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Cannulas offer a safer, less painful way to inject fillers 

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Injectable fillers like Juvederm, Restylane and Sculptra plump up wrinkles and reverse sun damage with a quick trip to the doctor's office. But some people don't like being stuck several times with a needle for the treatment. Now there's a safer way to use fillers to get rid of wrinkles on the face and in some areas of the body. Dermatologists are putting a modern twist on an old medical tool. Instead of injecting fillers with needles, they're using a cannula, a long, slim tube with a blunt end. With one initial stick, the longer cannula can be moved around under the skin, fanning out and filling in the damaged crevices. A topical numbing cream is used to stop pain, which patients say is minimal.

  "A little pressure, that's it. Nothing major," says Kimberly Maronge, who received fillers because she was concerned about photodamage and wrinkles in the decolletage area, incurred from decades of regular tanning.

  Tara Engeran agrees the procedure isn't painful. "It didn' t hurt. It was just a pressure-type feeling. So it wasn't like a prick, pain-type feeling," says Engeran, 43. The mother of three children keeps her body lean by teaching yoga and taking ballet. While a lean body is youthful, fullness in the face takes off the years. "As we age, we lose fat pockets in specific areas," dermatologist Dr. Mary Lupo says. "The temple is the big one."

  Engeran is getting fillers in her cheeks, chin, jawline and the area under her eyes. According to Lupo, a cannula is safer than a needle for injecting fillers under the eyes because it is much less likely to puncture a blood vessel.

  "It just gives you an overall increase in the safety margin when you're dealing with these very delicate areas," Lupo says. "It reduces bruising; it reduces the potential of getting into a blood vessel, but it also reduces any possibility ... of penetration or injury to the globe ... if the doctor slips."

  Cannulas are popular in Europe and are gaining a fan base in the United States because they're less traumatic to the skin.

  "We believe that cannulas have much less chance of causing any kind of bruising because the tip of the cannula's blunt," dermatologist Dr. Patricia Farris says. "It's not like a sharp needle where you're entering the skin over and over again."

  Lupo says her patients are more comfortable during the procedure, and she can treat areas of the face that she couldn't with a needle. "The cannula is better because you don't have as many sticks," says Joann Roberts, a 70-year-old patient of Lupo's who received fillers because she was tired of having a thin upper lip and creases on the side of the mouth.

  However, Dr. Barbara Bopp, a Metairie dermatologist and Tulane University School of Medicine faculty member, says cannula procedures can take longer than those with needles. "Right now I think there's a big learning curve (with cannulas)," Bopp says. "Cannulas will be the way of the future though, without a doubt." 

  Because cannulas are not as easy to work with, it's important to find a doctor who has experience using them. "Cannula injecting is very new and so those of us who are doing (it) are in our infancy in terms of our use of this particular new procedure," Farris says.

  Fillers are not permanent fixes, but they can last years when injected in places that don't move very much, like the cleavage or the area around the eyes. They may even stimulate the body to produce its own natural collagen, which means fewer touch-ups.

  "Studies have shown even with hyaluronic acid fill, when you stretch the skin, you stretch the fibroblasts," Lupo says. "This actually stimulates the fibroblasts, which are your cells in your dermis that make collagen. You actually wake them up and stimulate them."

  For certain areas, a combination approach is needed. In Maronge's case, getting rid of the sun damage on the chest area required laser treatments and prescription retinoids in addition to fillers. Maronge says she's happy with the results.

  "I definitely see a change," Maronge says. "Yeah, it's definitely tightened up."

Look for Meg Farris' Medical Watch reports weeknights on WWL-TV Channel 4 and anytime on

Cannulas resemble needles, but are longer and have blunt ends that are less likely to cause bruising.


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