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Handchir Mikrochir Plast Chir 2006; 38(6): 354-369
DOI: 10.1055/s-2006-955889
Übersichtsartikel

Georg Thieme Verlag KG Stuttgart · New York

Komplikationen nach Faltenunterspritzung und ihre Behandlung[1]

Complications After Dermal Fillers and Their TreatmentG. Lemperle1 , N. Gauthier-Hazan2 , M. Wolters3
  • 1Division of Plastic Surgery, University of California, San Diego, CA, USA
  • 2Privatpraxis, Paris, Frankreich
  • 3Gemeinschaftspraxis, Frankfurt/Main
Further Information

Publication History

Eingang des Manuskriptes: 5.6.2006

Angenommen: 28.9.2006

Publication Date:
11 January 2007 (online)

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Zusammenfassung

Alle injizierbaren Faltenmittel können frühe und späte Komplikationen verursachen. Zu den frühen gehören Schwellung, Rötung und Blutergüsse nach intradermalen oder subkutanen Injektionen, die vom Patienten akzeptiert werden müssen. Komplikationen, die länger als zwei Wochen anhalten, sind oft auf technische Mängel, d. h. auf eine zu oberflächliche Injektion des Füllmaterials, zurückzuführen. Die meisten dieser Nebenwirkungen können wirkungsvoll mit intraläsionalen Injektionen von Kortikosteroiden und 5-Fluorouracil, Laser oder „intense pulse light“ behandelt werden und, wenn dies nicht hilft, mit der Dermabrasion nivelliert oder tangential abgetragen werden. Spätkomplikationen sind vorwiegend immunologische Reaktionen wie chronische Rötungen oder Allergien vom Typ IV sowie Fremdkörper-Granulome. Beide Überreaktionen reagieren sehr effektiv auf intraläsional injizierte Steroidkristalle, die meist wiederholt appliziert werden müssen, bis die richtige Dosis gefunden ist. Chirurgische Exzisionen sollten unbedingt vermieden und nur bei sichtbaren harten Knötchen, besonders in den Lippen oder im subkutanen Fett, in Betracht gezogen werden.

Abstract

All dermal fillers are associated with the risk of both early and late complications. Early side effects such as swelling, redness, and bruising occur after intradermal or subdermal injections. The patient has to be aware of these risks and be prepared to accept them. Adverse events that last longer than 2 weeks can be attributable to technical shortcomings (e.g., the implantation of a long-lasting filler substance was too superficial). Such adverse events can be treated with intradermal 5-fluorouracil and steroid injections, vascular lasers, or intense pulsed light, and later with dermabrasion or shaving. Late adverse events also include immunological phenomena such as late-onset allergy and non-allergic foreign body granulomas. Both react well to intralesional steroid injections, which often have to be repeated to establish the right dose. Surgical excisions should remain the last option and are indicated for hard lumps in the lips and visible hard nodules or hard granulomas in the subcutaneous fat.

Schlüsselwörter

Faltenmittel - Komplikationen - Nebenwirkungen - Granuloma - Fremdkörper-Granulome - Kortikosteroid-Injektionen

Key words

Dermal fillers - complications - adverse events - foreign body granulomas - corticosteroid injections

1 Nach einem Vortrag anlässlich der gemeinsamen Jahrestagung der VDPC, VDÄPC und ÖGPÄRCH in München, 27. September bis 1. Oktober 2005

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1 Nach einem Vortrag anlässlich der gemeinsamen Jahrestagung der VDPC, VDÄPC und ÖGPÄRCH in München, 27. September bis 1. Oktober 2005

Prof. Dr. med. Gottfried Lemperle

Division of Plastic Surgery
University of California, San Diego

200 West Arbor Drive #8220

San Diego, CA 92103-8220

USA

Email: glemperle@aol.com