Safety and effectiveness of injection of calcium hydroxylapatite via blunt cannula compared to injection by needle for correction of nasolabial folds

Summary Background Pain and potential adverse events (AE) remain challenges for patients being treated with calcium hydroxylapatite (CaHA; Radiesse), especially CaHA not mixed with an anesthetic. The blunt cannula may provide more comfortable and lower risk delivery of CaHA for nasolabial folds (NLF) correction. Objective This 30‐day pilot study was designed to compare the effectiveness and safety of standard needles with that of blunt cannulas for CaHA application. Methods Twenty patients with moderate to severe NLF received split‐face injections of CaHA mixed with 2% lidocaine using a cannula for one NLF and needle for the other NLF. At day 0, patients evaluated pain; the treating investigator evaluated changes in NLF depth. At 0, 3, 7, 14, and 30 days, the investigator evaluated AEs and NLF correction. Patients recorded AEs in daily dairies. Results After initial treatment, patients experienced greater pain and displayed increased erythema and swelling in the needle‐treated side. At days 3 and 7, patients displayed greater instances of bruising, redness, and swelling in the needle‐treated sides. At day 30, 19 patients showed slightly better correction in the cannula‐treated sides. Conclusions The blunt cannula provided advantages in mitigation of pain and AEs, with a degree of correction similar to needle. The addition of blunt cannulas to the clinical setting may be appropriate.