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Blog / Dermal Fillers & Volumizers / Injectables / News / Cannula, Cannula, Cannula!...

Cannula, Cannula, Cannula!

May 28th, 2014 Share

My introduction to using Restylane and Juvederm was in 2000, during my last year of plastic surgery training at the University of Toronto.  By popular demand, dermal fillers for facial sculpting and volume replacement are at the top of the list for the highest numbers of cosmetic treatments worldwide along with Botox and Dysport for wrinkle injections.

Initially, dermal fillers came without local anesthetics in them.  Later on, local anesthetic was added and combined with some topical anesthetic cream and a gentle injection technique, the experience became a more pleasant one.  Yet, using needles, even the super-small ones, would commonly give small bruises, especially when working over the marionette lines and over the ‘tired-looking’ hollowed lower eye and tear troughs.

Now bruising has become so rare with the cannula technique!

The Cannula Revolution, as I call it, started in 2012 at the Visage Clinics in Toronto.  Plastic surgeons have the great advantage of being familiar with the cannulas since we have been performing fat grafting to face – and now to buttocks (aka Brazilian butt lift) and breasts – for more than a decade.  So it is a totally normal evolution for us, plastic surgeons, to use cannulas when injecting Juvederm, Restylane, Perlane, Volbella and Voluma.

The way it works…

The cannula has a blunt or rounded tip with a little side hole for the filler to exit.   The cannula is a super-small hollowed tube.  It is attached to the end of the filler syringe.   There is no sharp component on the cannula.  First, a tiny nick is made to the skin by the plastic surgeon after topical anesthetic cream was applied for 5-10 minutes.   Then the cannula is threaded gently in the skin layers where the injector wants the fillers to be added.  Because it is not sharp, the discomfort is minimal and cannulas do not tend to puncture blood vessels; therefore, there is much less chance of bruising.  Compare it to someone trying to go through spaghetti with a round tipped skewer; the spaghetti will just be pushed aside without being punctured.  The cannula works the same for the blood vessels.  The cannula technique is also safer in preventing inadvertent injection of fillers in blood vessels.

Personally, I find the cannula technique a unique tool for my aesthetic sculpting in several areas of the face.

The cannula allows exact placement of filler when rejuvenating the peri-ocular (eye) regions, the tear troughs, the lid-cheek dark and deep hollows and the aged supra-orbital rim above the upper lids.

The cannula is quite the revolution for the non-surgical rhinoplasty in defining the nasal tip and bridge and providing the gentle feminine curves to the nose when ascending into the inner eyebrow region.

The cannula is absolutely fantastic for replacing or adding volume to lips!

The cannula is also a great adjunct for the treatment of the temporal hollows, the jawline contouring, the cheeks and the marionettes.

In summary, the cannula technique is both technically and artistically demanding but it is significantly safer and the down-time has been greatly reduced.  Seek an experienced plastic surgeon – and an artist – for your facial rejuvenation with the cannula technique!


Dr. Marc DuPéré, Toronto plastic surgeon

Top plastic surgery clinic in Toronto 2013 and 2014

Top cosmetic clinic in Toronto for 2014