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New injection technology delivers fillers with more precision, less pain
An automated injection system is allowing aesthetic physicians to inject fillers in a constant and controlled fashion, helping doctors achieve better aesthetic outcomes with significantly less pain perceived by the patient.
New injection technology delivers fillers with more precision, less pain

An automated injection system is allowing aesthetic physicians to inject fillers in a constant and controlled fashion, helping doctors achieve better aesthetic outcomes with significantly less pain perceived by the patient. The Injection System by Anteis is set to change the status quo of traditional injection techniques, assuming physicians are open to using the new tool.

The system allows the physician to electronically control and regulate the volume and speed at which a product is injected into the dermis. Not only do patients report less pain during treatment compared to traditional injection techniques, there appear to be fewer and less severe side effects such as bruising, redness and swelling.

Dr. Zenker

"Regardless of how good an injector may be, the material can be introduced into the target area at an even pressure and even amount compared to 'manual' injections, resulting in superior aesthetic outcomes," says Sabine Zenker, M.D., an aesthetic dermatologist in private practice, Munich, Germany.

Most physicians agree that the satisfaction of patients receiving hyaluronic acid (HA) filler treatments is a direct result of three things: the efficacy of the injected product in achieving rejuvenation; the severity of side effects as a result of treatment; and the way the product is administered so as to avoid as much pain as possible. Evolving fillers address the issue of efficacy and longevity of effect. According to Dr. Zenker, the Anteis Injection System appears to deliver a given product with less pain and fewer side effects.

The decrease in side effects at the injection site can be appreciated subjectively as well as objectively. In a small series of patients, split-face results comparing the classical injection technique with Anteis' automated injection technique show that the automated injection system results in significantly less edema and bruising (witnessed by less dense tissues) compared to the traditional technique. Results were analyzed using Canfield 3-D imaging technology (Canfield Systems). This objective data indicates that the automated technique is more forgiving to the tissues, resulting in more targeted injection of HA as well as tissue damage and, therefore, less downtime.

PHYSICIAN FATIGUE Physicians who perform many filler treatments can suffer significant muscle fatigue, particularly when performing multiple injection procedures throughout the day. This can take a toll on the physical resilience of the injector, as well as result in less precise filler treatments as the day wears on. Using the automated injection system, the physician has the luxury of concentrating fully on placing the product into the target site without having to worry about manually pressing down on the plunger, sparing the physician physical strain (particularly when injecting fillers of a higher viscosity).

In addition, automated regulation of product flow can minimize the pain perceived on injection, as well as help to avoid "beading" and the uneven placement of filler. The electronically gauged, constant flow of material can be a particular advantage when treating long nasolabial folds or the vermilion border of the lips. Using a long blunt needle, the injector can pass all the way through the nasolabial fold, then slowly retract the needle while leaving small aliquots as the needle is withdrawn.

Dr. Gold

"When using a longer needle, a higher force must be applied to the plunger in order to extrude the filler material. This increased force cannot only result in physician fatigue, but also an uneven injection of material," says Michael H. Gold, M.D., cosmetic and dermatologic surgeon and director of Gold Skin Care Center, Tennessee Clinical Research Center and the Laser and Rejuvenation Center, Nashville, Tenn. "The automated injection system circumvents these variables, and allows you to inject product evenly and in the precise amounts desired to specific targeted tissues."
ALLEVIATING THE GUESSWORK According to Dr. Gold, the injection system allows users to inject the product at an appropriate speed into and through different densities of tissue. This takes the guesswork out of injecting evenly, whether the physician is experienced or a beginner. Regardless of the target tissue, the Anteis Injection System electronically regulates the constant flow of the product by adapting to the stretch effect caused by injected product. The needle is inserted at the target tissue, and the injector must then step on a foot pedal to activate the flow of the product, without the need of pressing down on a plunger. The device injects electronically at the values and parameters set by the physician prior to the procedure.

"While injecting, there is a progressive increase of the flow that lets the tissue adapt to the stretch, and this also has a positive effect of painless injections," says Cyrille Vinchon, research and development manager, Anteis S.A., Geneva, Switzerland. "If the product were to encounter a more dense tissue, the system will electronically adapt the pressure and keep constant the flow of the product."

PRODUCT COMPATIBILITY Not all filler products are compatible with the Anteis Injection System. Most fillers that come in a 1 ml or 2 ml glass syringe can be used by the system, but those that come in plastic syringes cannot. This lack of universal compatibility, as well as the cost of the device 5,000 euros can serve as obstacles to the potentially interested aesthetic physician. However, some consider the injection system worth the investment.

"Physicians should try the Injection System first-hand to gain their own experience. Not all physicians are equally skilled in performing filler treatments, and this device will be more forgiving to the less experienced, and positively surprise those physicians who are used to and satisfied with the cosmetic outcomes achieved with traditional techniques," Dr. Gold says.

According to Dr. Zenker, if a physician can perform filler treatments with less pain perceived by the patient, fewer side effects and less downtime, the investment can bring high dividends for the practice and the positive reputation of the aesthetic physician.

"Compared to the financial investment of laser devices, the Anteis Injection System is a drop in the bucket. However, the comparatively minimal financial burden can positively impact your office and aesthetic patients," Dr. Zenker says.

The Injection System is not currently available in the United States. Food and Drug Administration approval and United States launch are expected in 2011.

Dr. Gold reports no relevant financial interests. Dr. Zenker has conducted workshops for Anteis, without financial compensation

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