ArticleAesthetic surgery journal2022
Aspiration Before Tissue Filler-An Exercise in Futility and Unsafe Practice.
Article in Aesthetic surgery journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed.
- Cannula is safer than needle in filler injection?JPRAS open · 2026Review
- The SibUS-In Finger Probe: An Alternative Device and Method for Ultrasound-Guided Injections.Aesthetic surgery journal. Open forum · 2026Article
- Filling the Gap: Facial Anatomy and Safe Lower Lip Injection Practices.Journal of clinical medicine · 2025Article
- The Assessment, Strategy, and Treatment Protocol: Nasolabial Fold Assessment, Strategy, and Treatment With Hyaluronic Acid Fillers in Chinese Patients.Plastic and reconstructive surgery. Global open · 2025Article
- Labia Majora Rejuvenation With Hybrid Filler: A Narrative Review of the Literature and Report of Two Cases.Journal of cosmetic dermatology · 2025Review
- Precise Needle and Cannula Placement in the Forehead During Aesthetic Procedures: Can Device and Angulation Influence Accuracy? A Fresh Frozen Specimen Study.Aesthetic plastic surgery · 2025Article
- "Filler-Associated Acute Stroke Syndrome": Classification, Predictive Modelling of Hyaluronidase Efficacy, and Updated Case Review on Neurological and Visual Complications.Aesthetic plastic surgery · 2024Review
- Advancing the Era of Liquid Rhinoplasty: A Methodological Approach to Injection Protocols.Aesthetic plastic surgery · 2024Article
- In Vivo Ultrasound Study of the Angular Artery Anatomy: Practical Indications for the Treatment of the Deep Pyriform Space.Aesthetic surgery journal. Open forum · 2024Article
- Article
- Ophthalmic Complications after Needle-Based Medical Aesthetic Procedures: A Narrative Review.Journal of clinical medicine · 2022Review
- Five-point liquid rhinoplasty: Results from a retrospective analysis of a novel standardized technique and considerations on safety.Journal of cosmetic dermatology · 2022Article
- Bridging a Century-Old Problem: The Pathophysiology and Molecular Mechanisms of HA Filler-Induced Vascular Occlusion (FIVO)-Implications for Therapeutic Interventions.Molecules (Basel, Switzerland) · 2022Review
- The 10-Point Plan 2021: Updated Concepts for Improved Procedural Safety During Facial Filler Treatments.Clinical, cosmetic and investigational dermatology · 2021Article
- Detection of the Safe Zone for Upper Eyelid Hyaluronic Acid Injections.Indian journal of dermatologyArticle
- Central Retinal Artery Occlusion Following Intralesional Triamcinolone Injection for IgG4-related Orbital Disease.Ophthalmic plastic and reconstructive surgeryArticle
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAesthetic physicians rely on certain anecdotal beliefs regarding the safe practice of filler injections. These include a presumed safety advantage of bolus injection after a negative aspiration.
objectivesThe authors sought to review and summarize the published literature on inadvertent intravascular injection of hyaluronic acid and to investigate whether the technique of aspiration confers any safety to the practitioner and the patient.
methodsPertinent literature was analyzed and the current understanding of the safety of negative and positive aspiration outlined.
resultsThe available studies demonstrate that aspiration cannot be relied on and should not be employed as a safety measure. It is safer to adopt injection techniques that avoid injecting an intravascular volume with embolic potential than utilize an unreliable test to permit a risky injection.
conclusionsTo prevent intravascular injection, understanding "injection anatomy" and injection plane and techniques such as slow, low-pressure injection are important safety measures. Assurance of safety when delivering a bolus after negative aspiration does not appear to be borne out by the available literature. If there is any doubt about the sensitivity or reliability of a negative aspiration, there is no role for its utilization. Achieving a positive aspiration would just defer the risk to the next injection location where a negative aspiration would then be relied on. LEVEL OF EVIDENCE: 4:
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.