A simple, yet objective, technique of using a blunt-needle anesthetic injection for reducing postoperative bruising, hematoma and pain when performing upper blepharoplasty has been validated in a prospective randomized clinical study in JAMA Facial Plastic Surgery.
“It has been a common practice to use sharp needles to administer local anesthesia for upper blepharoplasty, but the evidence of benefit is lacking,” says principal investigator Xiaoxi Lin, M.D., Ph.D., founder and director of Shanghai Ninth People’s Hospital in China.
Complications resulting from hematoma and interventional pain procedures “have raised the issue of improved safety when using blunt needles instead of sharp needles in these procedures,” Dr. Lin tells The Aesthetic Channel.
The study consisted of 44 patients who underwent bilateral upper blepharoplasty in an academic medical setting. Patients were randomized to receive local anesthesia injections (lidocaine, 2%; 27-gauge needle) with a blunt needle in one eyelid and a sharp needle in the other eyelid.
A visual analog scale (VAS) was used to blindly assess pain in both eyelids. Postoperative photographs of the eyelids were also evaluated.
The study found that bruise/hematoma occurred at the sharp-needle injection site in 25% of patients versus 0 patients at the blunt-needle site.
For pain assessed at sharp- and blunt-needle injections, the mean VAS scores were 5.48 and 4.64 (on a scale of 0 to 10), respectively.
“The study found a statistically significant difference in occurrence of bruise/hematoma and pain in upper blepharoplasty using a blunt needle compared to a sharp needle,” Dr. Lin says. “Therefore, use of blunt needles to administer local anesthesia when performing upper blepharoplasty is less likely to cause hemorrhage and less likely to require interventional pain procedures than use of sharp needles.”
Dr. Lin says that for a more accurate surgical procedure and faster recovery, “a blunt needle may be a preferable choice. The use of a blunt needle results in fewer complications and provides more accurate and refined work, with faster patient recovery.”