Recommended Needle Size for Facial Rejuvenation Using PDO Threads
For facial rejuvenation using PDO threads, 29-30 gauge needles are recommended as the optimal size to ensure effective treatment while minimizing trauma and complications.
Needle Size Recommendations by Facial Area
Periorbital/Under-eye Area
- 30 gauge needles are specifically recommended for the delicate periorbital region 1
- Depth should be limited to 0.25mm when using microneedling devices in this area 1, 2
- For cannula-based delivery in the under-eye area, a 22G × 2 inches (~5 cm) cannula may be used for safety 1
Lip and Perioral Area
- 27 to 30 gauge needles are recommended for lip injections 1
- Injection should be performed in a retrograde fashion, with depth above the orbicularis oris muscle for vessel safety 1
- Alternative: 25 gauge cannula with only two entry points 1
General Facial Areas
- For cheeks and other facial regions, needle gauge may vary between 27-30G depending on the specific PDO thread type being used
- Bidirectional barbed PDO cog threads are typically inserted using 23G/90mm needles for effective facial rejuvenation 3
Technical Considerations
Insertion Technique
- Hold skin taut with one hand while inserting the needle at the appropriate angle
- For most facial areas, insertion should be into the subcutaneous tissue layer
- Retrograde injection technique is recommended for lip and perioral areas 1
- Tying PDO threads at the same entry point has been shown to prevent thread migration 3
Safety Precautions
- Avoid injecting into blood vessels, which is more likely with larger gauge needles
- Smaller gauge needles (29-30G) reduce the risk of bruising and vascular complications
- Be aware of facial anatomy and danger zones when inserting threads
Clinical Outcomes
PDO thread lifting using appropriate needle sizes has demonstrated:
- High satisfaction rates (87% of patients reporting satisfactory results) 4
- Excellent to good texture improvement in the majority of cases 4
- Effective facial rejuvenation with minimal complications 5, 3
- Immediate visible results with continued improvement over time 6
Common Pitfalls to Avoid
- Using needles that are too large: Increases risk of trauma, bruising, and patient discomfort
- Incorrect depth placement: Threads must be placed in the correct tissue plane for optimal results
- Ignoring facial anatomy: Failure to account for neurovascular structures can lead to complications
- Thread migration: Can occur if threads are not properly secured; tying threads at the entry point helps prevent this 3
- Inadequate patient selection: Best results are seen in patients with modest facial sagging rather than severe laxity 4
While there is limited rigorous scientific research on PDO thread techniques 7, current evidence and clinical guidelines support the use of 29-30 gauge needles as the optimal size for facial rejuvenation procedures, particularly in delicate areas like the periorbital region.