Safety Tips for Injectors

3 Jun

When it comes to injectable treatments, there can be risks of unwanted side effects and complications. It is because of this that injecting safety is paramount.

Whilst the most common risks include swelling and bruising, there is another rare, yet serious risk of an intravascular occlusion when using dermal filler. This can occur if the dermal filler is injected into an artery or blood vessel, thereby preventing blood flow through the vessel. If left untreated, this may lead to skin necrosis (death of skin cells due to lack of blood supply). Whether it is a complete occlusion or partial occlusion, precautions and protocols must be followed. Additionally, with anti-wrinkle injections, there can also be the risk of injecting muscle-relaxant into the wrong nerve or muscle, and relaxing the wrong muscle for up to 3 months.

It is because of these such risks, that injectors must have a thorough understanding of facial anatomy, are aware of safe injecting techniques, and understand the variety of injectable products when deciding what to use for each concern.

Below are common safety tips to consider that will help to reduce the risk of such complications, promote a safe injectable procedure and the optimal outcome for each patient.

Anatomy

Understanding what lies beneath the skin and how each injection interacts with these structures is imperative. This includes having a thorough understanding of facial anatomy such as nearby muscles, nerves, blood vessels, vascular patterns at the depth of injection, and bone.

Understanding the injection plane and techniques such as slow, low-pressure injections are also important safety measures. Examples of important landmarks to be aware of include the facial artery, the superior and inferior labial arteries, the transverse facial artery, the infraorbital foramen, supratrochlear nerve and many more.

Aspiration

Aspiration has long been considered a safety measure prior to injecting dermal filler. The reasoning behind this is because when the needle is placed in the desired position for injection and penetrates the dermis, if the aspiration is performed and is positive, it indicates to the injector that they are in a vessel. The injector must not proceed with the injection, remove the needle and attempt again. If the aspiration is performed and it is negative, then it is deemed to be safe to proceed with the injection.

It is important not to reposition the needle after aspirating to ensure it remains safely in the correct position and is not moved into a vessel whereby it is at risk of causing a vascular occlusion.

Needle vs. Cannula

The use of a needle allows for precise injections, whilst the use of a cannula enables the injector to cover larger areas of the face with fewer injections. Similarly, injecting with a needle allows the injector to penetrate directly through tissue, however, provides a higher risk of bruising. When compared to the use of a blunt-ended cannula, this lowers the risk of piercing through an artery, although can be more difficult to navigate under the skin. Both needles and cannulae are capable of piercing vessels and causing an embolism or intravascular occlusion, however, a cannula has a far less risk of doing so. The choice between which of these are used during treatment is entirely up to the injector, their confidence, skill level as well as the result they are trying to achieve.

Product Selection

Product choice comes down to a variety of factors. These include the area of concern, the patient’s skin integrity, level of tissue and volume in the area, the depth of injection, patient budget, product cohesivity and product cross-linking. It is important for the injector to understand each product thoroughly to provide the optimal outcome for the patient, but also reduce the risk of complications if the incorrect product was used in inappropriate areas.

Pre-Treatment Advice

When it comes to downtime post injectables, no one likes to be the big bleeder, bruiser or sweller. Although this is completely normal and often expected, there are tips that the patient can follow in the lead up to their treatment, to help reduce the risk of bleeding, bruising, swelling and prolonged downtime. Such advice includes avoiding the following for two weeks prior to treatment:

Alcohol
Blood thinning medications or supplements such as aspirin, fish oil tablets and turmeric, and
Anti-inflammatories such as ibuprofen and voltaren.

This will reduce the risk of bleeding, bruising and swelling post treatment.

Further to this, drinking caffeine the morning of an appointment may also increase the patient’s risk of bruising, so it is advised they do not have caffeine 24 hours prior to treatment.

It is important to note, that although a patient may follow this advice prior to treatment, such risks can still occur, at a lower severity.

RN Isabelle

Isabelle graduated from the University of Notre Dame with a Bachelor of Nursing in 2018.

She completed her graduate program working in a hospital setting at King Edward Memorial Hospital and Sir Charles Gairdner Hospital, caring for a variety of patients with varying health concerns and conditions.

Isabelle is also currently studying a Graduate Diploma in Cosmetic Nursing and Injectables through the AACDS.

She first began her role at Youth Lab as a Client Liaison, regularly corresponding with clients and answering client enquiries. She has since developed a thorough understanding of the products and treatments offered within the clinic.

Isabelle is passionate about educating and guiding her clients toward the right direction in addressing their concerns and developing a treatment journey uniquely tailored to each individual.

Since working as one of our Cosmetic Registered Nurse within the clinic, Isabelle has built a wealth of knowledge and understanding of injectables and skin health and put her passion into practice.

She has a strong desire for knowledge and keeps up to date with modern techniques and treatments within the healthcare industry and new research regarding gut and skin health.