What is the proper technique for injecting Prohilo (Hyaluronic acid)?

How to Inject Profhilo (Hyaluronic Acid)

Needle Selection and Preparation

Use a 29-32 gauge needle or a 25-27 gauge blunt-tip cannula for Profhilo injections to minimize pain and tissue trauma 1. The smaller gauge (higher number) reduces procedural discomfort while maintaining adequate product delivery 2.

• Ensure the skin is clean and dry before injecting 3, 1
• Keep Profhilo at room temperature before injection—cold product increases pain sensation 3, 1
• Use a new, sterile needle for each injection to prevent infection and ensure optimal penetration 3

Injection Technique

Insert the needle at a shallow angle (10-15 degrees) with the bevel facing upward when targeting the intradermal plane, and deliver 0.2 mL per injection point in the deep dermis or superficial subcutaneous layer 1.

Step-by-Step Injection Process:

• Stabilize the syringe with two hands before needle insertion, with your thumb ready on the plunger 4
• Pull the skin taut at the injection site to facilitate smooth needle entry 3, 1
• Insert the needle through the skin in a smooth, non-jabbing movement at 90 degrees to minimize pain fiber stimulation 3, 4
• Inject slowly—rapid injection increases pain and tissue trauma 3, 2
• Pause for 5-10 seconds after full depression of the plunger before withdrawing the needle to ensure complete product delivery 3, 1
• Never advance the needle into tissue that is not yet numb if using local anesthetic 4

BAP (Bio Aesthetic Points) Technique for Facial Treatment

Use the BAP technique with 5 injection points per facial side, delivering 0.2 mL per point 1. This standardized approach maximizes product diffusion while minimizing vascular risk 5.

Optimal Injection Sites:

• Target the deep dermis or superficial subcutaneous layer to restore adipose tissue 1, 5
• For facial aging, focus on superficial medial and lateral-temporal cheek fat compartments and the preauricular area 5
• Total volume per treatment session is typically 2 mL (1 mL per side of face) distributed across the BAP points 1

Site Rotation and Tissue Assessment

Rotate injection sites by at least 1 cm (half an inch) from previous injections to prevent lipohypertrophy and ensure proper absorption 3, 1.

• Avoid injecting into areas with lipohypertrophy, scars, or damaged tissue—these appear as soft, smooth raised areas and cause unpredictable absorption 3, 1
• Examine injection sites at each visit for signs of tissue changes 3, 1
• Use truncal sites (abdomen, buttocks) over limbs when applicable to reduce vascular risk 3, 1

Treatment Protocol

Administer 2 treatment sessions spaced 4 weeks apart as the standard Profhilo protocol 1.

• Repeat treatments every 6 months to sustain rejuvenation effects 1
• The maximum volume generally accepted for subcutaneous injection is around 1.5 mL, although volumes of up to 3 mL are well tolerated when injected in the abdomen 2

Pain Minimization Strategies

Buffer the injection experience using multiple sensory distraction techniques 3.

• Use vibration, cold temperature, or pressure to activate gate control theory and reduce pain perception 3
• Inject volumes of 0.5-0.8 mL or less to avoid substantially increasing pain beyond needle insertion alone 2
• Ensure pH close to physiological levels (around 7.4) and osmolality around 300 mOsm/kg to minimize tissue irritation 2
• If patients experience sharp pain during injection, reassure them the needle may have touched a nerve ending—this happens randomly and causes no damage 3

Safety Monitoring and Complications

Be alert for signs of vascular occlusion including blanching, severe pain, and skin mottling—this requires immediate hyaluronidase administration, though risk is lower with Profhilo's non-cross-linked formulation 1.

• Warn patients about potential bruising and swelling, which is common when treating facial areas 3
• If bleeding or bruising occur, reassure patients these do not affect product absorption or outcomes 3
• If bruising continues or hematomas develop, observe injection technique and improve site rotation 3
• Persistent pain warrants evaluation of injection technique by a healthcare professional 3

Common Pitfalls to Avoid

• Do not inject too slowly through the skin—prolonged needle passage through pain fibers increases discomfort 3
• Do not use needles longer than necessary—shorter needles (4 mm when available) are less painful and reduce risk of intramuscular injection 3, 6
• Do not inject into the dermis itself—inject in the fat just below it to minimize pain 4
• Do not advance sharp needle tips into areas that are not yet anesthetized if using local anesthetic 4