Safer Injections with Needle Punching Technique

Filler injections into the glabella come with risk of necrosis from vascular compression, obstruction, or direct injury.

A recent study in the Journal of Cosmetic Dermatology examines the use of a needle punching technique for to make filler injections safer in the glabellar region by avoiding the supratrochlear artery and its branches.

In the retrospective study, which included 50 patients, researchers used a 23-gauge punching needle at three equidistantly spaced sites inserted perpendicularly through the skin. The needle was inserted until it met the periosteum of the frontal bone and was then withdrawn.

“Once the bleeding is controlled through pressure application, an alternate site located 1-2mm above or below is tested for safety using the puncture techniques,” says Dr. Özdemir Çetinkaya, study author, department of dermatology and venereology, Nazillili State Hospital, Aydin, Turkey.

Resulting bleeding from each site was assessed and categized based on whether it originates from the dermal papillae or the lumen of the supratrochlear artery or one of its branches.

Although further studies are needed, study authors say that they, “encountered no cases of skin necrosis or visual impairment among our patients, and we achieved a very high rate of patient satisfaction.”

More details on the study’s findings and needle punching technique can be found at “Pretreatment punch technique guides safe injection” in our sister publication, Dermatology Times.