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CC BY-NC-ND 4.0 · Indian J Plast Surg 2020; 53(03): 335-343
DOI: 10.1055/s-0040-1721872
Review Article

Nonvascular Complications of Injectable Fillers—Prevention and Management

Kuldeep Singh
1   Department of Aesthetic, Plastic & Reconstructive Surgery, Indraprastha Apollo Hospital, New Delhi, India
,
Shahin Nooreyezdan
1   Department of Aesthetic, Plastic & Reconstructive Surgery, Indraprastha Apollo Hospital, New Delhi, India
› Author Affiliations Source of Funding None.
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Abstract

Injectable filler treatments have increased in popularity because of enhanced safety profile and improved physical characteristics. ISAPS (International Society of Plastic Surgery) put out global data showing 3.7 million hyaluronic acid (HA) filler procedures in 2018, making it the second most often performed procedure in the world, after botulinum toxin. And these are only ‘those’ performed by qualified plastic surgeons. There was a concomitant increase in both the nonvascular and vascular complications, which coincided with the number and type of filler procedures performed. Filler complications were reviewed from existing literature, and an attempt was made to understand etiology, elucidate clinical features, and clarify optimum treatment strategies for each. Complications can be early or delayed in presentation, early consisting of injection site complications like bruising, edema, and hypersensitivity, Tyndall effect, and intravascular injection. Delayed complications included hypersensitivity type IV, acute infections like cellulitis, abscesses, and herpes and delayed ones like granulomas, biofilms, and atypical mycobacterial infections. These were analyzed and treatment options, protocols, and consensus guidelines were suggested. A clear understanding of facial anatomy, physical characteristics of all fillers used, early recognition, and treatment options of complications will ensure optimum outcomes.

Keywords

fillers - injectable fillers - complications - nonvascular - hypersensitivity - infection - biofilm - atypical mycobacteria


Publication History

Article published online:
24 December 2020

© 2020. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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