The Force Required to Inject a Column of Filler Through Facial Arteries

The Force Required to Inject a Column of Filler Through Facial Arteries: BACKGROUND

Injectable fillers have become an integral part of facial rejuvenation, but vascular occlusion is a dreaded complication of such injections.

OBJECTIVE

To determine the force required by the fingertip onto the plunger of the syringe to cause retrograde migration.

METHODS

In this cadaver study, twelve 2-cm arterial segments and 4 fillers were tested. Injection pressure required to force a column of filler for 1 cm was measured. Five oculoplastics specialists were subsequently recruited and asked to inject the filler at a typical injection pressure.

RESULTS

The nonhyaluronic acid filler required significantly more pressure to cause propagation of the material compared with all other fillers (p