Exact dosing is less important to me; why do I need a dosing syringe?
Method of delivery represents one of the main areas to consider in the use of BoNT. With low volumes of solution being injected, it is important to deliver accurate dosages and minimize loss of BoNT. Incorrect doses and placement may potentially result in a debilitating and unsightly (even unbalanced) appearance resulting in a dissatisfied patient. Under-dosing could precipitate unwanted and disfiguring complication; whereas over-dosing would result in unwanted wastage of BoNT.
[Reference: A.L. Baker, A. Pickett, D. Humzah: Emerging aspects in Botulinum Toxin use]
I have been injecting for 20 years and I am already very accurate, isn’t the 3Dose™ syringe only for beginning injectors?
This is a major misconception that is believed in the market today and tests have shown that even the most experienced injectors are up to 10-20% inaccurate. The small BoNT doses are extremely difficult to consistently measure using the ml scale on a standard syringe, depending on the eye sight and skill of the doctor. Even with a perfect injection technique, there is the inaccuracy of the ml scale on all syringe which following the ISO norm 7886-1 has an acceptable variation of +/- 10% (!). Moreover, rather than focusing on monitoring whether the planned and proper dose has been injected, because of the tactile and audible confirmation with the 3Dose™ Unit Dose Injector, the experienced doctor can now enhance the procedure by focusing more on the injection and the patient.
I am used to injecting 0.1ml (or 10 insulin units). How would this work with the 3Dose™ syringe?
The 0.1ml scale on standard syringes is commonly used because it is the only available setting that can be clearly seen with the naked eye. Within the 0.1ml volume there are multiple units represented based on the preferred BoNT dilution and this can often cause confusion. With the 3Dose™ Unit Dose Injector you can reliably inject units without having to look at the ml scale on the syringe during injection. The doctor can feel and hear how much is administered every time and this allows the doctor to think in units rather than in ml volume. By setting the appropriate ml dose scale that is equivalent to one unit, there can’t be any confusion on how many units are injected per injection site. Knowing the exact amount of units being injected results in a more predictable outcome and better reproducible results.
Why should I replace the syringe that I currently use with the 3Dose Unit Dose Injector?
There are two variables impacting the clinical outcome when injecting BoNT: where to inject and how much to inject. With the 3Dose™ Unit Dose Injector the doctor only needs to focus on where to inject because with the 3Dose™ Unit Dose Injector the doctor gets audible and tactile confirmation that the correct unit amount had been administered. The 3Dose™ Unit Dose Injector eliminates the need to monitor the small print on the barrel of a typical syringe to ensure that the appropriate and planned volume of toxin has been administered.
I am already accurate because after I fill my syringe there is nothing left when I am finished!
It is not only about the total BoNT volume injected, but rather the accuracy of the individual BoNT units per injection point. If for example more BoNT units are injected on the left side of the face vs. the right sight of the face, the result could be greatly unbalanced.
Is the use of the 3Dose Unit Dose Injector more or less painful in comparison to a standard injection syringe?
In one study, the volume of injection was found to be related to pain on injection; a higher injection volume gives more pain. Another aspect of injection pain which often is overlooked relates to the needle size being employed. Research has indicated that a 33G needle gives less pain in four areas of the face in comparison to a 30G needle. Now an even smaller needle is being developed by TSK called THE INViSIBLE NEEDLE™ and this needle is compatible with the 3Dose™ Unit Dose Injector. There are currently ongoing studies to validate that THE INViSIBLE NEEDLE™ significantly reduces or eliminates the risk for bruising (hematomas).
[References: 1) Kranz G. Sycha T, Voller B, Gleiss A, Schnider P, Auff E.: Pain sensation during intradermal injections of three different toxin preparation in different doses and dilution. Dematol Surg.. 32(7) (2006), 886-90], 2) Sezgin B. Ozel B. Bulum H, Guney K. Tuncer S, Cenetoglu S. “The Effect of Microneedle Thickness on Pain During Minimally Invasive Facial Procedures: A Clinincal Study”, Aesthetic Surg J. (2014)]
For which area is exact dosing especially important?
Exact dosing is always important, but dosing in the lower face is crucially important as the musculature is complex and less forgiving in terms of erroneous placement compared to the upper face. Complications which arise in the lower face can be much more unsightly than the upper face; asymmetric smile/inability to smile, heavy top or bottom lip/incompetence in eating/drinking, compromise to airway (platysma erroneous placement/dosage).
[Reference: A.L Baker: Off-label cosmetic use of botulinum toxin in the lower face and the role of injection delivery devices]
Does this syringe help me with Micro-botox (or Meso-botox) injections?
Microbotox is the injection of multiple micro-droplets of diluted BoNT in the dermis or the interface between the dermis and superficial layer of facial muscles. The intention is to decrease sweat and sebaceous gland activity to improve skin texture and sheen and to target the superficial layer of muscles that find attachment to the underface of the dermis causing visible rhytides. Depending on the chosen dilution, the micro-botox injections are often delivered in mircro-droplets of 0.01ml or 0.0125ml. [Reference: Wu WTL. Microbotox of the Lower Face and Neck: Evolution of a Personal Technique and Its Clinical Effects].
Isn’t the click of the syringe annoying to the patient?
The use of the 3Dose™ syringe by doctors have shown quite the reverse! The patient is now sub-consciously feeling engaged in the treatment and impressed that the clinician is using sophisticated equipment to ensure that the treatment is accurate. In the experience of doctors who used the 3Dose™ syringe, the patient feels reassured and more comfortable.
What are the potential cost savings using the 3Dose Unit Dose Injector?
There are quantifiable and non-quantifiable savings that can be achieved with the 3Dose™ Unit Dose Injector. The quantifiable savings for the low dead-space 3Dose™ Unit Dose Injector in combination with a low-dead space needle are 0.08ml when compared to a standard syringe and needle. Other quantifiable savings can be achieved by drawing the exact amount of units and not having to over-dose, which potentially can save up to 20% of the BoNT used per patient(!). Non-quantifiable savings include a high patient retention rate, more patient referrals and a reduced need for patient touch up and adverse effects.
Which needle do I use to draw up the BoNT in my syringe?
We strongly suggest to use a larger gauge (21 to 25G, 50mm) vial access needle to be used to draw up the BoNT in the syringe and this needle needs to be replaced by a sharp micro needle right before injecting. The needle used for the actual injection should never be used to draw up the BoNT. The slightest contact of the micro needle with the vial will make the micro needle blunt and result in a painful injection. Moreover, it is also much more cumbersome drawing BoNT with a small needle as this takes a long time and generates more air bubbles in the syringe.