201
|
Complications of hyaluronic acid fillers and their managements. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2016. [DOI: 10.1016/j.jdds.2016.01.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
202
|
Chen W, Wu L, Jian XL, Zhang B, Li JY, Qin XL, Yu B. Retinal Branch Artery Embolization Following Hyaluronic Acid Injection: A Case Report. Aesthet Surg J 2016; 36:NP219-24. [PMID: 27075374 DOI: 10.1093/asj/sjw054] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/23/2016] [Indexed: 11/12/2022] Open
Abstract
Injection of hyaluronic acid (HA) filler is a common aesthetic procedure. Impairment of vision, although rare, is a devastating complication of this procedure, which may not be reversible. We report on a patient who experienced visual acuity impairment and ischemic oculomotor nerve palsy after injection of HA into the nasal dorsum. In this case, clinical signs improved within 14 days of treatment. We also provide a review of the mechanism, clinical features, risk factors, and prevention and treatment strategies relating to embolization of ocular circulation after injection of HA. Vision loss is a rare but devastating complication of injection of hyaluronic acid (HA) in the face. Visual acuity seldom recovers completely. We report on a 22-year-old Asian woman who experienced obstruction of a branch of the retinal artery after injection of HA to augment her nose. The patient's visual acuity declined shortly after the procedure, and ophthalmoplegia occurred. Combination treatment was administered to restore the perfusion and oxygen supply to the retina and optic nerve. Within 14 days of rigorous treatment, the patient experienced improvement in visual acuity, extraocular movement, and visual field defects. LEVEL OF EVIDENCE 5: Risk.
Collapse
Affiliation(s)
- Wei Chen
- Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China
| | - Lin Wu
- Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China
| | - Xing-Ling Jian
- Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China
| | - Bin Zhang
- Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China
| | - Jin-Ying Li
- Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China
| | - Xiao-Lei Qin
- Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China
| | - Bo Yu
- Dr Chen is Associate Chief Physician, Department of Ophthalmology, Peking University Shenzhen Guangdong, China. Drs Wu and Jian are Residents, Dr Qin is an Attending Physician, and Dr Yu is Chief Physician, Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China, and the Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China. Drs Zhang and Li are Residents, Shenzhen Key Laboratory for Translational Medicine of Dermatology, Shenzhen-PKU-HKUST Medical Center, Shenzhen, Guangdong, China
| |
Collapse
|
203
|
Bertl K, Gotfredsen K, Jensen SS, Bruckmann C, Stavropoulos A. Adverse reaction after hyaluronan injection for minimally invasive papilla volume augmentation. A report on two cases. Clin Oral Implants Res 2016; 28:871-876. [PMID: 27252126 DOI: 10.1111/clr.12892] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To report two cases of adverse reaction after mucosal hyaluronan (HY) injection around implant-supported crowns, with the aim to augment the missing interdental papilla. MATERIAL AND METHODS Two patients with single, non-neighbouring, implants in the anterior maxilla, who were treated within the frames of a randomized controlled clinical trial testing the effectiveness of HY gel injection to reconstruct missing papilla volume at single implants, presented an adverse reaction. Injection of HY was performed bilaterally using a 3-step technique: (i) creation of a reservoir in the mucosa directly above the mucogingival junction, (ii) injection into the attached gingiva/mucosa below the missing papilla, and (iii) injection 2-3 mm apically to the papilla tip. The whole-injection session was repeated once after approximately 4 weeks. RESULTS Both patients presented with swelling and extreme tenderness with a burning sensation on the lip next to the injection area, after the second injection session. In one of the cases, a net-like skin discoloration (livedo reticularis) was also noted. The symptoms lasted for up to 7 days, and in both cases, symptoms resolved without any signs of skin or mucosal necrosis or any permanent damage. CONCLUSION Most likely, water attraction over time by the highly hygroscopic HY, exerted progressively an external vascular compression and at least partial occlusion of neighbouring blood vessels. An infection or an allergic reaction seems unlikely, since all symptoms gradually disappeared within a week irrespective use of antimicrobials, while an allergic reaction most likely would not have been restricted to one side.
Collapse
Affiliation(s)
- Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Klaus Gotfredsen
- Department of Oral Rehabilitation, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Simon S Jensen
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Corinna Bruckmann
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| |
Collapse
|
204
|
Zhuang Y, Yang M, Liu C. An Islanded Rabbit Auricular Skin Flap Model of Hyaluronic Acid Injection-Induced Embolism. Aesthetic Plast Surg 2016; 40:421-7. [PMID: 27118463 DOI: 10.1007/s00266-016-0630-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Accepted: 03/02/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Hyaluronic acid (HA) injection-induced embolism is a rare but severe complication. This article is aimed to introduce an islanded rabbit auricular skin flap model of HA injection-induced embolism and to study its pathophysiological progress. METHODS An islanded skin flap was elevated based on the proximal central auricular artery/vein. Eighteen rabbits were randomized into three groups. Ten, twenty, and forty microliters of HA were injected into the central auricular artery in each group, respectively. Flap fluorescence angiography was performed. One-way ANOVA was used to compare fluorescence area at different time points and between dose groups. Two rabbits in each group were randomly chosen for histology examination. In addition to regular HE staining, Alcian Blue staining was performed to better show the existence of HA in the vessel lumen. RESULTS The mean calculated fluorescence area was 64.41 % on POD 1, 79.77 % on POD 3, 88.20 % on POD 5, and 92.03 % on POD 7 in 10 μl group; 60.51 % on POD 1, 58.84 % on POD 3, 71.20 % on POD 5, and 76.54 % on POD 7 in 20 μl group; 21.60 % on POD 1, 3.08 % on POD 3, 2.91 % on POD 5, and 7.52 % on POD 7 in 40 μl group. In all three groups, infiltration of eosinophilic granulocytes was observed in the muscular layer of both artery and vein. CONCLUSION Our study successfully created a rabbit auricular skin necrosis model of HA embolism, which provided a valuable animal model for further investigation of the pathophysiological progress and the efficacy of potential treatments. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Collapse
|
205
|
Abstract
Hyaluronic acid soft tissue fillers include a range of products (Juvederm Ultra, Juvederm Ultra Plus, Voluma, Restylane Silk, Restylane, Restylane Lyft, and Belotero Balance) that are used commonly for facial rejuvenation and enhancement of facial features. Although these products are similar in many ways, they are not interchangeable and have unique characteristics that need to be considered. Injection sites and techniques for facial rejuvenation are discussed.
Collapse
Affiliation(s)
- Karol A Gutowski
- Division of Plastic Surgery, University of Illinois, Chicago, IL 60611, USA.
| |
Collapse
|
206
|
Abstract
BACKGROUND Over recent decades, the options available to patients for cosmetic rejuvenation have expanded dramatically. The range of options commonly available to patients now includes neuromodulators, fillers, sclerotherapy, chemical peels, liposculpture, lasers, and lights and other energy devices and continues to grow. As with all therapeutic interventions, these cosmetic dermatologic procedures are not without risk. Timely recognition of complications and intervention are paramount for optimal patient outcomes. OBJECTIVE Part 1 of this review will focus on the common complications of injectable cosmetic procedures, such as neuromodulators, fillers, and sclerotherapy. The second part will discuss the complications of chemical peels, lasers, light and energy devices, and fat removal procedures. MATERIALS AND METHODS A MEDLINE search was performed on cosmetic dermatology complications from 1989 to 2015, and results are summarized. Practical considerations of these complications are also provided. RESULTS Reports of complications after neuromodulator, injectable hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, polymethylmethacrylate, sclerotherapy, fat transfer, liposuction, cryolipolysis, chemical peels, lasers, and light sources, such as Q-switched laser, intense pulsed light, nonablative and ablative resurfacing lasers, were found. CONCLUSION Review of the literature revealed multiple management options for potential complications of the multitude of cosmetic dermatology procedures now available to patients.
Collapse
|
207
|
|
208
|
Serious Vascular Complications after Nonsurgical Rhinoplasty: A Case Report. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e683. [PMID: 27200245 PMCID: PMC4859242 DOI: 10.1097/gox.0000000000000668] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 02/16/2016] [Indexed: 11/25/2022]
Abstract
There has been an increased global demand for dermal filler injections in recent years. Although hyaluronic acid-based dermal fillers generally have a good safety profile, serious vascular complications have been reported. Here we present a typical case of skin necrosis following a nonsurgical rhinoplasty using hyaluronic acid filler. Despite various rescuing managements, unsightly superficial scars were left. It is critical for plastic surgeons and dermatologists to be familiar with the vascular anatomy and the staging of vascular complications. Any patients suspected to experience a vascular complication should receive early management under close monitoring. Meanwhile, the potentially devastating outcome caused by illegal practice calls for stricter regulations and law enforcement.
Collapse
|
209
|
Abstract
BACKGROUND Most of the complications associated with hyaluronic acid (HA) fillers can be addressed by hyaluronidase. Extensive experience with this enzyme was accumulated in ophthalmology and anesthesia. In dermatologic use multiple aspects still remain controversial. OBJECTIVE To elucidate questions with regard to hyaluronidase use in HA-induced complications, including appropriate dosage, timing, and technique of delivery, differences in the activity of hyaluronidases of different origins, interaction between the enzymes and different HA gels, and safety issues. MATERIALS AND METHODS Extensive review of the relevant literature was conducted. The conclusions are based on this review and personal author's experience. RESULTS FDA-approved hyaluronidases provide predictable results and can be used interchangeably. A physician has to be closely familiar with specific characteristics of other hyaluronidases. Different brands of HA fillers have different sensitivity to degradation by hyaluronidase. For filler overcorrection or misplacement, low dose of the enzyme has to be injected directly into the palpable HA mass. In case of vascular accident, flushing of the ischemic area with high doses of hyaluronidase is required. Hypersensitivity reactions to hyaluronidase are so far not reported in dermatologic literature. CONCLUSION With increased popularity of HA fillers, hyaluronidase had become an indispensable tool in dermatology office. It is safe and reliable for treatment of HA-induced complications.
Collapse
|
210
|
Rethinking the Role of Nitroglycerin Ointment in Ischemic Vascular Filler Complications. Ophthalmic Plast Reconstr Surg 2016; 32:118-22. [DOI: 10.1097/iop.0000000000000446] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
211
|
Abstract
Any injectable filler may elicit moderate-to-severe adverse events, ranging from nodules to abscesses to vascular occlusion. Fortunately, severe adverse events are uncommon for the majority of fillers currently on the market. Because these are rare events, it is difficult to identify the relevant risk factors and to design the most efficacious treatment strategies. Poor aesthetic outcomes are far more common than severe adverse events. These in contrast should be easily avoidable by ensuring that colleagues receive proper training and follow best practices.
Collapse
|
212
|
Abstract
BACKGROUND As the popularity of soft tissue fillers increases, so do the reports of adverse events. The most serious complications are vascular in nature and include blindness. OBJECTIVE To review the cases of blindness after filler injection, to highlight key aspects of the vascular anatomy, and to discuss prevention and management strategies. METHODS A literature review was performed to identify all the cases of vision changes from filler in the world literature. RESULTS Ninety-eight cases of vision changes from filler were identified. The sites that were high risk for complications were the glabella (38.8%), nasal region (25.5%), nasolabial fold (13.3%), and forehead (12.2%). Autologous fat (47.9%) was the most common filler type to cause this complication, followed by hyaluronic acid (23.5%). The most common symptoms were immediate vision loss and pain. Most cases of vision loss did not recover. Central nervous system complications were seen in 23.5% of the cases. No treatments were found to be consistently successful in treating blindness. CONCLUSION 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.
Collapse
|
213
|
|
214
|
|
215
|
Affiliation(s)
- John H Joseph
- 9400 Brighton Way, Suite 203, Beverly Hills, CA 90210, USA.
| |
Collapse
|
216
|
Cohen JL, Biesman BS, Dayan SH, DeLorenzi C, Lambros VS, Nestor MS, Sadick N, Sykes J. Treatment of Hyaluronic Acid Filler-Induced Impending Necrosis With Hyaluronidase: Consensus Recommendations. Aesthet Surg J 2015; 35:844-9. [PMID: 25964629 DOI: 10.1093/asj/sjv018] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2014] [Indexed: 11/13/2022] Open
Abstract
Injection-induced necrosis is a rare but dreaded consequence of soft tissue augmentation with filler agents. It usually occurs as a result of injection of filler directly into an artery, but can also result from compression or injury. We provide recommendations on the use of hyaluronidase when vascular compromise is suspected. Consensus recommendations were developed by thorough discussion and debate amongst the authors at a roundtable meeting on Wednesday June 18, 2014 in Las Vegas, NV as well as significant ongoing written and verbal communications amongst the authors in the months prior to journal submission. All authors are experienced tertiary care providers. A prompt diagnosis and immediate treatment with high doses of hyaluronidase (at least 200 U) are critically important. It is not felt necessary to do a skin test in cases of impending necrosis. Some experts recommend dilution with saline to increase dispersion or lidocaine to aid vasodilation. Additional hyaluronidase should be injected if improvement is not seen within 60 minutes. A warm compress also aids vasodilation, and massage has been shown to help. Some experts advocate the use of nitroglycerin paste, although this area is controversial. Introducing an oral aspirin regimen should help prevent further clot formation due to vascular compromise. In our experience, patients who are diagnosed promptly and treated within 24 hours will usually have the best outcomes.
Collapse
Affiliation(s)
- Joel L Cohen
- Dr Cohen is an Associate Clinical Professor in the Department of Dermatology at the University of Colorado, Boulder, and an Assistant Clinical Professor in the Department of Dermatology at the University of California Irvine. Dr Biesman is a Clinical Assistant Professor in the Departments of Ophthalmology and Otolaryngology and the Division of Dermatology at Vanderbilt University Medical Center, Nashville, TN. Dr Dayan is a Clinical Assistant Professor in the Department of Otolaryngology at the University of Illinois, Chicago. Dr DeLorenzi is a plastic surgeon in private practice in Kitchener, Ontario, Canada. Dr Lambros is a Clinical Professor of Plastic Surgery at the University of California Irvine. Dr Nestor is a Voluntary Associate Professor in the Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine, FL. Dr Sadick is a Clinical Professor of Dermatology at Weill Cornell Medical College, New York, NY. Dr Sykes is a Professor and the Director of Facial Plastic Surgery in the Department of Otolaryngology at the UC Davis Health System of the University of California Davis, Sacramento
| | - Brian S Biesman
- Dr Cohen is an Associate Clinical Professor in the Department of Dermatology at the University of Colorado, Boulder, and an Assistant Clinical Professor in the Department of Dermatology at the University of California Irvine. Dr Biesman is a Clinical Assistant Professor in the Departments of Ophthalmology and Otolaryngology and the Division of Dermatology at Vanderbilt University Medical Center, Nashville, TN. Dr Dayan is a Clinical Assistant Professor in the Department of Otolaryngology at the University of Illinois, Chicago. Dr DeLorenzi is a plastic surgeon in private practice in Kitchener, Ontario, Canada. Dr Lambros is a Clinical Professor of Plastic Surgery at the University of California Irvine. Dr Nestor is a Voluntary Associate Professor in the Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine, FL. Dr Sadick is a Clinical Professor of Dermatology at Weill Cornell Medical College, New York, NY. Dr Sykes is a Professor and the Director of Facial Plastic Surgery in the Department of Otolaryngology at the UC Davis Health System of the University of California Davis, Sacramento
| | - Steven H Dayan
- Dr Cohen is an Associate Clinical Professor in the Department of Dermatology at the University of Colorado, Boulder, and an Assistant Clinical Professor in the Department of Dermatology at the University of California Irvine. Dr Biesman is a Clinical Assistant Professor in the Departments of Ophthalmology and Otolaryngology and the Division of Dermatology at Vanderbilt University Medical Center, Nashville, TN. Dr Dayan is a Clinical Assistant Professor in the Department of Otolaryngology at the University of Illinois, Chicago. Dr DeLorenzi is a plastic surgeon in private practice in Kitchener, Ontario, Canada. Dr Lambros is a Clinical Professor of Plastic Surgery at the University of California Irvine. Dr Nestor is a Voluntary Associate Professor in the Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine, FL. Dr Sadick is a Clinical Professor of Dermatology at Weill Cornell Medical College, New York, NY. Dr Sykes is a Professor and the Director of Facial Plastic Surgery in the Department of Otolaryngology at the UC Davis Health System of the University of California Davis, Sacramento
| | - Claudio DeLorenzi
- Dr Cohen is an Associate Clinical Professor in the Department of Dermatology at the University of Colorado, Boulder, and an Assistant Clinical Professor in the Department of Dermatology at the University of California Irvine. Dr Biesman is a Clinical Assistant Professor in the Departments of Ophthalmology and Otolaryngology and the Division of Dermatology at Vanderbilt University Medical Center, Nashville, TN. Dr Dayan is a Clinical Assistant Professor in the Department of Otolaryngology at the University of Illinois, Chicago. Dr DeLorenzi is a plastic surgeon in private practice in Kitchener, Ontario, Canada. Dr Lambros is a Clinical Professor of Plastic Surgery at the University of California Irvine. Dr Nestor is a Voluntary Associate Professor in the Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine, FL. Dr Sadick is a Clinical Professor of Dermatology at Weill Cornell Medical College, New York, NY. Dr Sykes is a Professor and the Director of Facial Plastic Surgery in the Department of Otolaryngology at the UC Davis Health System of the University of California Davis, Sacramento
| | - Val S Lambros
- Dr Cohen is an Associate Clinical Professor in the Department of Dermatology at the University of Colorado, Boulder, and an Assistant Clinical Professor in the Department of Dermatology at the University of California Irvine. Dr Biesman is a Clinical Assistant Professor in the Departments of Ophthalmology and Otolaryngology and the Division of Dermatology at Vanderbilt University Medical Center, Nashville, TN. Dr Dayan is a Clinical Assistant Professor in the Department of Otolaryngology at the University of Illinois, Chicago. Dr DeLorenzi is a plastic surgeon in private practice in Kitchener, Ontario, Canada. Dr Lambros is a Clinical Professor of Plastic Surgery at the University of California Irvine. Dr Nestor is a Voluntary Associate Professor in the Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine, FL. Dr Sadick is a Clinical Professor of Dermatology at Weill Cornell Medical College, New York, NY. Dr Sykes is a Professor and the Director of Facial Plastic Surgery in the Department of Otolaryngology at the UC Davis Health System of the University of California Davis, Sacramento
| | - Mark S Nestor
- Dr Cohen is an Associate Clinical Professor in the Department of Dermatology at the University of Colorado, Boulder, and an Assistant Clinical Professor in the Department of Dermatology at the University of California Irvine. Dr Biesman is a Clinical Assistant Professor in the Departments of Ophthalmology and Otolaryngology and the Division of Dermatology at Vanderbilt University Medical Center, Nashville, TN. Dr Dayan is a Clinical Assistant Professor in the Department of Otolaryngology at the University of Illinois, Chicago. Dr DeLorenzi is a plastic surgeon in private practice in Kitchener, Ontario, Canada. Dr Lambros is a Clinical Professor of Plastic Surgery at the University of California Irvine. Dr Nestor is a Voluntary Associate Professor in the Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine, FL. Dr Sadick is a Clinical Professor of Dermatology at Weill Cornell Medical College, New York, NY. Dr Sykes is a Professor and the Director of Facial Plastic Surgery in the Department of Otolaryngology at the UC Davis Health System of the University of California Davis, Sacramento
| | - Neil Sadick
- Dr Cohen is an Associate Clinical Professor in the Department of Dermatology at the University of Colorado, Boulder, and an Assistant Clinical Professor in the Department of Dermatology at the University of California Irvine. Dr Biesman is a Clinical Assistant Professor in the Departments of Ophthalmology and Otolaryngology and the Division of Dermatology at Vanderbilt University Medical Center, Nashville, TN. Dr Dayan is a Clinical Assistant Professor in the Department of Otolaryngology at the University of Illinois, Chicago. Dr DeLorenzi is a plastic surgeon in private practice in Kitchener, Ontario, Canada. Dr Lambros is a Clinical Professor of Plastic Surgery at the University of California Irvine. Dr Nestor is a Voluntary Associate Professor in the Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine, FL. Dr Sadick is a Clinical Professor of Dermatology at Weill Cornell Medical College, New York, NY. Dr Sykes is a Professor and the Director of Facial Plastic Surgery in the Department of Otolaryngology at the UC Davis Health System of the University of California Davis, Sacramento
| | - Jonathan Sykes
- Dr Cohen is an Associate Clinical Professor in the Department of Dermatology at the University of Colorado, Boulder, and an Assistant Clinical Professor in the Department of Dermatology at the University of California Irvine. Dr Biesman is a Clinical Assistant Professor in the Departments of Ophthalmology and Otolaryngology and the Division of Dermatology at Vanderbilt University Medical Center, Nashville, TN. Dr Dayan is a Clinical Assistant Professor in the Department of Otolaryngology at the University of Illinois, Chicago. Dr DeLorenzi is a plastic surgeon in private practice in Kitchener, Ontario, Canada. Dr Lambros is a Clinical Professor of Plastic Surgery at the University of California Irvine. Dr Nestor is a Voluntary Associate Professor in the Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine, FL. Dr Sadick is a Clinical Professor of Dermatology at Weill Cornell Medical College, New York, NY. Dr Sykes is a Professor and the Director of Facial Plastic Surgery in the Department of Otolaryngology at the UC Davis Health System of the University of California Davis, Sacramento
| |
Collapse
|
217
|
Wortsman X. Identification and Complications of Cosmetic Fillers: Sonography First. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015; 34:1163-1172. [PMID: 26112618 DOI: 10.7863/ultra.34.7.1163] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Cosmetic fillers are frequently used these days for enhancing beauty and to treat wrinkles or sagging skin. However, information on the history of injections may be difficult to obtain, and there is a growing number of reports on complications with these agents. In contrast to other imaging techniques, sonography has been successfully used for detecting and identifying common types of cosmetic fillers and has become the first-line imaging modality to deal with these exogenous components.
Collapse
Affiliation(s)
- Ximena Wortsman
- Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile.
| |
Collapse
|
218
|
Han X, Hu J, Cheng L, Li F. Multiplane hyaluronic acid (EME) in female Chinese rhinoplasty using blunt and sharp needle technique. J Plast Reconstr Aesthet Surg 2015; 68:1504-9. [PMID: 26261094 DOI: 10.1016/j.bjps.2015.06.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 06/20/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Hyaluronic acid has been widely used for nonsurgical rhinoplasty. Little literature focuses on Chinese women of the Han nationality, who have a characteristic flattened facial contour. Projection of the nose, including the nasal dorsum, nasal tip, and columella, plays an important role in achieving an attractive face. AIM The aim of this study was to investigate the application of multiplane hyaluronic acid in rhinoplasty using blunt and sharp needle technique. METHOD From June 2011 to February 2014, 280 cases of nonsurgical rhinoplasty by hyaluronic acid were applied; 1-9 months follow-up showed satisfactory appearance. RESULT Postoperative results showed no complications, such as infection or flap necrosis. CONCLUSION For esthetic and safety considerations, we suggest multiple plane injections using blunt combined with sharp needle-filling techniques.
Collapse
Affiliation(s)
- Xuefeng Han
- VIP Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, No. 33 Ba-Da-Chu Road, Shi Jing Shan District, Beijing 100144, PR China
| | - Jintian Hu
- 4th Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, No. 33 Ba-Da-Chu Road, Shi Jing Shan District, Beijing 100144, PR China
| | - Lin Cheng
- VIP Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, No. 33 Ba-Da-Chu Road, Shi Jing Shan District, Beijing 100144, PR China
| | - Facheng Li
- VIP Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, No. 33 Ba-Da-Chu Road, Shi Jing Shan District, Beijing 100144, PR China.
| |
Collapse
|
219
|
Tan M, Kontis TC. Midface Volumization with Injectable Fillers. Facial Plast Surg Clin North Am 2015; 23:233-42. [DOI: 10.1016/j.fsc.2015.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
220
|
Abstract
Eyebrow and upper eyelid aging occurs in all tissue planes, and manifests most commonly in skin quality, tissue volume loss (soft tissue and bone), and tissue descent. All these involutional changes are amenable to less-invasive (nonsurgical) interventions with natural and aesthetically pleasing results. It is critical for aesthetic facial surgeons to familiarize themselves with these procedures because they are in high demand by patients. This article outlines current concepts of nonsurgical management options for brow and upper eyelid aging. The anatomy and age-related changes in these structures are reviewed, and minimally invasive techniques to address these changes are detailed.
Collapse
|
221
|
Update on Hyaluronic Acid Fillers. CURRENT OTORHINOLARYNGOLOGY REPORTS 2015. [DOI: 10.1007/s40136-014-0070-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
222
|
Qassemyar Q, Gianfermi M. Supermicrosurgery and hyaluronic acid: experimental feasability study of a new method. ANN CHIR PLAST ESTH 2014; 60:e59-65. [PMID: 25447214 DOI: 10.1016/j.anplas.2014.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 08/28/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION As a technique of anastomosis for vessels of less than 0.8mm in diameter, supermicrosurgery has aroused renewed interest on account of its potential clinical applications. The technical difficulty of surgery at such a small scale necessitates exploration of new methods likely to render the anastomoses accessible and reliable. The aim of this article is to present the results of an experimental study on the feasibility of anastomoses (arterial diameter ≤0.5mm), assisted by the injection of hyaluronic acid (HA). MATERIALS AND METHODS Ten end-to-end arterial anastomoses of the inferior epigastric artery (diameter ≤0.5mm) were performed in 5 rats. An injection of HA had previously been carried out in the vessel lumen and the sutures were made with 12-0 nylon. Immediate and 3-day permeability were controlled and anastomosis times were measured. RESULTS Average diameter of the arteries was 0.42 mm (range 0.29-0.48 mm). Mean anastomosis duration was 19.5 min (range 15-23 min). The average number of stitches was 6. Immediate patency was 100% with a success rate of 80% at 3 days. CONCLUSIONS The properties of HA seem to effectively facilitate anastomoses of arteries with a diameter ≤0.5mm. HA provides comfort and promotes safety in performance of exceedingly small-scale surgery. While the results appear promising, but further studies are needed in order to determine the potential toxicity of this method on tissues.
Collapse
Affiliation(s)
- Q Qassemyar
- Service de chirurgie plastique et reconstructrice, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Laboratoire d'anatomie et d'organogenèse, université de Picardie Jules-Verne, rue des Louvels, 80000 Amiens, France.
| | - M Gianfermi
- Laboratoire d'anatomie et d'organogenèse, université de Picardie Jules-Verne, rue des Louvels, 80000 Amiens, France
| |
Collapse
|
223
|
DeLorenzi C. Commentary on: internal and external carotid artery embolism following facial injection of autologous fat. Aesthet Surg J 2014; 34:NP88-90. [PMID: 24970273 DOI: 10.1177/1090820x14540457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Claudio DeLorenzi
- Dr DeLorenzi is a plastic surgeon in private practice in Kitchener, Ontario, Canada
| |
Collapse
|
224
|
Commentary on "are nurse injectors the new norm?". Aesthetic Plast Surg 2014; 38:957-8. [PMID: 25209529 DOI: 10.1007/s00266-014-0393-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 08/01/2014] [Indexed: 10/24/2022]
|
225
|
Mancini R. Nonsurgical considerations for addressing periocular aesthetics: a conceptual dimensional approach. JAMA FACIAL PLAST SU 2014; 16:451-6. [PMID: 25144216 DOI: 10.1001/jamafacial.2014.498] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Ronald Mancini
- Section of Oculoplastic and Orbit Surgery, Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas
| |
Collapse
|