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Dr Tim Pearce
You may have seen aesthetic clinicians at conference events or on social media demonstrations bending their needle prior to a cosmetic injectable procedure, and asked yourself, why would an injector bend their dermal filler needle, does it improve the result, or enhance the technique?
In this blog, Dr Tim Pearce will explain the various methods for bending, kinking, or curving a needle to inject in hard-to-reach places, including the end of the nose, the gonial angle, and the curvature of the lips.
Do you feel anxious about causing complications? Many clinicians feel so overwhelmed with the thought of causing a vascular occlusion that it stops them growing their aesthetics business. Dr Tim is currently hosting a webinar series to help you overcome your fear of complications so that you can uplevel your knowledge, and increase your CPD-certified learning to build a successful aesthetics business. Sign up here >>
Why would you need to bend a needle for dermal filler injections?
The decision to bend a needle is linked to reducing the amount of work your injecting hand must do. When injecting, there are different curves and structures within the face that you are trying to go around, or you are trying to avoid other parts of the patient’s body that are blocking your movement. Thus, when you bend the needle, you enable greater flexibility and greater control for that procedure. Let’s review a few example situations when bending the needle might be appropriate.
Bending the needle for non-surgical rhinoplasty or nose injections
Dr Tim explains that he likes to bend the needle when treating the distal aspect of the nose, particularly when treating the little V-shape on the nose or when trying to make the tip of the nose a little bit sharper.
How to bend a needle
The first step when bending a needle is to remove the cap to make sure the bevel is facing the right direction. Usually, we want the bevel facing upwards, but there may be times when it is facing downwards. The key is to make that decision before you start bending because it determines how you bend the needle and where the needle bend is located; you cannot change it once there is a kink in the needle. Slide the cap back onto the needle, then, in the direction you want to bend it, you simply lean within that instrument. This is a nice clean place to bend the surface of the needle.
This new angle provides greater flexibility, enabling you to stay at the right plane when injecting the nose. Find your entry point into the skin, slide the bent needle to the right depth, change the angle so the bent needle is now straight along the line of the nose; you will remain at the same depth as you slide along the nose. You will see the needle tip through the skin on the tip of the nose and can inject accordingly before exiting.
Bending the needle for treating the gonial angle
Another practical example of where bending a needle or cannula can be useful is when treating the gonial angle. Where the shoulder sits on your patient, it can be in the way, meaning that it becomes difficult to find a good entry when treating their gonial angle. Thus, a little bit of curvature to the instrument that you use, needle or cannula, enables you to accommodate for their shoulder. A bend can be helpful to maintain the position or the depth.
How to curve a needle
Another option, rather than simply bending a needle or creating a kink, is to create a curved needle; this involves a different preparation technique.
You will require a pair of clinical pliers – the type you might use to remove the tops from vials of botulinum toxin. To maintain cleanliness, use a cotton swab inside the pliers. Place the needle, with the bevel facing in the right direction, within the pliers and close them tightly. Create the first bend in the needle and with pressure firmly on the needle, pull it out. This bends the needle sequentially as you retract it from the pliers to create a curve.
Curving the needle for better lip injections
Considering why we might use a curved needle for lip injections becomes more obvious, notes Dr Tim, when you look at the lip in profile. In most patients, with an average lip, there is a natural curvature to the tissue. To maintain the same depth as you inject vertically all the way around, having a slight bend or gentle curve in your needle makes it easier to follow the curve of the lip more accurately.
You can still perform the injections without a curved needle; however, you will need to move your needle outwards and it gives you more to think about than when using a curved needle which enables you to hold the depth as you slide in.
What are the pros and cons of bending needles in aesthetic medicine
Many aesthetic practitioners have asked Dr Tim about the pros and cons of bending or curving needles for dermal filler injections; here, he answers some of the most common questions he has received.
Will bending the needle affect the extrusion force of the dermal filler?
It is correct that there will be an increase in extrusion force resistance if you bend a needle, but for most practitioners it will be an imperceptible difference, explains Dr Tim.
The bend or kink created in the needle is an incredibly short distance. If we review Poiseuille’s Law, we can see that one of the factors that affects extrusion force is the distance of the narrowness. Therefore, although we have created a smaller space in the ‘tube’ for the filler to flow through, that smaller space is also incredibly small, perhaps only a quarter of a millimetre where it is narrower, and the rest of the ‘tube’ is the same. Many of the hyaluronic acid-based filler products in use today already have relatively low extrusion forces. If you are using a very thick dermal filler that is difficult to inject, then a bend in the needle may well have a more noticeable affect on the extrusion force.
What if the needle snaps off because it has been weakened?
To avoid the potential for this occurring, Dr Tim advises not to insert the needle beyond the kink or bend point or go in that far when injecting. This would protect you from what he believes to be a very low risk of these needles, which are inherently short, snapping when used in aesthetic practice.
How do I find the tip of my needle when I have bent it?
A potential downside when you first start using this technique, warns Dr Tim, is that you may forget that as you rotate your hand you are changing the position of the tip of the needle. Rotation with a straight needle does not change the position, but, as soon as the needle has a bend in it, rotation will flex the tip of the needle and you could end up in a very different place if you are not aware of this dynamic. Always think very carefully about where the tip of your needle is, and not the direction of your syringe, because that is no longer the same once you have a bend or a kink in your needle.
Needle control is an art and can be difficult to master. If you want to improve your needle control to become a safer, more stable injector to produce better results, download Dr Tim’s How To Improve Your Needle Control: 6-Step Blueprint.
Dr Tim loves to hear from his followers; if you have any questions or ideas for topics he can cover in future videos, please drop him a comment on social media; you can find Dr Tim Pearce on Instagram.
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Aesthetics Mastery Show
How To Bend Your Needle For Better Patient Results
In this episode, Dr Tim shows the various ways you can bend and kink your needles for injecting those hard to reach places such as the end of the nose and the curvature in the lips; along with the pros and cons of doing so.. Watch the full Aesthetics Mastery Show here.
The show has had thousands of views and a number of comments from practitioners and patients. The latest include:
@cherbach7219
“I’ve been kinking needles & cannulas for probably about 7 yrs. And never had one break.”
@maribelquintero4908
“Excited to try this today ..big fan of your technique”
@doctoralkasskincarehealthc5558
“Thanks Dr for this very useful tip.You are doing amazing work.”
Dermal Filler eLearning Courses
If you want to increase your knowledge about safe and effective dermal filler injectable treatments, Dr Tim Pearce offers a series of fabulous courses. The foundation level is a popular starting point, with many delegates continuing to complications courses focused around safety, including how to minimise the risk and how to handle things if the worst occurs:
Both give CPD and certificates on completion and are highly rated by our delegates.
In addition, browse our FREE downloadable resources.
Dr Tim Pearce eLearning
Dr Tim Pearce MBChB BSc (Hons) MRCGP founded his eLearning concept in 2016 in order to provide readily accessible BOTOX® and dermal filler online courses for fellow Medical Aesthetics practitioners. His objective was to raise standards within the industry – a principle which remains just as relevant today.
Our exclusive video-led courses are designed to build confidence, knowledge and technique at every stage, working from foundation level to advanced treatments and management of complications.
Thousands of delegates have benefited from the courses and we’re highly rated on Trustpilot. For more information or to discuss which course is right for you, please get in touch with our friendly team.
