Background Over the past decades, soft‐tissue filler injections have become an essential part of cosmetic practice worldwide. Due to the increasing demand, unlicensed practitioners venture in performing this minimally invasive procedure, injecting illegal fillers that pose serious complications. Objectives To compare the adverse effects of legal and illegal soft‐tissue fillers injected by licensed and unlicensed practitioners. Materials and methods A 10‐year retrospective, descriptive, single‐center study conducted at the outpatient dermatology department and skin laser center at Siriraj Hospital from January 2009 to December 2019. Patients were identified as having treatment‐related complications. Their demographic data, clinical history, and injection history were reviewed. Results Forty patients with mean age of 37 years old were included in the study. Thirty‐five of them (87.5%) were female. Illegal soft‐tissue fillers were used in 28 patients (70%) and were performed by unlicensed practitioners (18 cases, 64.3%, P = .001). Adverse effects from illegal fillers (26 cases, 92.9%) developed longer than legal fillers (7 cases, 58.3%) (P = .017). Symptoms significantly lasted longer in patients injected with illegal fillers, 10 (0.07‐288) weeks, as compared to patients injected with legal fillers 0.75 (0.14‐72) weeks (P = .01). Injections from illegal fillers resulted to foreign body reaction (22 cases, 78.6%) and infections (6 cases, 21.4%). Vascular complications were identified in legal fillers injections (5 cases, 41.7%). Conclusions The incidence of adverse effects and complications from soft‐tissue filler injections are superior when performed by novice injectors and unlicensed practitioners using illegal fillers. Proper training of filler injections, selection of appropriate fillers, and early recognition of adverse effects are critically important to the success of treatments.

Introduction Laser lipolysis is a rapidly growing noninvasive body-contouring treatment in Asians. There is increasing demand for leg contouring, especially in areas where unwanted fat deposits are prominent despite diet and exercise. Medial fat knees are one of the esthetic concerns of women today and can be a challenging problem in terms of treatment. There are few noninvasive options to remove fat from these areas. This study aims to evaluate the safety and efficacy of a 1060-nm diode laser for medial knee fat reduction. Methods Nineteen subjects with localized unwanted fat on the medial knees were enrolled into this study. All of them were treated with a single session of 1060-nm diode laser at a power setting of 1.0–1.4 W/cm 2 , depending on patient tolerance. Body weight, knee circumference at 3 cm above the medial epicondyle of the femur, and knee fat thickness measured by ultrasonography were recorded at baseline and 1, 3, and 6 months after treatment. Clinical photographs and ultrasound images were taken before and after treatment. Side effects were documented during follow-up visits. Subjects answered a satisfaction questionnaire at the completion of the study. Results All subjects were female, with mean age of 32.3 ± 5.3 years and body weight of 59.8 ± 11.6 kg. The average power setting was 1.3 ± 0.1 W/cm 2 with pain score of 6.1 ± 1.0. Significant reduction in knee circumferences ( p < 0.001) at 1-, 3-, and 6-month follow-up visits compared with baseline, and knee fat thickness measured by ultrasound in both axial and sagittal plane at 1 and 6 months after treatment ( p = 0.036 and p < 0.001, respectively) were recorded. Side effects were mild and transient, including mild erythema and tenderness. Conclusion The 1060-nm diode laser is effective and safe for knee circumference and medial knee fat layer thickness reduction. Trial registration ClinicalTrials.gov identifier, TCTR20220219002. Retrospectively registered on February 19, 2022.

Background: Submental fat is a noticeable fat in the submental region that is of great concern aesthetically, especially to female patients. A 1060-nm diode laser is a clinically proven device for the laser lipolysis of subcutaneous fat cells. This study aimed to evaluate the safety and efficacy of a 1060-nm diode laser for submental fat reduction. Methods: Twenty subjects with unwanted localized submental fat were treated with a single session of a 1060-nm diode laser with an energy setting between 0.95 and 1.40 W/cm 2 , depending on each patient's tolerance. Submental fat thickness measurements were documented at baseline, and 1, 3, and 6 months after treatment. Clinical photographs, ultrasound images, and adverse events were evaluated at each follow-up visit. Subjects responded to a satisfaction questionnaire at the end of the study. Results:The subjects had a mean age of 34.55 ± 6.19 years, a mean body weight of 70.66 ± 10.55 kilograms, and most (95%) were women. The average energy setting was 0.95-1.40 W/cm 2 , with a pain score of 3.90 ± 1.30 on a 0-to-10 scale. A significant reduction in submental fat thickness measured by ultrasound was noted at post-treatment month 3 (falling to 0.46 ± 0.13; P = 0.013). However, there was a slight increase in the submental fat thickness at the 6-month follow-up (to 0.48 ± 0.12); the change in the thickness relative to the baseline was nonsignificant (P = 0.121). Most subjects reported an improvement 6 months after the treatment. No severe adverse events were observed throughout the study period. Conclusion:Our study demonstrated the potential role of 1060-nm Diode laser for the treatment of localized submental subcutaneous adiposities. It is a promising alternative treatment modality for patients seeking an in-office, nonsurgical procedure for fat reduction without severe complications.