‘Needle-less’ filler injection using flexible cannulas

The needle-less filler injection using flexible cannulas is the one of the most important change in the world of dermal fillers. The technique, introduced to wide audience less than 2 years ago, has spread throughout Europe and is spreading very rapidly through South America and Asia.

Aesthetic physicians around the world have embraced this chance to make filler injection strikingly less unpleasant and much safer! Botox injection training specialists have also taken notice.

The concept of a no-needle technique is not a new idea; it has been used for fat transfer for quite some time. Yet, the use of flexible cannulas for dermal fillers seems to lag behind in the US.  

The main obstacle had been the lack of manufacturer of flexible microcannulas . This has changed since last September when FDA gave approval for a flexible, 27G, 1.5” cannula made by Dermasculpt, a French company lead by Dr. Luc Dewandre . The cannula has a blunt tip and a side-hole for filler extrusion.

What are the advantages of using cannula?

• First, the filler can be placed with great precision at any facial area without bleeding or bruising.
• Second, only 2-4 entry points are needed for full face injections.
• Third, the blunt tip of cannula prevents intra-arterial injection, the cause the most devastating complications.
• Forth, patients undergoing cannula injection experience much less discomfort than during needle injections. Fifth, the social downtime associated with traditional technique is practically eliminated.

There seems to be other advantages of using cannulas, theoretical at this point. One is based on the hypothesis that stimulation of fibroblasts by this technique may stimulate additional collagen production. The other considers physical laws of fluids with delayed metabolic process of a filler due to the smallest surface area assumed by the filler injected by cannula.

Is cannula always preferable to needle in facial injections? Chin augmentation, nose and earlobe recontouring are better served with traditional needle. A Tri-bolus technique of upper cheek enhancement is another example.

Overall, the introduction of flexible cannula to our practice is a great step forward allowing much safer injections and detailed facial sculpting.  One must keep in mind, however, that cannula is a tool. Its proper use depends on meticulous knowledge of anatomy, art form and dexterity of the injector.

The only FDA approved flexible cannula is made by Dermasculpt, French company lead by Dr. Luc Dewandre. He is a Vice-President and Co-Founder of the International
Society of Aesthetic and Mesotherapy in Switzerland and the Chairman of the American Institute of Aesthetic Medicine.