierce blood vessels than the needle. In addition, it takes more time to handle the cannula with great skill than the needle.

 

Thus, if skill level of the injector is low, using a small-diameter needle is judged to lower the risk of blindness. With the needles with a small diameter (30G or less), the amount of filler to be injected at one time is small (Generally, a bolus to be injected is 0.05cc or less.). Therefore, there is a high frequency of injection necrosis due to the filler injection into the blood vessel when the blood vessel is penetrated, but blindness is difficult to occur.

 

In recent years, a growing number of patients are undergoing various types of procedures and operations such as fillers and cog threads. In the case of the nose area, particularly, the number of procedures using threads for fear of blindness is increasing.

 

If a skin tissue damage occurred during the previous filler procedure, the nasal tissue fibrosis may progress, which is followed by the fixed blood vessels and the increased diameter of blood vessels, making it possible for even the cannula to penetrate the blood vessels.

 

Also, fibrosis may occur even in the frontal region, as a growing number of fat grafting has recently been applied in this region; and peeling are often done during forehead filler procedures.

 

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Instead of having a dichotomous way of thinking in which only a single procedure tool is safe and other tools are dangerous, all injectors need to carefully consider advantages and disadvantages of multiple procedure tools to perform a safer filler procedure. In addition, they should become more proficient in handling a procedure tool by consistently using it.

 

By doing so, they are able to know what layer the filler is being injected into and what structure the filler is going through and meeting. They should also know how it feels to pierce the blood vessel, what patients' response is at that time, and what changes happen in the surrounding tissue.

 

Most importantly, filler procedure itself has the potential to become a danger because it should be performed while being invisible. Therefore, it is necessary to ensure sufficient time and charges for procedure. Otherwise, a large quantity of filler is highly likely to be injected for a short time at one time in order to fill in the economic loss. In this case, the risk of vascular events and blindness increases.

 

It is safe and effective to have at least 15 minutes or more per region during a filler procedure and to gradually and gently inject the filler in small quantity. The biggest reason for blindness is the injection of a large amount of filler into the blood vessel at one time under strong pressure.

 

The injector should exercise caution during a filler procedure like an artist’s carefulness and precision. The way of only concentrating on the procedure itself may cause a problem.

 

- To be cntinued