Undesirable effects after treatment with dermal fillers

J Drugs Dermatol. 2013 Apr;12(4):e59-62.

Abstract

Background: Soft tissue augmentation is one of the most frequent techniques in cosmetic dermatology. Nowadays, there are a high number of available materials. Nonanimal hyaluronic acid (HA) is one of most useful fillers for lip augmentation and for treating nasolabial folds, marionette lines, and the dynamic wrinkles of the upper face.

Objective: To evaluate the type and management of undesirable effects of nonanimal reticulated or stabilized HA observed in our cosmetic unit in the past 3 years.

Materials and methods: The consecutive patients using HA attending to our clinic in the past 3 years were divided into 3 categories, according to the time of presentation of the adverse reactions: immediate, early, and late-onset complications. All patients were treated.

Results: Twenty-three patients presented to our clinic complaining of complications after soft tissue augmentation with HA. Ten patients presented immediate-onset complications, 8 showed early-onset complications, and 5 cases complaint of late-onset complications. Treatment of the first group consisted of hyaluronidase injection, massage, and topical antibiotics. Early- and late-onset complications were treated with intralesional triamcinolone acetonide. All patients improved, with the exception of a woman with recurrent granulomas.

Conclusion: Generally, undesirable effects of HA (immediate, early, or late onset) are not frequent, and when present, they improve if treated properly. Physicians need to be aware of these possible adverse events in order to establish proper treatment and prevent scarring or other sequelae.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Cosmetic Techniques / adverse effects*
  • Face
  • Female
  • Humans
  • Hyaluronic Acid / administration & dosage
  • Hyaluronic Acid / adverse effects*
  • Hyaluronoglucosaminidase / administration & dosage
  • Hyaluronoglucosaminidase / therapeutic use
  • Injections, Intralesional
  • Massage / methods
  • Skin Aging / drug effects*
  • Time Factors
  • Treatment Outcome
  • Triamcinolone Acetonide / administration & dosage
  • Triamcinolone Acetonide / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Hyaluronic Acid
  • Hyaluronoglucosaminidase
  • Triamcinolone Acetonide