Cosmetic medicine review article: Etiology, prevention, and treatment of dermal filler complications

Aesthetic Surgery Journal

Volumn 31, Issue 1, 2011, Pages 110-121

  Bailey, Steven H ^a   Cohen, Joel L ^b   Kenkel, Jeffrey M ^a  

^a UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER   (United States)

^b UNIVERSITY OF COLORADO SCHOOL OF MEDICINE   (United States)

Author keywords

biofilm prevention; dermal fillers; filler complications; filler injection techniques; soft tissue augmentation

Indexed keywords

ALCOHOL; ANTIHISTAMINIC AGENT; CHLORAPREP; CHLORHEXIDINE; CHLORHEXIDINE GLUCONATE; CHLOROXYLENOL; CLARITHROMYCIN; DERMAL FILLER; DEXAMETHASONE; FILLER; FLUOROURACIL; HYALURONIC ACID; HYALURONIDASE; HYDROXYAPATITE; IMIQUIMOD; IODINE; IODOPHOR; LIDOCAINE; NONSTEROID ANTIINFLAMMATORY AGENT; POLYLACTIC ACID; STEROID; TACROLIMUS; UNCLASSIFIED DRUG;

ALLERGIC REACTION; ANGIONEUROTIC EDEMA; ANTICOAGULATION; ANTISEPSIS; BASAL CELL CARCINOMA; BIOFILM; BONE NECROSIS; ESTHETIC SURGERY; FILLER COMPLICATION; GRANULOMATOSIS; GRANULOMATOUS SKIN DISEASE; HUMAN; HYPERSENSITIVITY; HYPERSENSITIVITY REACTION; INFECTION PREVENTION; INJECTION; INJECTION SITE REACTION; INJECTION SITE STERILE ABSCESS; NEEDLE; PATIENT SATISFACTION; PREVENTION STUDY; PRIORITY JOURNAL; REVIEW; SKIN DISEASE; SKIN NECROSIS; SKIN TEST; SOFT TISSUE; SURGICAL TECHNIQUE; TECHNIQUE; TREATMENT RESPONSE; VASODILATATION; CUTANEOUS PARAMETERS; FACE; REJUVENATION;

COSMETIC TECHNIQUES; FACE; HUMANS; INJECTIONS; PATIENT SATISFACTION; REJUVENATION; SKIN AGING;

EID: 79751470412     PISSN: 1090820X     EISSN: 1527330X     Source Type: Journal    
DOI: 10.1177/1090820X10391083     Document Type: Review

References (82)

1. American Society for Aesthetic Plastic Surgery 2008 Cosmetic Surgery National Data Bank statistics. Available at: http://www.surgery.org/sites/ default/files/2008stats.pdf
2. Andre P. Evaluation of the safety of a non-animal stabilized hyaluronic acid (NASHA-Q-Medical, Sweden) in European countries: a retrospective study from 1997 to 2001. J Eur Acad Dermatol Venereol 2004 ; 18: 422-425. (Pubitemid 38967974)
3. Godin MS, Majmundar MV, Chrzanowski DS, Dodson KM Use of Radiesse in combination with Restylane for facial augmentation. Arch Facial Plast Surg 2006 ; 8: 92-97. (Pubitemid 44859520)
4. Glaich AS, Cohen JL, Goldberg LH Injection necrosis of the glabella: protocol for prevention and treatment after use of dermal fillers. Dermatol Surg 2006 ; 32: 276-281.
5. Beljaards Robc, De Roos K-P., Bruins FG NewFill for skin augmentation: a new filler or failure? Dermatol Surg 2005 ; 31: 772-777.
6. Berlin A., Cohen JL, Goldberg DJ Calcium hydroxylapatite for facial rejuvenation. Semin Cutan Med Surg 2006 ; 25: 132-137. (Pubitemid 44572810)
7. Brian R., Toy PJF. Outbreak of mycobacterium abscessus infection after soft tissue augmentation. Dermatol Surg 2003 ; 29: 971-973.
8. Inoue K., Sato K., Matsumoto D., Gonda K., Yoshimura K. Arterial embolization and skin necrosis of the nasal ala following injection of dermal fillers. Plast Reconstr Surg 2008 ; 121: 127e - 128e. (Pubitemid 351642871)
9. Jham BC, Nikitakis NG, Scheper MA, Papadimitriou JC, Levy BA, Rivera H. Granulomatous foreign-body reaction involving oral and perioral tissues after injection of biomaterials: a series of 7 cases and review of the literature. J Oral Maxillofac Surg 2009 ; 67: 280-285.
10. Leonhardt JMM, Lawrence NM, Narins RSM. Angioedema acute hypersensitivity reaction to injectable hyaluronic acid. Dermatol Surg 2005 ; 31: 577-579.
11. Fernández-Aceñero MJ, Zamora E., Borbujo J. Granulomatous foreign body reaction against hyaluronic acid: report of a case after lip augmentation. Dermatol Surg 2003 ; 29: 1225-1226. (Pubitemid 38009924)
12. Narins RSM, Jewell MM, Rubin MM, Cohen JM, Strobos JM Clinical conference: management of rare events following dermal fillers-focal necrosis and angry red bumps. Dermatol Surg 2006 ; 32: 426-434.
13. Parada MB, Michalany NS, Hassun KM, Bagatin E., Talarico S. A histologic study of adverse effects of different cosmetic skin fillers. Skinmed 2005 ; 4: 345-349.
14. Hirsch RJ, Cohen JL, Carruthers JD Successful management of an unusual presentation of impending necrosis following a hyaluronic acid injection embolus and a proposed algorithm for management with hyaluronidase. Dermatol Surg 2007 ; 33: 357-360. (Pubitemid 46328237)
15. Stewart DB, Morganroth GS, Mooney MA, Cohen J., Levin PS, Gladstone HB Management of visible granulomas following periorbital injection of poly-L-lactic acid. Ophthal Plast Reconstr Surg 2007 ; 23: 298-301. (Pubitemid 47220626)
16. Zielke H., Wölber L., Wiest L., Rzany B. Risk profiles of different injectable fillers: results from the injectable filler safety study (IFS Study). Dermatol Surg 2008 ; 34: 326-335. (Pubitemid 351316823)
17. Eppley BL, Dadvand B. Injectable soft-tissue fillers: clinical overview. Plast Reconstr Surg 2006 ; 118: 98e - 106e. (Pubitemid 44412913)
18. Johl SS, Burgett RA Dermal filler agents: a practical review. Curr Opin Ophthalmol 2006 ; 17: 471-479. (Pubitemid 44319040)
19. Murray CA, Zloty D., Warshawski L. The evolution of soft tissue fillers in clinical practice. Dermatol Clin 2005 ; 23: 343-363.
20. Rohrich RJ, Rios JL, Fagien S. Role of new fillers in facial rejuvenation: a cautious outlook. Plast Reconstr Surg 2003 ; 112: 1899-1902. (Pubitemid 39195841)
21. Beasley KL, Weiss MA, Weiss RA Hyaluronic acid fillers: a comprehensive review. Facial Plast Surg 2009 ; 25: 86-94.
22. Bogdan Allemann I., Baumann L. Hyaluronic acid gel (Juvederm) preparations in the treatment of facial wrinkles and folds. Clin Interv Aging 2008 ; 3: 629-634.
23. Cosmetic Surgery National Data Bank Statistics. 2007. Available at: http://www.cosmeticplasticsurgerystatistics.com/statistics.html#
24. Owens JM Soft tissue implants and fillers. Otolaryngol Clin North Am 2005 ; 38: 361-369.
25. Cockerham K., Hsu VJ Collagen-based dermal fillers: past, present, future. Facial Plast Surg 2009 ; 25: 106-113.
26. Friedman PM, Mafong EA, Kauvar AN, Geronemus RG Safety data of injectable nonanimal stabilized hyaluronic acid gel for soft tissue augmentation. Dermatol Surg 2002 ; 28: 491-494. (Pubitemid 34686633)
27. Klein AW Skin filling: collagen and other injectables of the skin. Dermatol Clin 2001 ; 19: 491-508. (Pubitemid 32924292)
28. Shoshani D., Markovitz E., Cohen Y., Heremans A., Gold-lust A. Skin test hypersensitivity study of a cross-linked, porcine collagen implant for aesthetic surgery. Dermatol Surg 2007 ; 33 (suppl 2). S152 - S158.
29. Narins RS, Brandt FS, Lorenc ZP, Maas CS, Monheit GD, Smith SR Twelve-month persistency of a novel ribose-cross-linked collagen dermal filler. Dermatol Surg 2008 ; 34 (suppl 1). S31 - S39.
30. Narins RS, Brandt F., Leyden J., Lorenc ZP, Rubin M., Smith S. A randomized, double-blind, multicenter comparison of the efficacy and tolerability of Restylane versus Zyplast for the correction of nasolabial folds. Dermatol Surg 2003 ; 29: 588-595. (Pubitemid 36702442)
31. Dinehart SM, Henry L. Dietary supplements: altered coagulation and effects on bruising. Dermatol Surg 2005 ; 31: 819-826, discussion 826.
32. Khalifeh MR, Redett RJ The management of patients on anticoagulants prior to cutaneous surgery: case report of a thromboembolic complication, review of the literature, and evidence-based recommendations. Plast Reconstr Surg 2006 ; 118: 110e - 117e. (Pubitemid 44511395)
33. Ong AT, Hoye A., Aoki J., et al. Thirty-day incidence and six-month clinical outcome of thrombotic stent occlusion after bare-metal, sirolimus, or paclitaxel stent implantation. J Am Coll Cardiol 2005 ; 45: 947-953. (Pubitemid 40342824)
34. Silber S., Albertsson P., Aviles FF,, et al. Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology. Guidelines for percutaneous coronary interventions. The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology [see comment]. Eur Heart J 2005 ; 26: 804-847.
35. King SB III, Smith SC Jr, Hirshfeld JW Jr, et al. 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: 2007 writing group to review new evidence and update the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention, writing on behalf of the 2005 writing committee [erratum appears in Circulation 2008;117:e161]. Circulation 2008 ; 117: 261-295.
36. Stone GW, Aronow HD Long-term care after percutaneous coronary intervention: focus on the role of antiplatelet therapy. Mayo Clin Proc 2006 ; 81: 641-652.
37. Zimarino M., Renda G., De Caterina R. Optimal duration of antiplatelet therapy in recipients of coronary drug-eluting stents. Drugs 2005 ; 65: 725-732. (Pubitemid 40593622)
38. Douketis JD, Berger PB, Dunn AS,, et al. American College of Chest Physicians. The perioperative management of antithrombotic therapy: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest 2008 ; 133: 299S - 339S. (Pubitemid 351894915)
39. Calfee DP, Farr BM Comparison of four antiseptic preparations for skin in the prevention of contamination of percutaneously drawn blood cultures: a randomized trial. J Clin Microbiol 2002 ; 40: 1660-1665. (Pubitemid 34493136)
40. Reichel M., Heisig P., Kohlmann T., Kampf G. Alcohols for skin antisepsis at clinically relevant skin sites. Antimicrob Agents Chemother 2009 ; 53: 4778-4782.
41. Soothill JS, Bravery K., Ho A., Macqueen S., Collins J., Lock P. A fall in bloodstream infections followed a change to 2% chlorhexidine in 70% isopropanol for catheter connection antisepsis: a pediatric single center before/after study on a hemopoietic stem cell transplant ward. Am J Infect Control 2009 ; 37: 626-630.
42. Donald LM, Naomi POG. Guidelines for the prevention of intravascular catheter-related infections: recommendations relevant to interventional radiology. J Vasc Interv Radiol 2003 ; 14: S355 - S358.
43. Moskowitz SM, Foster JM, Emerson J., Burns JL Clinically feasible biofilm susceptibility assay for isolates of Pseudomonas aeruginosa from patients with cystic fibrosis. J Clin Microbiol 2004 ; 42: 1915-1922. (Pubitemid 38637802)
44. Alam M., Yoo SS Technique for calcium hydroxylapatite injection for correction of nasolabial fold depressions. J Am Acad Dermatol 2007 ; 56: 285-289. (Pubitemid 46074253)
45. Lam SM, Azizzadeh B., Graivier M. Injectable poly-L-lactic acid (Sculptra): technical considerations in soft-tissue contouring. Plast Reconstr Surg 2006 ; 118: 55S - 63S. (Pubitemid 44319091)
46. Cohen JL Understanding, avoiding, and managing dermal filler complications. Dermatol Surg 2008 ; 34 (suppl1). S92 - S99.
47. Donald WB, Murad A., John YSK. Injectable fillers for facial rejuvenation: a review. J Plast Reconstr Aesthetic Surg 2009 ; 62: 11-18.
48. Lemperle G., Rullan PP, Gauthier-Hazan N. Avoiding and treating dermal filler complications. Plast Reconstr Surg 2006 ; 118: 92S - 107S. (Pubitemid 44319095)
49. Lemperle G., Romano JJ, Busso M. Soft tissue augmentation with Artecoll: 10-year history, indications, techniques, and complications. Dermatol Surg 2003 ; 29: 573-587. (Pubitemid 36702440)
50. Arlette JP, Trotter MJ Anatomic location of hyaluronic acid filler material injected into nasolabial fold: a histologic study. Dermatol Surg 2008 ; 34 (suppl): S56 - S62.
51. DW II, Alam M., Kim JY Injectable fillers for facial rejuvenation: a review. J Plast Reconstr Aesthetic Surg 2009 ; 62: 11-18.
52. Narins RS, Bowman PH Injectable skin fillers. Clin Plast Surg 2005 ; 32: 151-162. (Pubitemid 40462271)
53. Werschler WMP. Advanced injection techniques of polyL-lactic acid: a case-based presentation. Dermatol Ther 2007 ; 20 (suppl): S16 - S19.
54. Kusin S., Lippitz J. Skin fillers. Dis Mon 2009 ; 55: 236-256.
55. Nicolau PJ Long-lasting and permanent fillers: biomaterial influence over host tissue response. Plast Reconstr Surg 2007 ; 119: 2271-2286. (Pubitemid 46847128)
56. Hirsch RJ, Carruthers JD, Carruthers A. Infraorbital hollow treatment by dermal fillers. Dermatol Surg 2007 ; 33: 1116-1119. (Pubitemid 47339697)
57. Hirsch RJ, Narurkar V., Carruthers J. Management of injected hyaluronic acid induced Tyndall effects. Lasers Surg Med 2006 ; 38: 202-204.
58. Brody HJ Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement [erratum appears in Dermatol Surg 2008 ; 34: 135 ]. Dermatol Surg 2005 ; 31: 893-897. (Pubitemid 350308610)
59. Beer KR Radiesse nodule of the lips from a distant injection site: report of a case and consideration of etiology and management. J Drugs Dermatol 2007 ; 6: 846-847.
60. Rohrich RJ, Ghavami A., Crosby MA The role of hyaluronic acid fillers (Restylane) in facial cosmetic surgery: review and technical considerations. Plast Reconstr Surg 2007 ; 120: 41S - 54S.
61. Carruthers JD, Carruthers A. Facial sculpting and tissue augmentation. Dermatol Surg 2005 ; 31: 1604-1612.
62. Glogau RG, Kane MA Effect of injection techniques on the rate of local adverse events in patients implanted with nonanimal hyaluronic acid gel dermal fillers. Dermatol Surg 2008 ; 34 (suppl 1). S105 - S109.
63. Cohen JL, Brown MR Anatomic considerations for soft tissue augmentation of the face. J Drugs Dermatol 2009 ; 8: 13-16.
64. Broder KW, Cohen SR ArteFill: a permanent skin filler. Expert Rev Med Devices 2006 ; 3: 281-289.
65. Stolman LP Human collagen reactions. Dermatol Surg 2005 ; 31: 1634.
66. Nijhawan RI, Cohen JL, Kaufman J. Persistent erythema after human collagen injections. Cosmetic Dermatol 2008 ; 21: 90-94.
67. Hirsch RJ, Cohen JL, Carruthers JD Successful management of an unusual presentation of impending necrosis following a hyaluronic acid injection embolus and a proposed algorithm for management with hyaluronidase. Dermatol Surg 2007 ; 33: 357-360. (Pubitemid 46328237)
68. Schanz S. Arterial embolization caused by injection of hyaluronic acid (Restylane). Br J Dermatol 2002 ; 146: 928-929. (Pubitemid 34539217)
69. Lemperle G., Gauthier-Hazan N., Wolters M., Eisemann-Klein M., Zimmermann U., Duffy DM Foreign body granulomas after all injectable dermal fillers: Part 1. Possible causes. Plast Reconstr Surg 2009 ; 123: 1842-1863.
70. Bentkover SH The biology of facial fillers. Facial Plast Surg 2009 ; 25: 73-85.
71. Christensen L., Breiting V., Janssen M., Vuust J., Hogdall E. Adverse reactions to injectable soft tissue permanent fillers. Aesthetic Plast Surg 2005 ; 29: 34-48. (Pubitemid 40685159)
72. Christensen L. Normal and pathologic tissue reactions to soft tissue gel fillers. Dermatol Surg 2007 ; 33 (suppl2). S168 - S175.
73. Hamilton DG, Gauthier N., Robertson BF Late-onset, recurrent facial nodules associated with injection of poly-L-lactic acid. Dermatol Surg 2008 ; 34: 123-126, discussion 126. (Pubitemid 350308607)
74. Woerle B., Hanke CW, Sattler G. Poly-L-lactic acid: a temporary filler for soft tissue augmentation. J Drugs Dermatol 2004 ; 3: 385-389.
75. Butterwick K., Lowe NJ Injectable poly-L-lactic acid for cosmetic enhancement: learning from the European experience. J Am Acad Dermatol 2009 ; 61: 281-293.
76. Burgess CM, Quiroga RM Assessment of the safety and efficacy of poly-L-lactic acid for the treatment of HIV-associated facial lipoatrophy. J Am Acad Dermatol 2005 ; 52: 233-239.
77. Lowe NJ, Maxwell CA, Patnaik R. Adverse reactions to dermal fillers: review. Dermatol Surg 2005 ; 31: 1616-1625.
78. Vleggaar D. Soft-tissue augmentation and the role of poly-L-lactic acid. Plast Reconstr Surg 2006 ; 118: 46S - 54S. (Pubitemid 44319090)
79. Borelli C., Kunte C., Weisenseel P., Thoma-Greber E., Korting HC, Konz B. Deep subcutaneous application of polyL-lactic acid as a filler for facial lipoatrophy in HIV-infected patients. Skin Pharmacol Physiol 2005 ; 18: 273-278. (Pubitemid 41527617)
80. Salles AG, Lotierzo PH, Gimenez R., Camargo CP, Ferreira MC Evaluation of the poly-L-lactic acid implant for treatment of the nasolabial fold: 3-year follow-up evaluation. Aesthetic Plast Surg 2008 ; 32: 753-756.
81. Holzapfel AM, Mangat DS, Barron DS Soft-tissue augmentation with calcium hydroxylapatite: histological analysis. Arch Facial Plast Surg 2008 ; 10: 335-338.
82. Alcalay J., Alkalay R., Gat A., Yorav S. Late-onset granulomatous reaction to Artecoll. Dermatol Surg 2003 ; 29: 859-862. (Pubitemid 36927510)