title: Novel administration technique for large-particle stabilized hyaluronic acid-based gel of nonanimal origin in facial tissue augmentation.
abstract: The use of large-particle stabilized hyaluronic acid-based gel of nonanimal origin (NASHA™) for facial aesthetic procedures is widespread and increasing. A panel of experts with extensive clinical experience with NASHA based gel recently attended an advisory board meeting to develop guidelines for its use in volumetric tissue augmentation.Discussions included details of the blunt-cannula injection technique currently recommended for administration of large-particle NASHA-based gel. With the aim of optimizing patient comfort and control over administration of NASHA-based gel, the panel members explored an alternative,sharp-needle technique. In this article we describe the new technique in detail, together with practical recommendations and precautions. The technique has several advantages over blunt-cannula injection: improved patient comfort, lack of need for a skin incision, increased precision regarding the implant position, and improved control of injection volume. However, the sharp-needle technique requires a high level of skill and a good knowledge of facial anatomy.
authors.affiliation: Aesthetic Surgery & Laser Centre, Camden Medical Centre, Singapore.  woffles@woffleswu.com
authors.forename: Woffles
authors.initials: W
authors.lastname: Wu
authors.forename: Ian
authors.initials: I
authors.lastname: Carlisle
authors.forename: Peter
authors.initials: P
authors.lastname: Huang
authors.forename: Natalia
authors.initials: N
authors.lastname: Ribé
authors.forename: Rosalba
authors.initials: R
authors.lastname: Russo
authors.forename: Claudia
authors.initials: C
authors.lastname: Schaar
authors.forename: Alexis
authors.initials: A
authors.lastname: Verpaele
authors.forename: Anders
authors.initials: A
authors.lastname: Strand
mesh_terms: D000328:Adult; D003357:Cosmetic Techniques; D003911:Dextrans / Q000008:administration & dosage; D005145:Face / Q000601:surgery*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D007279:Injections, Subcutaneous; D008875:Middle Aged; D009339:Needles; D015595:Skin Aging
chemical_list: D003911:Dextrans; C496587:NASHA-Dx copolymer; D006820:Hyaluronic Acid; C445361:Restylane