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Evaluation of Blunt and Sharp Needle Tips in Correction of the Tear Trough Deformity
Kristopher Katira MD, Matthew Brown MD, James Gatherwright MD, David Rowe MD
University Hospitals Case Medical Center Department of Plastic Surgery
2014-03-10
Presenter: Kristopher Katira
Affidavit:
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Director Name: Hooman Soltanian MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
BACKGROUND:
Injection of the tear-trough has raised concern from a safety standpoint because of its anatomic location near the eye. The current literature provides no information if there is a difference between blunt versus sharp needle tip tear-trough injection in regards to anatomic plane violation and filler placement.
METHODS:
An anatomic study using fresh frozen cadavers was designed to determine any differences between blunt and sharp needle injection of the tear trough. 8 fresh frozen cadaver heads were obtained and 16 hemifacial tear troughs underwent injection. Hyaluronic acid facial filler was mixed with 0.1cc of methylene blue in 1cc syringes. After injection a detailed anatomic dissection was performed on each eyelid within an hour of injection, exposing orbital septum to the infraorbital rim.
RESULTS:
In all cases, the tear trough was visibly altered altered after injection prior to dissection. In all 16 hemifacial sections the periorbita was intact with no staining of the infraorbital fat pads, and the methylene blue stained filler was found along the orbital rim both supraperiosteally and with the subobicularis oculi fat. There were no perceived differences between each side.
CONCLUSION:
This study advocates that sharp needles are equally safe as blunt cannulas as far as anatomic plane violation. The tear trough in many of these cadaver heads was perhaps more accentuated than a typical patient because of the significant age of many of these cadavers. This study does not determine the risk of intravascular injection and retinal or ocular thrombosis.
