Soft Tissue Dermal Filler–Associated Necrosis and Impending Necrosis: A Systematic Review of the Literature

Abstract

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Commentary on “Soft Tissue Dermal Filler-Associated Necrosis and Impending Necrosis: A Systematic Review of the Literature”

“…e.g., 71.9% of the cases in this study were caused by hyaluronic acid filler, but only 19.1% were treated initially with hyaluronidase (Hyaluronidase use for the dissolution of hyaluronic acid is off label.). 1 Quantifying the risk of inadvertent intravascular injection is important for informed consent but is challenging to calculate without accurate reporting. Determining the risks of progression to necrosis is crucial.…”

“…e.g., 71.9% of the cases in this study were caused by hyaluronic acid filler, but only 19.1% were treated initially with hyaluronidase (Hyaluronidase use for the dissolution of hyaluronic acid is off label.). 1…”

“…Cutaneous necrosis is one of the most serious adverse events associated with soft tissue filler injection. Rentfro and colleagues 1 review 97 papers encompassing 192 cases of this complication that is feared even by the most experienced injectors. 2 A number of factors suggest we can expect to observe an increase in the number of these adverse events and ensuing litigation: filler treatments are becoming increasingly mainstream among the public; the number of marketed products and associated advertising is increasing; and the number of injectors is rapidly multiplying, including not only core specialists, but also noncore physicians and physician extenders with varying degrees of training and expertise.…”