The Current State of Treatment of Adverse Reactions to Injectable Fillers

Sperling, Berit; Bachmann, Frank; Hartmann, Vanessa; Erdmann, R.; Wiest, Luitgard; Rzany, Berthold

doi:10.1111/j.1524-4725.2010.01782.x

Cited by 19 publications

(5 citation statements)

References 43 publications

(75 reference statements)

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“…For late-onset nodules or granulomas, intralesional steroids (betamethasone 5 mg/mL or triamcinolone 10–40 mg/mL for 10 days up to 4 weeks) can be considered, although care needs to be taken to avoid skin atrophy. 2 , 4 …”

Section: Recognition and Treatment Recommendations – Delayed Eventsmentioning

confidence: 99%

“…For persistent cases, additional measures can include a series of injections of 5-fluorouracil (50 mg/mL) in combination with steroids and/or lidocaine (1:3), methotrexate, local tacrolimus, 2 , 4 , 49 cortivasol, allopurinol, colchicine, isotretinoin, imiquinod, 49 laser-assisted removal, 45 or ultimately excision by surgery as a last resort. 12 …”

Section: Recognition and Treatment Recommendations – Delayed Eventsmentioning

confidence: 99%

“…There remains, however, no consensus on the best treatment for adverse reactions, and each treatment option with its advantages and disadvantages should be carefully considered and discussed with the patient. 4 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Patient factors influencing dermal filler complications: prevention, assessment, and treatment

Boulle¹,

Heydenrych

2015

CCID

135

182

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While rare, complications do occur with the esthetic use of dermal fillers. Careful attention to patient factors and technique can do much to avoid these complications, and a well-informed practitioner can mitigate problems when they do occur. Since cosmetic surgery is usually an elective process, requested by the patient, clinical trials are complex to organize and run. For this reason, an international group of practicing physicians in the field of esthetics came together to share knowledge and to try and produce some informed guidance for their colleagues, considering the literature and also pooling their own extensive clinical experience. This manuscript aims to summarize the crucial aspects of patient selection, including absolute contraindications as well as situations that warrant caution, and also covers important considerations for the pre- and posttreatment periods as well as during the procedure itself. Guidance is given on both immediate and long-term management of adverse reactions. The majority of complications are related to accepting patients inappropriate for treatment or issues of sterility, placement, volume, and injection technique. It is clear that esthetic practitioners need an in-depth knowledge of all aspects of treatment with dermal fillers to achieve optimal outcomes for their patients.

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Section: Recognition and Treatment Recommendations – Delayed Eventsmentioning

confidence: 99%

Section: Recognition and Treatment Recommendations – Delayed Eventsmentioning

confidence: 99%

See 1 more Smart Citation

Patient factors influencing dermal filler complications: prevention, assessment, and treatment

Boulle¹,

Heydenrych

2015

CCID

135

182

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“…Adverse events (AE) to the different filler types have been reported, but their origin has been debated (Alijotas-Reig et al, 2010;Sperling et al, 2010;Alijotas-Reig & Garcia-Gimenez, 2011;Bachmann et al, 2011). Some have presumed the events to be due to a hypersensitivity inflammatory response to the fillers, whereas others have demonstrated that bacterial infection is the cause of AEs, at least to polyacrylamide gels (Christensen et al, 2005(Christensen et al, , 2013Bjarnsholt et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Bacterial biofilm formation and treatment in soft tissue fillers

Eickhardt

Kragh

et al. 2014

Pathogens Disease

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Injection of soft tissue fillers plays an important role in facial reconstruction and esthetic treatments such as cosmetic surgery for lip augmentation and wrinkle smoothening. Adverse events are an increasing problem, and recently, it has been suggested that bacteria are the cause of a vast fraction these. We developed a novel mouse model and evaluated hyaluronic acid gel, calcium hydroxyl apatite microspheres, and polyacrylamide hydrogel for their potential for sustaining bacterial infections and their possible treatments. We were able to culture Pseudomonas aeruginosa, Staphylococcus epidermidis, and Probionibacterium acnes in all three gels. When contaminated gels were left for 7 days in a mouse model, we found sustainment of bacterial infection with the permanent gel, less with the semi-permanent gel, and no growth within the temporary gel. Evaluation of treatment strategies showed that once the bacteria had settled (into biofilms) within the gels, even successive treatments with high concentrations of relevant antibiotics were not effective. Our data substantiate bacteria as a cause of adverse reactions reported when using tissue fillers, and the sustainability of these infections appears to depend on longevity of the gel. Most importantly, the infections are resistant to antibiotics once established but can be prevented using prophylactic antibiotics.

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“…In a review of patients with complications entered in the Injectable Filler Safety Study, all participants improved whether they underwent treatment or not. 23 The Tyndall effect, or bluish discoloration, can be seen with HA injections (►Fig. 6).…”

Section: Complicationsmentioning

confidence: 99%

Filling the Midface: Injectables

Winslow

2016

Facial plast Surg

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Volumizing the face has become commonplace on the facial aesthetic scene, with a rapid explosion of popularity in the field of nonsurgical rejuvenation. Three-dimensional enhancement of the midface with fillers provides the surgeon with a minimal downtime opportunity to treat early aging or reverse nonsurgical volume loss. With new products come advancements in techniques and the understanding of reversal of the effects of aging. While providing minimal downtime and risk, complications can occur and the physician must be able to recognize and treat these issues. It is crucial for the injector to understand and process these factors to ensure patient satisfaction and safety.

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The Current State of Treatment of Adverse Reactions to Injectable Fillers

Cited by 19 publications

References 43 publications

Patient factors influencing dermal filler complications: prevention, assessment, and treatment

Patient factors influencing dermal filler complications: prevention, assessment, and treatment

Bacterial biofilm formation and treatment in soft tissue fillers

Filling the Midface: Injectables

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