Injections

Question 1

How to minimise discomfort

Answer 1

Slow bolus

Question 2

Benefits of low pressure injections

Answer 2

Reduce risk of vascular occlusion

Question 3

Large bore needles

Answer 3

Increase likelihood of positive flashback

Accomodate lower extrusion pressire

Question 4

Higher G-prime filler

Answer 4

27G needle due to extrusion force needed

Question 5

Lower G-prime filler

Answer 5

30G needle

Question 6

Anatomical Layers

Answer 6

1. Skin
2. Superficial fat
3. Muscles/SMAS
4. Deep fat
5. Periosteum

Question 7

Visual cue for needle depth

Answer 7

Intra-dermal - grey of the needle can be seen

Deep dermal - shape of the needle can be seen

Question 8

Techniques for placing filler

Answer 8

Linear threads
Blanching
Bolus
Fanning
Cross hatching
Serial puncture

Question 9

Bolus technique common layer

Answer 9

Layer 4 - deep fat

Question 10

Linear thread common layer

Answer 10

anterograde of retrograde

Layer 2 - superficical fat
Layer 4 - deep fat

Question 11

Blanching

Answer 11

Multiple small papules with fine bore needle

Tenting skin with needle

Low G prime filler

Perioral, perioribital lines, neck & declolletage, hands & feet

Question 12

Advantages of fanning

Answer 12

Spread product through a single entry point

Question 13

Advantages of cross hatching

Answer 13

Fiill proad areas

Physical support & stability for tissues

Question 14

Needle Pros

Answer 14

Easier to learn to use

Precise placement of prescise volumes

Easier to assess depth through tenting

Low dead space

Cheaper

Question 15

Needle cons

Answer 15

Bruising

Higher risk of intravascular injection

More entry points required to spread product

Rigid and limited by length

Question 16

Cannula Pros

Answer 16

Flexible

Blunt - Lower risk to critical structures

Single entry point, can spread product

Question 17

Cannula Cons

Answer 17

More expensive

Increased risk of infection

Increased dead space

Less accuracy and control

Question 18

At what gauge do cannulas become sharp

Answer 18

above 25G

Question 19

Recommended areas for cannula

Answer 19

Deep mid face

Superficial temporal fascia

Nasolabial folds

Near angular artery

Question 20

Safe injection rate

Answer 20

2 minutes/0.3ml

Question 21

Needlestick injury management

Answer 21

1. Encourage bleeding
2. Wash wound with soap and water 2 minutes
3. Fresh waterprood dressing
4. Inform line manager
5. Record incident
6. Risk assessment for further blood test