Hyaluronic acid (HA) fillers have increased in popularity. Although complications are rare, knowledge regarding their prevention and management are crucial. The utility of preinjection aspiration has become controversial.
Our study investigated the utility of preinjection aspiration as a safety checkpoint for HA fillers through comparison of physiochemical and rheological properties in an in vitro model.
Whole blood was drawn from vacutainers using syringes containing 10 commonly used HA fillers. Each HA filler was examined with the plunger pulled back at volumes of 0.2 and 0.5 cc. The time required to visualize a flash was recorded. Data were compared using physiochemical and rheological properties, pullback volumes, and needle gauges.
Using a multivariable regression model, HA concentration, elastic modulus (G′), viscous modulus (G″), and complex modulus (G*) had significant relationships with time to flash, whereas needle gauge and pullback volume did not. However, when comparing pullback volume using an appropriate paired analysis, 0.5 cc pullback volume had a significantly decreased mean time to flash than 0.2 cc.
Preinjection aspiration may have utility as a safety checkpoint for HA fillers. Practitioners may have to adjust pullback volume and waiting time to visualize the flash based on physiochemical and rheological properties.
*Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York;
†Private Practice, New York, New York;
‡Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
Address correspondence and reprint requests to: Richard L. Torbeck, MD, Department of Dermatology, Icahn School of Medicine at Mount Sinai, 234 E 85th Street, 5th Floor, New York, NY 10028, or e-mail: richard.torbeck@mountsinai.org
The authors have indicated no significant interest with commercial supporters.
