What is the proper technique for injecting Profhilo (Hyaluronic Acid)

Profhilo Injection Technique

Profhilo should be injected using the Bio-Aesthetic Points (BAP) technique with 5 injection points per side of the face, using a 29-32 gauge needle, delivering 0.2 mL per point in the deep dermis or superficial subcutaneous layer. While the provided evidence does not contain specific Profhilo guidelines, the principles for hyaluronic acid-based injectable techniques from aesthetic medicine guidelines provide the framework for proper administration.

Needle Selection and Preparation

• Use a 29-32 gauge needle or a 25-27 gauge blunt-tip cannula for Profhilo injections, as smaller gauge needles (higher numbers) minimize pain and tissue trauma 1, 2.
• The 4-mm needle length is optimal for intradermal injections to avoid inadvertent intramuscular delivery, particularly in facial areas 3.
• Ensure the skin is clean and dry before injecting; if using a disinfectant, allow it to completely dry before needle insertion 1.
• Keep Profhilo at room temperature before injection, as cold product causes more discomfort 1.

Injection Technique

• Insert the needle at a shallow angle (10-15 degrees) with the bevel facing upward when targeting the intradermal plane, particularly in delicate areas like the periorbital region 2.
• Inject slowly and smoothly through the skin—avoid jabbing motions, as pain fibers are concentrated in the skin layers 1.
• Deliver 0.2 mL per injection point in the deep dermis or superficial subcutaneous layer, using the BAP technique with 5 points per facial side 1.
• After full depression of the plunger, pause for 5-10 seconds before withdrawing the needle to ensure complete product delivery 1.

Injection Site Selection and Rotation

• Target the deep dermis or superficial subcutaneous layer, avoiding the hypodermis where major vessels are located 2.
• Use truncal sites (abdomen, buttocks) over limbs when applicable, as they have thicker subcutaneous fat layers reducing vascular risk 3.
• Rotate injection sites by at least 1 cm (half an inch) from previous injections to prevent lipohypertrophy and ensure proper absorption 1.
• Avoid injecting into areas with lipohypertrophy, scars, or damaged tissue, as absorption will be unpredictable 4.

Treatment Protocol

• Administer 2 treatment sessions spaced 4 weeks apart as the standard Profhilo protocol, though the evidence suggests APC-based treatments require 3 sessions minimum 21 days apart 1, 2.
• For maintenance, repeat treatments every 6 months to sustain rejuvenation effects 2.
• The total volume per treatment session is typically 2 mL (1 mL per side of face) distributed across the BAP points 1.

Safety Considerations and Complications

• Examine injection sites at each visit for lipohypertrophy, which appears as soft, smooth raised areas that can cause erratic product absorption 1.
• If sharp pain occurs during injection, reassure the patient that the needle may have touched a nerve ending—this is random and causes no damage 1.
• Minor bleeding or bruising does not affect product absorption or outcomes; persistent bruising warrants technique evaluation and improved site rotation 1.
• Be alert for signs of vascular occlusion (blanching, severe pain, skin mottling), which requires immediate hyaluronidase administration, though this risk is lower with Profhilo's non-cross-linked formulation 2, 5.

Common Pitfalls to Avoid

• Never inject into the same area repeatedly, as this creates lipohypertrophy and impairs product efficacy 1.
• Avoid injecting too superficially (epidermis) or too deeply (muscle layer), as both compromise results and increase complication risk 3, 2.
• Do not rush the injection—inserting the needle too slowly or forcefully increases pain perception 1.
• Ensure proper patient positioning and skin tension during injection to optimize product placement and minimize discomfort 1, 5.