Filler Migration to the Orbit

Hamed-Azzam, Shirin; Burkat, Cat N.; Mukari, Abed; Briscoe, Daniel; Joshi, Narish; Scawn, Richard; Alon, Eran E.; Hartstein, Morris E.

doi:10.1093/asj/sjaa264

Cited by 16 publications

(19 citation statements)

References 19 publications

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“…In one case, filler migration led to the patient not being able to adduct one eye. 13 One xanthelasma-like reaction was diagnosed as a paraffinoma, which occurs due to an inflammatory reactive process associated with exogenous or endogenous lipids in the dermis. 14 Paraffinomas typically occur in areas that have been traumatically injured allowing exogenous oils such as paraffin, mineral oil, or vaseline to accumulate.…”

Section: Demographicsmentioning

confidence: 99%

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Delayed Complications following Dermal Filler for Tear Trough Augmentation: A Systematic Review

Trinh

McGuigan

Gupta³

2021

Facial Plast Surg

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Tear trough deformity is a popular target for the treatment with filler injections. The side effects are generally mild and transient. However, delayed complications may occur. We aim to perform a thorough systematic review of the published literature related to delayed complications after tear trough filler injections. A search of published literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in June 2021 and included PubMed, ScienceDirect, and Embase databases. The Medical Subject Headings (MeSH) terms used included the following terms: delayed complications, nodules, granulomas, swelling, discoloration, dermal filler, hyaluronic acid (HA), polyacrylamide, calcium hydroxyapatite (CaHA), poly-L-lactic acid (PLLA), eyelid, periorbital, periocular, and tear trough. Twenty-eight articles consisting of 52 individual cases were included in the final analysis. 98% (51/52) of patients were female and had an average age of 48.3 years. HA was the most reported product (71.2%, 37/52), followed by PLLA (4/52, 7.7%), and CaHA (4/52, 7.7%). The most common delayed complication with any dermal filler was swelling (42.3%, 22/52) followed by lumps or nodules (25.0%, 13/52). Xanthelasma-like reaction (17.3%, 9/52), migration (7.7%, 4/52), discoloration (3%, 3/52) also occurred. The average time of onset of any complication was 16.8 months with xanthelasma-like reaction appearing soonest (mean: 10 months) and discoloration appearing latest (mean: 52 months). Most swelling cases were caused by HA. Semi-permanent fillers such as PMMA and synthetic fillers such as PLLA were more likely to be associated with lumps and nodules than other complications. It is important that clinicians who perform tear trough augmentation with dermal fillers have a thorough understanding of the risks of the procedure to diagnose and manage them promptly as well as provide patients with accurate information regarding the potential adverse effects.

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Section: Demographicsmentioning

confidence: 99%

“…19 Many cases of filler migration were managed operatively. 13,24,25 There is no standard treatment for xanthelasma-like reactions, and many cases are not treated. 18,26 Oral steroids, hyaluronidase, and 5-FU did not improve the appearance of these yellow plaques.…”

Section: Triggering or Predisposing Factorsmentioning

confidence: 99%

Delayed Complications following Dermal Filler for Tear Trough Augmentation: A Systematic Review

Trinh

McGuigan

Gupta³

2021

Facial Plast Surg

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“…Inadvertent cosmetic filler migration can occur to locations distant from the injection site, including the extraocular muscles leading to fibrosis and restrictive strabismus occurring weeks to years after injection [105,109]. Injection at the incorrect site, high-volume injection, and injection under pressure are thought to be related to migration of the injected material (BTA and dermal fillers) [105,106].…”

Section: Post-aesthetic Injection Diplopiamentioning

confidence: 99%

Nonneurologic causes of binocular diplopia for the neurologist

Mosleh¹,

Peragallo

2022

Current Opinion in Neurology

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Purpose of reviewTo review several etiologies of nonneurologic diplopia that the neurologist should be familiar with. The pathophysiology, clinical presentation, neuroimaging findings, and treatment options are briefly summarized for each condition. Recent findingsCertain etiologies for diplopia can be associated with life-threatening neurologic conditions and should be investigated thoroughly for proper localization and immediate management of the underlying disease. However, nonneurological causes of binocular diplopia are very common and disabling, but are often nonemergent and may not require in-depth investigation or neuroimaging. Some of the etiologies of nonneurologic diplopia mimic cranial nerve palsies, making them confusing to evaluate when the physician is not familiar with these etiologies. Unfamiliarity with these diagnoses can lead to unnecessary neuroimaging, inefficient utilization of medical resources, and undue alarm to the patient. Recent advances in clinical diagnostic tools and neuroimaging have clarified our understanding of the diverse underlying mechanisms of nonneurologic binocular diplopia. SummaryDiplopia can be a difficult symptom for the neurologist to evaluate. A systematic approach to the evaluation of diplopia can help establish the urgency and necessity of an extensive workup. This review will help to familiarize the neurologist with nonneurological causes of binocular diplopia, minimize expensive and unnecessary evaluations, and reassure patients and physicians alike.

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“…This situation may present undesired circumstances in terms of aesthetic and functional outcomes. 15–18…”

Section: Introductionmentioning

confidence: 99%

“…This situation may present undesired circumstances in terms of aesthetic and functional outcomes. [15][16][17][18] Agarose is a material known for its different rheological properties. 19 Its hydrocolloid and nonhydrophilic nature allow for accurate injections.…”

Section: Introductionmentioning

confidence: 99%

Hybrid Nasal Filler: Combining Agarose Gel and Hyaluronic Acid for Nonsurgical Rhinoplasty

Buhsem¹,

Kirazoglu

2022

Plastic and Reconstructive Surgery - Global Open

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Introduction: Given its structural properties, it would be a mistake to assume that a single type of filler fits perfectly to each anatomical region of the nose in nonsurgical rhinoplasty procedures. Therefore, we aimed to develop a hybrid treatment model by applying two different structural types of fillers. Hyaluronic acid (HA), a hydrophilic material, and agarose gel (AG), a nonhydrophilic and high G-prime material, were used in the study according to their advantages and disadvantages. Methods: Patients who presented to the office desiring filler treatment for nonsurgical correction of the nose in a 2-year period were enrolled in the study. HA was used intradermally 0.1 ml per each point in the tip defining points and supratip. Injections of 0.4–0.7 and 0.4–0.6 ml AG were used supraperiosteally in the radix and nasal spine, respectively. Clinical improvement was evaluated two weeks later using the Global Aesthetic Improvement Scale from 1 to 5 (1: exceptional improvement; 5: worsened patient). Patient satisfaction was evaluated on a scale from 0 to 10 (0: not satisfied; 10: very satisfied). Results: A total of 32 patients (mean age: 27 years) were enrolled in the study. Mean score of patient satisfaction was 9.09 of 10 after injection and 9 of 10 after 2 weeks. Clinical evaluation scores after injection were 1.72 of 5 and 1.69 of 5 on the Global Aesthetic Improvement Scale. No major complication was observed. Conclusion: The HA and AG filler hybrid concept applied in different anatomical locations represents a safe and convenient option for nonsurgical rhinoplasty procedures.

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Filler Migration to the Orbit

Cited by 16 publications

References 19 publications

Delayed Complications following Dermal Filler for Tear Trough Augmentation: A Systematic Review

Delayed Complications following Dermal Filler for Tear Trough Augmentation: A Systematic Review

Nonneurologic causes of binocular diplopia for the neurologist

Hybrid Nasal Filler: Combining Agarose Gel and Hyaluronic Acid for Nonsurgical Rhinoplasty

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