An Experimental Model Exhibiting Anterograde and Retrograde Vascular Occlusion of Facial Fillers to Avoid Vision Loss
Background:. Facial filler injection techniques that help decrease the risk of vascular occlusion are an important growing area of study. This study demonstrates a model of injecting fillers into a simulated bifurcated arterial system, using different sized needle gauges at a constant injection pres...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-09-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005270 |
| _version_ | 1827805099855970304 |
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| author | Gabriel Scott, MD Meghana Khonda, MD Tammy Hsu, MD Alexander Rivkin, MD Konstantin Frank, MD John Fezza, MD Julie Woodward, MD |
| author_facet | Gabriel Scott, MD Meghana Khonda, MD Tammy Hsu, MD Alexander Rivkin, MD Konstantin Frank, MD John Fezza, MD Julie Woodward, MD |
| author_sort | Gabriel Scott, MD |
| collection | DOAJ |
| description | Background:. Facial filler injection techniques that help decrease the risk of vascular occlusion are an important growing area of study. This study demonstrates a model of injecting fillers into a simulated bifurcated arterial system, using different sized needle gauges at a constant injection pressure.
Methods:. Three facial fillers were injected into a bifurcated intravenous tubing with continuous irrigation at a constant pressure to simulate a vascular system. Videography was used to observe for retrograde flow through the simulated supratrochlear artery to the bifurcation point, where the filler was redirected by anterograde flow into the branch representing the ophthalmic artery.
Results:. Filler injection with retrograde flow to the bifurcation occurred with all the 27G needle trials. In comparison, the 30G needle trials were only able to reach the bifurcation point in three of the nine trials. The average time to the bifurcation point with subsequent ophthalmic artery anterograde flow with the 27G and 30G needles were 8.44 (95% confidence interval ±2.06) and 33.33 (95% confidence interval ±16.56) seconds, respectively.
Conclusions:. Larger 27G needles consistently reached retrograde flow and the bifurcation point faster than 30G needles. This study suggests thinner needles may be less likely to cause retrograde occlusion. |
| first_indexed | 2024-03-11T21:20:46Z |
| format | Article |
| id | doaj.art-42a2ab7c474c4929a0252c38fb90516f |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-11T21:20:46Z |
| publishDate | 2023-09-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-42a2ab7c474c4929a0252c38fb90516f2023-09-28T07:09:03ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-09-01119e527010.1097/GOX.0000000000005270202309000-00030An Experimental Model Exhibiting Anterograde and Retrograde Vascular Occlusion of Facial Fillers to Avoid Vision LossGabriel Scott, MD0Meghana Khonda, MD1Tammy Hsu, MD2Alexander Rivkin, MD3Konstantin Frank, MD4John Fezza, MD5Julie Woodward, MD6From the * Department of Ophthalmology, Duke University Medical Center, Durham, N.C.From the * Department of Ophthalmology, Duke University Medical Center, Durham, N.C.From the * Department of Ophthalmology, Duke University Medical Center, Durham, N.C.† Rivkin Aesthetics, Los Angeles, Calif.‡ Department of Hand, Plastic and Aesthetic Surgery, Ludwig–Maximilians University, Munich, Germany§ Center for Sight, Sarasota, Fla.From the * Department of Ophthalmology, Duke University Medical Center, Durham, N.C.Background:. Facial filler injection techniques that help decrease the risk of vascular occlusion are an important growing area of study. This study demonstrates a model of injecting fillers into a simulated bifurcated arterial system, using different sized needle gauges at a constant injection pressure. Methods:. Three facial fillers were injected into a bifurcated intravenous tubing with continuous irrigation at a constant pressure to simulate a vascular system. Videography was used to observe for retrograde flow through the simulated supratrochlear artery to the bifurcation point, where the filler was redirected by anterograde flow into the branch representing the ophthalmic artery. Results:. Filler injection with retrograde flow to the bifurcation occurred with all the 27G needle trials. In comparison, the 30G needle trials were only able to reach the bifurcation point in three of the nine trials. The average time to the bifurcation point with subsequent ophthalmic artery anterograde flow with the 27G and 30G needles were 8.44 (95% confidence interval ±2.06) and 33.33 (95% confidence interval ±16.56) seconds, respectively. Conclusions:. Larger 27G needles consistently reached retrograde flow and the bifurcation point faster than 30G needles. This study suggests thinner needles may be less likely to cause retrograde occlusion.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005270 |
| spellingShingle | Gabriel Scott, MD Meghana Khonda, MD Tammy Hsu, MD Alexander Rivkin, MD Konstantin Frank, MD John Fezza, MD Julie Woodward, MD An Experimental Model Exhibiting Anterograde and Retrograde Vascular Occlusion of Facial Fillers to Avoid Vision Loss Plastic and Reconstructive Surgery, Global Open |
| title | An Experimental Model Exhibiting Anterograde and Retrograde Vascular Occlusion of Facial Fillers to Avoid Vision Loss |
| title_full | An Experimental Model Exhibiting Anterograde and Retrograde Vascular Occlusion of Facial Fillers to Avoid Vision Loss |
| title_fullStr | An Experimental Model Exhibiting Anterograde and Retrograde Vascular Occlusion of Facial Fillers to Avoid Vision Loss |
| title_full_unstemmed | An Experimental Model Exhibiting Anterograde and Retrograde Vascular Occlusion of Facial Fillers to Avoid Vision Loss |
| title_short | An Experimental Model Exhibiting Anterograde and Retrograde Vascular Occlusion of Facial Fillers to Avoid Vision Loss |
| title_sort | experimental model exhibiting anterograde and retrograde vascular occlusion of facial fillers to avoid vision loss |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005270 |
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