And now, let’s map your arteries…

How far would you go for extra safety when you’re having an injectable treatment? You’d find a great practitioner with enough training in facial anatomy to know what they’re doing… You’d quiz them about how they avoid creating problems by injecting into a blood vessel… But would you consider stepping up for the latest innovation, a technology that uses augmented reality to show exactly where the arteries in your face lie, so that your injector can see them and avoid sticking a needle into them? This tech is called ARtery 3D – it’s fascinating, groundbreaking, and expensive, and I had the chance to try it.

The man behind the tech

In a quiet corner of a meeting room at the IMCAS conference in Paris, where 17,000 of the aesthetic-medicine industries finest are surging around the display stands and auditoria, I get the chance to ask Professor Benoit Hendrickx, a highly respected plastic and reconstructive surgeon based in Belgium, about how and why he turned his dream of seeing through someone’s skin into a practical technology, using augmented reality.

‘When we perform injections, we have no clue where the blood vessels are,’ says Professor Hendrickx, who has written many scientific publications on anatomy. ‘Everyone’s anatomy is different, so there is a danger. That’s why we came up with this.’ Injecting filler into an artery is problematic, he explains, because the filler can block the vessel, stopping the skin from getting nutrients and oxygen, which – if not swiftly treated, can cause necrosis, ie death of the skin tissue. Worse, if the blob of filler travels back up towards the area around the eye, it can even cause blindness. (That’s rare, but becoming less rare the more popular fillers become, particularly in the UK where there is as yet no legislation to stop anyone setting themselves up as a cosmetic injector, whether or not they have any training or competence.)

What does ARtery 3D offer?

The ARtery 3D tech offers greater safety, less risk of bruising and a better experience for the patient, explains Prof Hendrickx. He whips out his phone, points it at his face and on screen, I can see a network of arteries superimposed onto the surface of his face.  ‘Now, you can see the anatomy,’ he says. ‘You can see all the relevant blood vessels.’

So how do you map facial arteries? 

Before the augmented reality technology can get to work, it needs MRI images of the patient’s face, plus a scan, done with a phone camera using the ARtery 3D tech, of the patient’s face turning slowly from side to side. The ARtery 3D team put me through the process, the better to understand it.

First, an MRI scan

Before the MRI scan at the King Edward VII hospital in central London, I sit in front of an infrared lamp for 10 minutes, pulling faces. The lamp is to warm up the blood in my arteries, so that they show up better, and the gurning is to keep the blood moving around my face. The MRI takes only eight minutes and the images are amazing. There on screen is my brain, and there, goodness, are the internal and external arteries, not something I thought I’d ever have cause to see.

Using ARtery3D in clinic

Two weeks later, I meet up with aesthetic practitioner Dr Amanda Penny at the Phi Clinic in Harley Street. She has my arterial map stashed on her phone and explains how they have been put together.

‘With the video of you turning your head, we capture your superficial anatomy. Then once we have the MRI which has captured the vessels of your face – the superficial ones and the deep ones — we use the app’s augmented reality technology to superimpose the two things, so we have an image of your vessels in your face, that I can then use on the app, through the phone, to show your anatomy in clinic.’

Seeing my arteries spring to life

I settle on the treatment bed and Dr Penny points her phone at my face. The app summons up my scanned, augmented arteries on her screen and superimposes them on my face. As ‘wow’ moments go, it’s a good one. There are my arteries, branching and twisting across my face. If I turn my head, the superimposed arteries writhe and shift with it.

What are the advantages of ARtery 3D?

The advantages of this technology, as Dr Penny explains, are chiefly, improved comfort and safety during injections, ‘because you can see the blood vessels, so you can avoid them. You’re much less likely to bruise if we are able to avoid the vessels, and there’s less pain for the patient. It’s particularly reassuring for people who’ve had an adverse event with filler in the past, like a blocked blood vessel, or who have had facial surgery, because that can change the vasculature.’

(In case you’re wondering, I didn’t have any injections with Dr Penny; seeing ARtery 3D in action was enough excitement for one day.)

What are the other ways that injectors avoid blood vessels?

The time-honoured way for injectors to check that they’re not injecting into a blood vessel is to ‘aspirate’; to pop the needle into the spot where they’re planning to inject, then pull back on the plunger. If blood appears in the syringe, the needle is clearly in a blood vessel, and needs to be moved. But the validity of aspirating as a safety measure has been increasingly debated for the past few years.

Isn’t ultrasound imaging easier?

Increasing numbers of aesthetic practitioners have taken to using hand-held ultrasound devices when injecting, to avoid blood vessels, but Prof Hendrickx isn’t a fan, because it’s such a fiddly process. ‘You need to put the ultrasound probe on the face of the patient then look back to the screen of the device to try to find the blood vessels. This [ARtery 3D] is just so much easier because you hold it up in front of your patient and look straight at them. I really believe that within a few years, we won’t be doing any filler injections without using this sort of technology.’

What does ARtery 3D cost?

To me as a patient, the only drawback of the ARtery 3D tech is the cost – between £600 and £800, depending on the price of a private MRI in your area. It’s a one-off cost; unless you have facial surgery, your arterial map isn’t going to change. Because the technology is so new, how clinics may share the cost with patients is something still under discussion.

For more information, see ARtery3d.com