Severe Granulomatous Allergic Tissue Reaction After Hyaluronic Acid Injection in the Treatment of Facial Lines and Its Surgical Correction

Hönig, Johannes Franz; Brink, Ulrich; Korabiowska, M

doi:10.1097/00001665-200303000-00011

Cited by 99 publications

(64 citation statements)

References 5 publications

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“…Notably, the incidence of adverse events on the two treatment sides was similar. There were rare reports of infection and allergic cases after HA injection [7,9], which were not observed in the present study. Injection techniques including fan techniques, rapid injection, rapid flow rates, and higher volumes that increase the dissection of the sub-epidermal plane were shown to increase the incidence of local adverse events [6].…”

Section: Discussioncontrasting

confidence: 69%

Clinical comparison between two hyaluronic acid-derived fillers in the treatment of nasolabial folds in Chinese subjects: BioHyalux versus Restylane

Sun

et al. 2016

Arch Dermatol Res

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Hyaluronic acid fillers are used to improve the appearance of nasolabial folds (NLF). This study aimed to compare the efficacy, safety, and durability of a new hyaluronic acid gel (BioHyalux) versus Restylane for the correction of NLF. This was a multicenter, double-blinded, randomized, controlled, non-inferiority clinical trial involving 88 subjects with moderate to severe NLF. Subjects were randomized to BioHyalux and Restylane on either sides of the NLF. NLF was assessed before and right after injection, and at 1 week, 1, 3, and 6 months. Patients were followed up for 13-15 months to evaluate the durability and long-term safety. A clinically meaningful response was predefined as at least one-point improvement on the Wrinkle Severity Rating Scale, which is a five-point scale. At 6 months, the response rate of BioHyalux was not inferior to that of Restylane (P < 0.05). At the 13-15 months follow-up, the response rate by investigators was 58.0 % on the BioHyalux side versus 63.8 % on the Restylane side. The response rate by subjects showed similar results, which was 56.5 % on the BioHyalux side versus 60.9 % on the Restylane side at 13-15 months. The subjects' Global Aesthetic Improvement Scale (GAIS) showed that most subjects felt improvements on both sides of NLF (P > 0.05) at all time points. At 6 months, 100 % reported improvements on both side; at 13-15 months, 60 % of subjects reported improvements with BioHyalux versus 64 % with Restylane. Adverse events were transient and predominantly mild or moderate in severity including injection site swelling, pain, itching, bruising, and tenderness. BioHyalux had reliable safety and tolerance, and could be an effective injectable filler for correcting NLF.

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Section: Discussioncontrasting

confidence: 69%

Clinical comparison between two hyaluronic acid-derived fillers in the treatment of nasolabial folds in Chinese subjects: BioHyalux versus Restylane

Sun

et al. 2016

Arch Dermatol Res

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“…There is 1 report of arterial embolization 23 and 3 reports of granulomatous foreign body reaction 24 after injection of hyaluronic acid. 25,26 In my study, aside from transient erythema at the injection sites and infrequent bruising, these patients were free of adverse effects.…”

Section: Commentmentioning

confidence: 68%

A New Classification of Lip Zones to Customize Injectable Lip Augmentation

Jacono

2008

Archives of Facial Plastic Surgery

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To present a new classification of 15 anatomical lip zones used to direct placement of injectable fillers during lip augmentation and to evaluate the new classification's ability to customize lip contour and size.Methods: Study participants were consecutive patients presenting to a facial plastic and reconstructive surgery practice for injectable lip augmentation with a nonanimal-sourced stabilized hyaluronic acid (Restylane; Medicis Aesthetic Inc, Scottsdale, Arizona). A nonrandomized, prospective case series.Results: A total of 137 treatments were performed on lips of 66 patients. The mean (SD) satisfaction score was 4.5 (0.6) on an integral scale of 1 (dissatisfied) to 5 (most satisfied). The mean (SD) persistence until lips returned to preoperative appearance based on patient subjective evaluation was 4.9 (1.5) months. Patients were free of adverse effects. Conclusions:Using a new classification of lip anatomical zones to direct the injection of a nonanimal-sourced stabilized hyaluronic acid has increased my ability to better control lip shape and size in lip augmentation. This technique was met with high patient satisfaction and no adverse effects. Persistence of injected nonanimalsourced stabilized hyaluronic acid was similar to that seen in other studies.

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“…Due to the extensive venous plexus, procedures involving injections in and around the injection site can cause NTPE. Although HA is thought to be non-immunogenic, it can cause localized granulomatous foreign body reactions with multinucleated giant cells around amorphous basophilic materials in the pulmonary vessels and lung parenchyma, as seen on video-assisted lung biopsy (FernandezAcenero et al, 2003;Honig et al, 2003;Raulin et al, 2000). Treatment is mainly supportive.…”

Section: Hyaluronic Acid Embolismmentioning

confidence: 99%