PEER-REVIEW | INJECTABLE TREATMENTS | Tenderness of the treated area(s)
This analysis specifically looked at the degree of pain or discomfort that patients experienced at the treated area(s) during the microcannula procedure. In all, 62% of patients felt no pain or discomfort during the procedure and 21% of patients reported a discomfort level that ranged between 1 and 3 (Figure 7). Fifteen percent of patients rated the discomfort level between 4 and 6. This indicates that for a majority of patients (85%), the use of the microcannula is a comfortable procedure. The degree of pain that the patient experiences would be dependent on two main factors. The first is the technique used during cannula treatment, as the more aggressive the injector is the greater the degree of discomfort that will be felt. Additionally, if the cannula does not glide easily through the fatty layer, the more pain or discomfort a patient will experience, and forcing the cannula in the wrong plane of tissue will also increase patient discomfort. The second factor is the type of filler used, as fillers with no lidocaine tend to burn as the material is deposited and will increase the discomfort level of patients. All patients enrolled in the study were treated with either the Juvéderm® ULTRA® range or Juvéderm VOLUMA® (Allergan, Irvine, CA), which contains lidocaine.
All patients were asked whether the filler treatment met
their expectations, and 98% of patients
reported ‘yes’.
Patient satisfaction All patients were asked whether the filler treatment met their expectations, and 98% of patients reported ‘yes’ (Figure 8). All patients were then asked to rate the degree of satisfaction starting at 0% and ending at 100%; 63% of patients were between 90% and 100% satisfied; 87% of patients were between 80% and 100% satisfied; and 93% of patients were between 70% and 100% satisfied with their end result (Figure 9). The author also asked in the online
questionnaire, ‘Did the use of the microcannula change your view on future filler treatments?’ and ‘Would you recommend this treatment to your friends?’ In all, 97% of patients responded that the
use of the microcannula had changed their view on future filler treatments, and that 95% of treated patients would recommend the microcannula to their friends (Figure 10).
Figure 9 Expectation rating
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
76 ❚ 93% 87% 63%
Figure 8 Expectations of filler treatment 98%
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
Yes
No 2%
DID THE FILLER MEET YOUR EXPECTATIONS?
Discussion A literature review surprisingly reveals very few medical studies that examine the side-effect profile of microcannula versus hypodermic needle. The study objective of Fulton et al1
was to compare the
injection of dermal fillers with microcannulae versus hypodermic needles with regard to ease of use, amount of filler required to achieve desired aesthetic outcome, perceived pain by patient, adverse events such as bleeding and bruising, and to demonstrate the advantages of single-port injection technique with the blunt-tip microcannula. Ninety-five patients aged 30– 76 years with a desire to augment facial, décolleté, and hand features were enrolled in the study. Anaesthesia was used with a topical anaesthesia peel-off mask of lidocaine/tetracaine. The volume of hyaluronic acid injected was variable, depending on the depth and the extent of the defect. There were no significant differences in the Global Aesthetic Improvement Scale (GAIS) score between the microcannula and the hypodermic needle. The Visual Analog Scale for pain assessment produced
a different picture; pain was described as 3 (mild) for injections with the microcannula and this increased to 6 (moderate) for injections with the hypodermic needle. Mild erythema was observed by the authors of this study following use of the microcannula. Unfortunately, the authors did not quantify the degree or extent of bruising and ecchymosis (for both microcannula and hypodermic needle), except to state that bruising was more marked following the use of the hypodermic needle.
Figure 10 Future filler treatment/friend recommendation 97%
90–100% 80–100% EXPECTATION RATING 70–100%
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
95%
Yes
3% No
DID THE USE OF THE CANNULA CHANGE YOUR VIEW ON FUTURE FILLER TREATMENTS?
Yes
5% No
WOULD YOU RECOMMEND THIS TREATMENTTO YOUR FRIENDS?
October 2013 |
prime-journal.com
Patient %
Patient %
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