Full Facial Contouring: Cannula vs. Needle

Cannula vs. Needle

So for the much-debated issue of needle vs. cannula…Those of you who have trained with us know—for us, this issue is really a NON-issue. It’s a very clear, evidence-supported concept fully rooted in science and clinical evidence. But for those who have not trained with us or those who are still only dabbling into cannula use, please hear me out. 

So here it goes—based on studies, it is indisputable that a cannula is safer. Those of you who primarily work with HA products understand me – nothing else makes us lose more sleep at night than the dreaded chance of intravascular occlusion. Well, cannula’s got you here. Multiple studies have repeatedly shown a higher safety profile with using larger bore cannulas (read at least 25G and bigger) so it’s a no-brainer here. 

When it comes to anecdotal evidence (I was a needle injector for 10 years), it is also indisputable based on my own clinical practice that using a cannula lead to significantly reduced swelling and UNBELIEVABLY reduced bruising (as in day-and-night different). Why is that? Well, as you may know, significantly fewer entry points are needed to enter the tissue when using a cannula. Remember, the cannula can deliver product up to 2 inches away from the entry point vs. using a needle where every site needing volume needs to be penetrated again and again. 

The other significant difference resulting in much-reduced swelling lies in the concept of tissue planes. As you may know, the delivery of needles and cannulas are very different. Cannula being a longer, more flexible device, can be very precisely positioned in the desired tissue plane whereas a needle, being stiff, cannot be localized with similar precision (unless we are using an extremely long needle and then we are forgoing any control claimed with needle use). Once the chosen plane is targeted, the product delivery is usually more flawless, smooth, bump and swelling free. While I cannot support this with studies, based on my own experience, I strongly believe that proper cannula use leads to reduced acute and delayed nodules with ALL product types due to smoother delivery of the filler of choice. 

Lastly, let me touch upon the actual aesthetics of cannula use. Guys, come on! These methods are NOT COMPATIBLE!!! I like to use simple analogies and here it goes: using needle vs. cannula is similar to comparing hammering a nail in using a hammer vs using finest paintbrush to create the most precise, gentlest strokes. Yes, we still use needles to fine-tune superficial rhytids, but those devices are definitely a “no go” when it comes to volumetric corrections of the face. 

As always, we are here to answer your questions and to connect for your mentorship session. View our next Master Course dates HERE. See you all soon in beautiful Naples, FL!

– Dr. Irene

Picture of Irene Gladstein, M.D., F.A.C.S.

Irene Gladstein, M.D., F.A.C.S.

With her innate passion for the industry, a keen artistic eye, and fervent work ethic, Irene Gladstein, M.D., F.A.C.S., has established herself a true leader in aesthetics.

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