Optimizing Injection Technique to Minimize Ecchymosis

To the Editor We read with interest the article by Yu et al titled "Occurrence of Bruise, Hematoma, and Pain in Upper Blepharoplasty Using Blunt-Needle vs Sharp-Needle Anesthetic Injection in Upper Blepharoplasty: A Randomized Clinical Trial." In the article, the authors describe the rate of ecchymosis, hematoma, and pain when using a 27-gauge, 1.4-in (35-mm) needle compared with the use of a 27-gauge, 2-in cannula. They report lower rates of hematoma formation when using the cannula compared with their standard needle injection technique. We submit that their control injection technique was not optimized for reducing the critical outcome studied.

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