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Due to the blunt end of the blunt needle, this special design is so that the blunt needle does not directly penetrate the tissue, so a "starter" needle or an interventional needle is used to create a skin opening. Of course, the larger the opening, the easier it will be to pass a blunt needle, but a correspondingly larger hematoma will result, causing more pain, bruising, and swelling. On the other hand, smaller openings can make blunt needle penetration more difficult and can also cause significant pain in the case of repeated punctures and inability to access through the opening. Therefore, the ideal choice should be based on the proficiency of different puncture operators, and use the smallest gauge needle that will not cause repeated punctures as the starting needle. When injecting Juvederm® (Joarden) and Restylane® (Ryland) with a 27G standard gauge blunt needle, the authors' choice was the 23G 1/2-inch starting needle.

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