TweetI always use at least a 23 guage no higher, make sure i aspertate first, then hold amp tilted slightly with left hand and hold syringe with thumb and finger next to pinky, and draw back with the index and middle finger. It is pretty easy once you get used to it. If you use a higher guage needle it will be difficult. I have even put the opened amp on a flat surface like formica and just put needle in the amp, but i wouldn't recommend this to beginner as you must be very steady, lol!