Part2 - To Aspirate or Not to Aspirate - Van Loghem et al

Author: Mike Clague Aesthetic Nurse BSC   Date Posted:30 August 2018 

To aspirate or not to aspirate? Part 2

There is still an alarming amount of doctors teaching ‘aspiration’ as a ‘safe’ method of injecting dermal filers. There is still much controversy over whether aspirating before injecting dermal fillers enhances your safety and protects you from having an ischemic event with filler. It is commonly accepted that aspiration on it’s own isn’t the best method of preventing an ischemic event with a filler but how much do you rely on it?

  • How long do you pull back on the plunger for?
  • Does EVERY filler allow aspiration with blood?

We review clinical research by on the question of aspiration.There are now 3 studies on the question of aspiration in prevention of ischemic events with dermal fillers. Carey, Casabona and now Van Loghem.

All 3 studies show that to aspirate and think you are safe is not sensible. All 3 show that some fillers will not aspirate and some take alot of time to aspirate.

We review the latest data below.

Sensitivity of aspiration as a safety test before injection of soft tissue fillers

Van Loghem JAJ, Fouché JJ, Thuis J. Sensitivity of aspiration as a safety test before injection of soft tissue fillers. J Cosmet Dermatol. 2018;17:39–46


Our Summary –



Dermal filler complications appear to be increasing each year. Many believe that blood aspiration tests (pulling back on the plunger before injection) are an adequate way of reducing ischemic complications with dermal fillers. Many injectors still perform this aspiration test and it is still widely taught by Key Opinion Leaders on stage at medical symposia. It is important to reduce the risk of ischemic complications, the most catastrophic being blindness or brain injury.


Dr Van Loghem aimed to evauluate the reliability of the blood aspiration test.


•2 tests

•One Ringers with Blue dye

•Other anticoagulated blood

•Both pressurized to 150mm Hg

•11 different needles, 24 fillers, 340 aspiration tests


•Only 112/340 (33%) had a positive aspiration with a 1 second pull, 37% still negative after a 10 second pull


•When only considering the needles supplied within the packages of the different STF products, the reliability of aspiration was 37% (positive within 1 s) and 74% (positive up to 10 s of aspiration)


Using aspiration is not reliable to prevent an ischemic event. 3 studies now have established that this technique will not prevent an ischemic event.

Do you think you can keep your hand genuinely still for 8-10 seconds? Also many of these fillers will not even aspirate.

This study is the first to replicate blood pressure at 150mm/hg and it shows similar results to the Carey and Casbona studies.

Inject slowly and keep your needle tip moving.

If you want to attend a safety with dermal fillers workshop in your capital city register now at

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