Adverse Events Associated With Aesthetic Dermal Fillers: A 10-Year Retrospective Study of FDA Data | Semantic Scholar (2024)

ARs associated with the use of neurotoxins and soft tissue fillers are underreported in Canada, and more complete and representative information regarding ARs is necessary for the development and validation of treatment algorithms and management strategies.

Filler migration distant from the injection site can occur even several years after the primary treatment, and permanent fillers bear a higher risk of very late filler migration.

Autologous fat was the most common filler associated with blindness despite HA fillers being the most commonly used across the globe, however, the blindness caused by other soft-tissue fillers like collagen and calcium hydroxylapatite was represented.

Although delayed nodules and inflammatory events are rare, reports for these events were extracted from the MAUDE database from 2016 to 2020 for HAVLR, HAVOB, HADEF, HARH4, HAREF, and HARH2 (most to least frequent).

A systematic review supports the development of American Society for Dermatologic Surgery practice guideline on the management of adverse events of skin fillers and suggests practitioners must have adequate knowledge of anatomy, elicit history of skin filler use, and establish preemptive protocols that prepare the clinical practice to manage complications.

Five practical considerations were recommended: patient assessment and individualization of treatment plan, choice of an appropriate HA filler, adequate knowledge of facial anatomy, strict adherence to aseptic methods, and proper injection technique, which support practitioners in optimizing safety and quality of aesthetic treatment with HA fillers.

A filler emergency kit (FEK) is proposed to deal with complications of hyaluronic acid fillers according to the new protocol to manage the stresses caused by these situations to avoid distressing the physician and the patient.

In conclusion, the high-pressure and high-volume filler injections probably caused a detachment of the tissues, with the orbicularis oris muscle concurrently acting as a pump and moving the HA implant, causing migration to the area with low-density tissue such as the cheek.

To the best of the knowledge, there has been no report of using the intradermal injection of the micro‐droplet HA to correct filler nodule and simultaneously revitalize the skin quality, suggesting this novel treatment technique could be a safe alternative for nodule formation correction.

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For optimum outcomes, aesthetic physicians should have a detailed understanding of facial anatomy; the individual characteristics of available fillers; their indications, contraindications, benefits, and drawbacks; and ways to prevent and avoid potential complications.

Adverse reactions can be documented for all injectable fillers, however, time until reaction as well as type of reaction, though, vary between different fillers.

This consensus document provides key elements to help clinicians who are starting to use dermal fillers to employ standard procedures and to understand how best to prevent potential complications of the treatment.

Vascular occlusion causing blindness is a rare yet greatly feared complication of the use of facial aesthetic fillers and a suggested helpful addition to the protocols for urgent management is suggested.

Different injectable products have highly divergent properties, associated risks, and injection requirements, and the dermasurgeon should be suitably experienced to select and use these products correctly.

Although the risk of blindness from fillers is rare, it is critical for injecting physicians to have a firm knowledge of the vascular anatomy and to understand key prevention and management strategies.

Complications of oral region fillers are similar in clinical presentation but differ in etiology, therefore necessitating different clinical approaches, and imaging techniques add useful information for treatment planning.

Clinicians and patients can benefit from ongoing guidance on adverse reactions to hyaluronic acid fillers and their management, and detailed understanding of facial anatomy, proper patient and product selection, and appropriate technique can further reduce the risks.

Worldwide and country-specific total and textured implant sales data are needed to determine critical incidence and prevalence analysis and federal reporting of breast implant–associated ALCL has limitations in providing clinical history, treatment, and oncologic follow-up.

The case of a young patient who presented an acute and severe complication after a dermal filler injection by an unlicensed therapist is reported, leaving the patient with a full thickness scar on the forehead region.

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