Practice matters


Injection techniques


In the treatment demonstration videos you will hear a lot of reference to certain techniques, both with needle and with cannula. In this video, I want to demonstrate the different needle techniques such as bolus, linear threading, serial puncture, and fanning.


Bolus technique


The first technique we will demonstrate is the bolus technique. A bolus simply means that the needle passes through the skin, usually to a deeper structure, and then we start injecting an amount of product with the needle remaining as still as possible. In this demonstration, we have injected a bolus of 0.1 ml of product.


Serial puncture


The next technique is serial puncture. This is usually performed very superficially in the intradermal depth. It involves multiple small boluses in a crease or static line. The amount of HA injected is minimal, typically 0.01 to 0.02 ml.


Linear threading


I will now demonstrate a linear thread. In this technique, the needle enters the skin and is kept in a parallel orientation. The product is injected while the needle is withdrawn backwards. This is called a retrograde linear thread. In some instances, we may want to inject the product ahead of the needle. This can be useful because it can push blood vessels out of the way. In this scenario, we call it an anterograde linear thread, and you can see the product is injected ahead of the advancing needle.




There is also a technique in which we can spread the product over a wider area, called fanning. Ina fanning technique, after the needle has passed under the skin, we lay down a linear thread of product as we withdraw the needle. However, instead of removing the needle completely, we simply change the angle of the needle and then create another linear thread of product back towards the entry. We can repeat these threads in a radial pattern. This is what we call the fanning technique.


Cross hatching


Finally, we have cross hatching. In cross hatching technique, we begin by injecting a series of linear threads. You can see me doing this in a parallel orientation. We then change the angle of the needle, so that it is 90 degrees from the original, then inject another series of linear threads, which are all perpendicular to the first row.