Dermal fillers: pathophysiology, prevention and treatment of complications

J Eur Acad Dermatol Venereol. 2017 Mar;31(3):405-413. doi: 10.1111/jdv.13977. Epub 2016 Oct 28.


Dermal fillers are increasingly used for soft tissue augmentation of the face and hands. The widespread use of dermal fillers for rejuvenation has led to a rise in reports of associated complications. Although the majority of complications are mild and transient, serious and long-lasting complications have been observed. This article discusses the key complications including pigmentary changes, hypersensitivity reactions, infections, nodule formation, granulomatous reactions, vascular occlusion and migration of filler material. A thorough literature review was performed in addition to the combined extensive authors' (GP and FA) experience. Complications from fillers are increasingly being recognized and highlighted in the literature partly reflecting the growth in the market. This article provides a comprehensive overview of the filler complications with mechanisms of prevention and treatment per complication. A thorough understanding of the preventative and management strategies for the associated dermal filler complications will help the physician to prepare the patient well, and deal with complications that may arise effectively.

Publication types

  • Review

MeSH terms

  • Arterial Occlusive Diseases / chemically induced*
  • Arterial Occlusive Diseases / complications
  • Arterial Occlusive Diseases / therapy
  • Dermal Fillers / adverse effects*
  • Drug Hypersensitivity / etiology
  • Drug Hypersensitivity / therapy
  • Ecchymosis / chemically induced
  • Ecchymosis / therapy
  • Edema / chemically induced*
  • Edema / therapy
  • Erythema / chemically induced
  • Erythema / therapy
  • Foreign-Body Reaction / chemically induced*
  • Foreign-Body Reaction / therapy
  • Humans
  • Injections, Intradermal / adverse effects
  • Necrosis / etiology
  • Retinal Artery Occlusion / chemically induced
  • Retinal Artery Occlusion / therapy
  • Skin / pathology*


  • Dermal Fillers