APPLICATION TECHNIQUE 




The injection of META<>CRILL® is performed in an outpatient manner. It is an extremely simple, fast and painless procedure.

For the procedure, the patient can be positioned in dorsal decubitus with elevation of the dorsum and the head around 40 degrees or can be kept sitting. This last position is favored for injection to the face, because, in this manner, the folds and depressions are shown exactly as they are.

The patient is prepped as for any surgical procedure, using soap and water to wash the area to be treated. Personally we use a 1% iodinated alcohol solution for anti-sepsis.

The flask containing the product must be placed with the cap facing down, in a vertical position, before its use. Due to the high viscosity of the PRODUCT, it takes some time to concentrate close to the rubber cap. A 11/2 (40x16) gauge needle is used, adapted to a 1, 3 or 5 cc syringe with which the implant will be performed.

The expected volume for injection is taken into the syringe.

The correction is done with 1¼ or 0,7 (28x5 or 28x7) needles or 1 mm sharp canola. The first is the one used preferentially, reserving the smaller one for small amounts. The penetration point of the needle must be at 0,5cm from the site of implantation, in this way avoiding the possibility of contact between the implant and the outside environment.

Some physicians prefer non-traumatic CANOLAS with a lateral orifice and 1mm width. Such modality of injection would decrease the incidence of ecchymosis at the site of puncture, because of minor trauma to the local vessels.

Introduction of the substance is performed in a parallel, crossing or fanlike fashion cylinders, according to the experience and the preference of the physician.

During injection one must avoid the formation of sequential bubbles, like a pearl necklace, because in this manner the cutaneous surface can show irregularities.
We can previously demarcate the area to be treated and divide it in equal segments, so that the injection follows an easier and more uniform evolution, especially in the cases where symmetry is important.

The anatomical plane of META<>CRILL® injection is extremely important, because this is where most of the called so-called "complications" reside, which are nothing but the result of inadequate technique .The implantation must be made IN THE SUBCUTANEOUS PLANE, immediately under the dermis, never in its thickness. If performed in the deep part of the subcutaneous tissue, the result will be poor but there will be a platform of support for future implanting.

Hypercorrection is always avoided, because, as META<>CRILL® is kept in all its volume where it is placed, with minimal absorption of its components, any over-correction will be abnormal, being difficult, after a while, to remove it, because of the cellular process that will involve the micro spheres.

An important aspect is the implanting in scar areas. In such cases, the injection must be made cautiously, not placing too much pressure on the syringe, because in this manner the META<>CRILL® will spread to neighboring tissues, due to the poor elasticity of the scar tissue. WITH THE FINGERS TIP WE LIMIT THE POSITIONING OF THE IMPLANT AS IT IS INJECTED.

The amount to be implanted will depend on the degree of expansion desired. Since the result appears immediately, the injection is interrupted at the achievement of the desired volume.

During the post-injection period, the use of cold compresses and relative rest of the implanted area are necessary to minimize the edema, which soon appears. Swelling lasts, on average, 3 days, but there are individual variations. When the lip vermilion is implanted there is intense edema.

Some analgesics may be used in very specials cases in hypersensitive patients.
With edema of significant volume, the intramuscular corticoids have to be evaluated.

The possible existing ecchymosis is of SPONTANEOUS evolution.