How to Use a Cannula for Aesthetics Treatments

When you’re first starting out in aesthetic medicine, you’ll learn using a needle. Once you’re confident in your technique, you’ll quickly want to know how to use a cannula for certain treatments.

The lips, nasolabial folds and cheeks in particular are areas that can benefit from using a cannula instead of – or as well as – a needle approach.

We spoke to cosmetic doctor, facial aesthetics specialist and clinical trainer, Dr Mariam Michail to find out more.

Here she answers the most commonly asked questions about how to use a cannula for aesthetics treatments…

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How do you know where to make your entry point for the lips?

“The key to deciding where to insert your cannula entry point is ensuring you are able to access the entire treatment area, whilst respecting the underlying anatomy,” advises Dr Mariam.

“For lip filler, at least two entry points are needed, one on each side, around 1cm from the oral commissure. Each entry point will allow access to the top and bottom lip on that side.”

She cautions, “Prior to placing the entry point, align the cannula against the lip, without touching the skin. This is to ensure that access to the midline of the lip is possible with the length of the cannula through the planned entry point!”

How do you know where to make your entry point for the medial and lateral cheeks?

“Again, the entry point will be placed to allow for the easiest access to the entire treatment area. Also, understanding the local anatomy and vasculature is key to ensure major structures, such as vessels, are avoided,” warns Dr Mariam.

Medial and lateral cheeks can usually be accessed through the same entry point,” she notes. “However, injectors may find it easier to use a separate entry point for each area, to optimise access. Reangling a cannula during treatment to access a different area can be challenging, so it may be best to use separate points.”

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What is the best cannula size to use for the lips, the medial cheeks and the lateral cheeks?

“At Harley Academy, we use 25G cannulas for the lips, medial cheeks and lateral cheeks,” states Dr Mariam.

“25G cannulas increase safety by significantly reducing the risk of vascular occlusion, whilst still being comfortable enough for the patient for treatment. Larger cannula sizes may be selected for higher risk areas to further increase safety. However, these can often be uncomfortable and may require the use of an additional local anaesthetic injection prior to treatment.”

She also reminds us, “Cannulas smaller than 25G become sharp, just like a needle. So the benefits of reducing the risk of occlusion are lost.” 

She adds, “Generally, for lips, medial cheeks and lateral cheeks, a 38mm cannula length is sufficient. This can be checked prior to starting treatment by measuring the cannula up against the patient. Longer cannulas, such as 50mm, can be associated with less control of the cannula.”

What are your top tips for aesthetics practitioners who are just learning to use a cannula?

Dr Mariam advises, “Cannulas are an excellent way to reduce swelling and bruising associated with dermal filler treatments, while significantly reducing the risk of vascular occlusion.They are also useful for fanning filler in wide areas, as opposed to the precision a needle technique can offer.”

“Using a cannula may feel like a steep learning curve, but it becomes significantly easier with practice. Many clinicians end up preferring the use of cannulas over needles, so don’t avoid upskilling in cannula use!”

She recommends starting off “with more straightforward cannula treatments, such as layer 2 treatments including nasolabial folds. Then progress on to cheek and lip filler with a cannula, as many find this more challenging.”

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Cannula Training for Aesthetics Practitioners

Cannula training is reserved for aesthetics practitioners who are already confident in their needle techniques. As such, cosmetic doctors, dentists, nurses and midwives can learn how to use a cannula as part of our Level 7 Diploma in Botox & Dermal Fillers course.

If you’re an intermediate to advanced practitioner looking to upskill and really concentrate on improving your cannula confidence, we offer one-to-one mentoring. Our 1:1 Injectables Training Sessions offer a dedicated Mid-Face and Cannula option if you’re looking to perfect your cheek filler technique. Alternatively, our Perioral and Lip Filler training may be your best fit if you want to practice using a cannula to create safe and proportionate lip augmentations.

For further details or to talk through what you’re looking for from your aesthetics training, book a call with Christine Slater, our courses advisor. She’ll guide you towards your matches and discuss the relevant requirements, including timelines and payment options, with you.

If you’d like more tips on how to use a cannula, check out our earlier article, Aesthetics Specialists Tips on Using a Cannula.