Prevention and Management of Dermal Filler Complications: A Review

ISAPS, International Society of Aesthetic Plastic Surgery. International Survey on Aesthetic/Cosmetic Procedures Performed in 2021. Available from: https://www.isaps.org/media/vdpdanke/isaps-global-survey_2021.pdf [Last accessed: November 22, 2023].

Aesthetic Society. Fillers—Safety Considerations. 2023. Available from: https://www.theaestheticsociety.org/procedures/skin-hair/fillers/safety-considerations#main-content [Last accessed: November 29, 2023].

Kapoor KM , Kapoor P , Heydenrych I , et al. Vision loss associated with hyaluronic acid fillers: A systematic review of literature. Aesthetic Plast Surg. 2020; 44(3):929–944; doi: 10.1007/s00266-019-01562-8

Kroumpouzos G , Harris S , Bhargava S , et al. Complications of fillers in the lips and perioral area: Prevention, assessment, and management focusing on ultrasound guidance. J Plast Reconstr Aesthet Surg. 2023; 84:656–669; doi: 10.1016/j.bjps.2023.01.048

Thanasarnaksorn W , Thanyavuthi A , Prasertvit P , et al. Case series of tongue necrosis from vascular complications after chin augmentation with hyaluronic acid: Potential pathophysiology and management. J Cosmet Dermatol. 2023; 22(3):784–791; doi: 10.1111/jocd.15475

Sito G , Manzoni V , Sommariva R . Vascular complications after facial filler injection: A literature review and meta-analysis. J Clin Aesthet Dermatol. 2019; 12(6):E65–E72.

Doerfler L , Hanke CW . Arterial occlusion and necrosis following hyaluronic acid injection and a review of the literature. J Drugs Dermatol., 2019; 18(6):587–591.

Urdiales-Gálvez F , Delgado NE , Figueiredo V , et al. Treatment of soft tissue filler complications: Expert consensus recommendations. Aesthetic Plast Surg. 2018; 42(2):498–510; doi: 10.1007/s00266-017-1063-0

Signorini M , Liew S , Sundaram H , et al. Global Aesthetics Consensus Group. Global aesthetics consensus: Avoidance and management of complications from hyaluronic acid fillers-evidence- and opinion-based review and consensus recommendations. Plast Reconstr Surg. 2016; 137(6):961e–971e; doi: 10.1097/PRS.0000000000002184

Convery C , Davies E , Murray G , et al. Delayed-Onset Nodules (DONs) and considering their treatment following use of Hyaluronic Acid (HA) fillers. J Clin Aesthet Dermatol., 2021; 14(7):E59–E67.

Fabi SG , Dayan S . Management & Prevention of Hyaluronic Acid Based Filler Complications. Available from: https://events.avenue.live/avenue-live/Management-Prevention-of-Hyaluronic-Acid-Based-Filler omplications?_hsmi=283096092&_hsenc=p2ANqtz-9IYJKlmJPIdvNHYzHRHvRZ8Rs5ilNh3s-go1konXD4yF3bhwgz_eoofwKHQJAMkBd8g5OTz_VJB0hKs9_wckDGdGEay-PdHX9bMBskvZ9IUqbwbGc [Last accessed: November 21, 2023].

Taylor GI , Palmer JH . The vascular territories (angiosomes) of the body: Experimental Study and clinical applications. Br J Plast Surg. 1987; 40(2):113–141; doi: 10.1016/0007-1226(87)90185-8

Taylor GI , Corlett RJ , Dhar SC , et al. The anatomical (angiosome) and clinical territories of cutaneous perforating arteries: Development of the concept and designing safe flaps. Plast Reconstr Surg. 2011; 127(4):1447–1459; doi: 10.1097/PRS.0b013e318208d21b

Taylor GI , Corlett RJ , Ashton MW . The functional angiosome: Clinical implications of the anatomical concept. Plast Reconstr Surg. 2017; 140(4):721–733; doi: 10.1097/PRS.0000000000003694

Ashton MW , Taylor GI , Corlett RJ . The role of anastomotic vessels in controlling tissue viability and defining tissue necrosis with special reference to complications following injection of hyaluronic acid fillers. Plast Reconstr Surg. 2018; 141(6):818e–830e; doi: 10.1097/PRS.0000000000004287

Taylor GI , Shoukath S , Gascoigne A , et al. The functional anatomy of the ophthalmic angiosome and its implications in blindness as a complication of cosmetic facial filler procedures. Plast Reconstr Surg. 2020; 146(4):745; doi: 10.1097/PRS.0000000000007155

Rohrich RJ , Bartlett EL , Dayan E . Practical approach and safety of hyaluronic acid fillers. Plast Reconstr Surg Glob Open. 2019; 7(6):e2172; doi: 10.1097/GOX.0000000000002172

DeLorenzi C . Complications of injectable fillers, part 2: Vascular complications. Aesthet Surg J. 2014; 34(4):584–600; doi: 10.1177/1090820X14525035

DeLorenzi C . New high dose pulsed hyaluronidase protocol for hyaluronic acid filler vascular adverse events. Aesthet Surg J. 2017; 37(7):814–825; doi: 10.1093/asj/sjw251

Evora PR , Pearson PJ , Chua YL , et al. Exogenous hyaluronidase induces release of nitric oxide from the coronary endothelium. J Thorac Cardiovasc Surg. 2000; 120(4):707–711; doi: 10.1067/mtc.2000.108905

Desyatnikova S , Mangieri L . Nitrous oxide improves tissue perfusion in vascular occlusion management. Plast Reconstr Surg Glob Open. 2023; 11(7):e5154; doi: 10.1097/GOX.0000000000005154

Murray G , Convery C , Walker L , et al. Guideline for the management of hyaluronic acid filler-induced vascular occlusion. J Clin Aesthet Dermatol. 2021; 14(5):E61–E69.

Desyatnikova S . Ultrasound-guided temple filler injection. Facial Plast Surg Aesthet Med. 2022; 24(6):501–503; doi: 10.1089/fpsam.2022.0176

Desyatnikova S , Schelke L . Treatment of filler-related vascular occlusion using handheld portable ultrasound device. J Cosmet Dermatol. 2022; 21(7):3166–3168; doi: 10.1111/jocd.15125

Schelke LW , Velthuis P , Kadouch J , et al. Early ultrasound for diagnosis and treatment of vascular adverse events with hyaluronic acid fillers. J Am Acad Dermatol. 2023; 88(1):79–85; doi: 10.1016/j.jaad.2019.07.032

Mlosek RK , Skrzypek E , Skrzypek DM , et al. High-frequency ultrasound-based differentiation between nodular dermal filler deposits and foreign body granulomas. Skin Res Technol. 2018; 24(3):417–422; doi: 10.1111/srt.12444

Goodman GJ , McDonald CB , Lim A , et al. Making sense of late tissue nodules associated with hyaluronic acid injections. Aesthet Surg J. 2023; 43(6):NP438–NP448; doi: 10.1093/asj/sjad028