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The "ART" of facial filler injections: Avoid, recognize, and treat hyaluronic acid-induced complications.
J Cosmet Dermatol. 2020 Jul 10 [Online ahead of print]JC

Abstract

BACKGROUND

Hyaluronic acid (HA) fillers are frequently used for cosmetic purposes as volumizers or as wrinkle fillers. One of the major advantages of hyaluronic acid use is the possibility to neutralize it by using hyaluronidase should complications occur.

PATIENT

A case of a 21-year-old female patient is presented, in whom a hyaluronic acid injection-induced vascular occlusion was seen four days after the initial injection, with increasing pain and severe signs of ischemia.

METHOD

Treatment consisted of an immediate hyaluronidase injection, supplemented with administration of acetylsalicylic acid, piracetam, low molecular weight heparin (LMWH), corticosteroids, analgesics, prophylactic antibiotics, application of topical nitroglycerin and warmth, smoking cessation, and hyperbaric oxygen therapy.

RESULTS

The initial progress and evolution of the deformity with possible therapeutic options are being discussed.

CONCLUSION

The "ART" (avoid, recognize, and treat) in handling filler complications is presented, as a new universal guideline for clinical aesthetic practitioners and injectors.

Authors+Show Affiliations

Department of Plastic and Reconstructive Surgery, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.Department of Plastic and Reconstructive Surgery, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.Department of Plastic and Reconstructive Surgery, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.Department of Plastic and Reconstructive Surgery, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.Department of Plastic and Reconstructive Surgery, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.Department of Plastic and Reconstructive Surgery, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.Department of Plastic and Reconstructive Surgery, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32649055

Citation

Zeltzer, Assaf, et al. "The "ART" of Facial Filler Injections: Avoid, Recognize, and Treat Hyaluronic Acid-induced Complications." Journal of Cosmetic Dermatology, 2020.
Zeltzer A, Geeroms M, Antoniazzi E, et al. The "ART" of facial filler injections: Avoid, recognize, and treat hyaluronic acid-induced complications. J Cosmet Dermatol. 2020.
Zeltzer, A., Geeroms, M., Antoniazzi, E., Giunta, G., De Baerdemaeker, R., Hendrickx, B., & Hamdi, M. (2020). The "ART" of facial filler injections: Avoid, recognize, and treat hyaluronic acid-induced complications. Journal of Cosmetic Dermatology. https://doi.org/10.1111/jocd.13611
Zeltzer A, et al. The "ART" of Facial Filler Injections: Avoid, Recognize, and Treat Hyaluronic Acid-induced Complications. J Cosmet Dermatol. 2020 Jul 10; PubMed PMID: 32649055.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The "ART" of facial filler injections: Avoid, recognize, and treat hyaluronic acid-induced complications. AU - Zeltzer,Assaf, AU - Geeroms,Maxim, AU - Antoniazzi,Elisa, AU - Giunta,Gabriele, AU - De Baerdemaeker,Randy, AU - Hendrickx,Benoit, AU - Hamdi,Moustapha, Y1 - 2020/07/10/ PY - 2020/06/13/received PY - 2020/07/06/accepted PY - 2020/7/11/pubmed PY - 2020/7/11/medline PY - 2020/7/11/entrez KW - complication KW - filler KW - hyaluronic acid KW - hyaluronidase KW - necrosis JF - Journal of cosmetic dermatology JO - J Cosmet Dermatol N2 - BACKGROUND: Hyaluronic acid (HA) fillers are frequently used for cosmetic purposes as volumizers or as wrinkle fillers. One of the major advantages of hyaluronic acid use is the possibility to neutralize it by using hyaluronidase should complications occur. PATIENT: A case of a 21-year-old female patient is presented, in whom a hyaluronic acid injection-induced vascular occlusion was seen four days after the initial injection, with increasing pain and severe signs of ischemia. METHOD: Treatment consisted of an immediate hyaluronidase injection, supplemented with administration of acetylsalicylic acid, piracetam, low molecular weight heparin (LMWH), corticosteroids, analgesics, prophylactic antibiotics, application of topical nitroglycerin and warmth, smoking cessation, and hyperbaric oxygen therapy. RESULTS: The initial progress and evolution of the deformity with possible therapeutic options are being discussed. CONCLUSION: The "ART" (avoid, recognize, and treat) in handling filler complications is presented, as a new universal guideline for clinical aesthetic practitioners and injectors. SN - 1473-2165 UR - https://www.unboundmedicine.com/medline/citation/32649055/The_"ART"_of_Facial_Filler_Injections:_Avoid,_Recognize_and_Treat_Hyaluronic_Acid-induced_Complications L2 - https://doi.org/10.1111/jocd.13611 DB - PRIME DP - Unbound Medicine ER -
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