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Buhsem O. Comparing the Effects of Different Injection Techniques Used in Lip Augmentation on Filler Migration and Patient Satisfaction. Cureus 2024; 16:e64716. [PMID: 39021739 PMCID: PMC11253074 DOI: 10.7759/cureus.64716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVE Lip rejuvenation has several aims, including enhancing lip volume, adjusting the upper and lower lip's length, diminishing fine lines, contouring and redefining the cupid bow and vermilion border, and eversion of the vermilion. Within the scope of this research, we aimed to compare popular injection techniques to augment the size of the lips. MATERIALS AND METHODS This randomized retrospective study included 216 female patients aged 19 to 39, who desired a lip filler treatment from 2017 to 2023. Pre- and post-procedure results were elaborated with top-to-the-bottom technique in Group 1, bottom-to-the-top technique in Group 2, and lateral-to-medial techniques in Groups 3 and 4.Once the patients were sufficiently anesthetized, the hyaluronic acid at a concentration of 20 mg/mL with 0.3% (3 mg/mL) lidocaine, was used in all groups. Patients were followed up for three weeks. Patient satisfaction scores were evaluated on a scale from 0 to 5 using a survey on the last follow-up day. RESULTS A statistically significant difference was found between the groups regarding satisfaction scores (p<0.05). The patient satisfaction scores after injection were 4.78/5 in Group 1, 3.70/5 in Group 2, 4.15/5 in Group 3, and 3.85/5 in Group 4. Kruskal-Wallis variance analysis for more than two groups revealed statistically significant differences between Group 1 and Group 2 (p<0.001), Group 1 and Group 3 (p<0.001), Group 1 and Group 4 (p<0.001), and Group 2 and Group 3 (p=0.009) (Mann Whitney U-Test with Bonferroni adjusted). No major complication was observed in any of the patients. CONCLUSION In this study, patient satisfaction was found to be highest in the group with needle orientation top to bottom, taking into account migration to the upper lip. These findings showed that the direction of the needle during injection also determines the direction of distribution of the filler on the lip and may be an important factor in patient satisfaction.
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Affiliation(s)
- Omer Buhsem
- Plastic Surgery, Private Practice, Bursa, TUR
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Baranska-Rybak W, Lajo-Plaza JV, Walker L, Alizadeh N. Late-Onset Reactions after Hyaluronic Acid Dermal Fillers: A Consensus Recommendation on Etiology, Prevention and Management. Dermatol Ther (Heidelb) 2024; 14:1767-1785. [PMID: 38907876 PMCID: PMC11265052 DOI: 10.1007/s13555-024-01202-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 05/31/2024] [Indexed: 06/24/2024] Open
Abstract
Hyaluronic acid (HA) dermal fillers, generally considered low-risk, can lead to rare late-onset reactions (LORs) manifesting between 3 and 4 months postinjection, occasionally even as early as 24 h postinjection. The Complication Assessment and Risk Evaluation (CARE) board was established to review these reactions. In this publication, the authors aims to explore the etiological hypotheses underlying LORs, associated risk factors, prevention, and management approaches suggested by the CARE board. The CARE board identified three etiological hypotheses contributing to LORs. Firstly, the physicochemical structure of the filler, particularly low molecular weight HA, which may trigger an immune response. Secondly, infection, potentially introduced during injection or by dormant biofilm activation. Lastly, an imbalance in the host immune system, caused by factors like autoimmune diseases or viral infections, may lead to extended foreign body reactions, delayed type IV hypersensitivity, or adjuvant-based reactions. Based on these hypotheses, the board categorized various risk factors as patient-related (e.g., recent dental treatment, current medical status, active autoimmune disease), product-related (e.g., molecular weight), and procedure-related (e.g., aseptic technique and trauma). To reduce the risk of LORs, the CARE board recommends diligent patient selection, including comprehensive medical history assessment and informed consent. Practitioners should maintain an effective aseptic technique, and choose an appropriate product and injection depth for the anatomical location. Post-procedure, patients should receive education on proper filler care. Management of LORs depends on the suspected etiology, and the CARE board has proposed an algorithm to determine the most appropriate treatment. Hyaluronidase is recommended for noninflammatory reactions in the absence of active infection, while watchful waiting and/or steroid treatment may be preferred for inflammatory reactions. Hyaluronidase is not recommended as a first-line treatment for infections, which require drainage, bacterial culture, and antibiotic treatment. However, the board emphasizes the need for individualized evaluation and treatment in all cases.
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Affiliation(s)
- Wioletta Baranska-Rybak
- Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Ul. Smoluchowskiego 17, 80-214, Gdańsk, Poland.
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Elnaquip E, Makki M, Mansour M, Moshrif A. Clinical and ultrasonographic evaluation of efficacy and safety of intralesional injection of autologous platelet-rich plasma in morphea: A comparative case series. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2024; 9:162-168. [PMID: 38910599 PMCID: PMC11188844 DOI: 10.1177/23971983231222664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/10/2023] [Indexed: 06/25/2024]
Abstract
Objective To evaluate the efficacy and safety of platelet-rich plasma to restore skin changes in morphea by ultrasound and Localized Scleroderma Cutaneous Assessment Tool. Methods Nine morphea patients (21 lesions) were diagnosed clinically and by histopathology. Intradermal platelet-rich plasma was injected into morphea lesion once weekly for 12 sessions. The disease severity and damage were evaluated at baseline, after the last session (3 months later), and at 6 months follow-up using the LoSCAT and a high-resolution ultrasound. The healthy corresponding side was considered as a control. Results The Localized Scleroderma Cutaneous Assessment Tool score showed a significant improvement starting from 13 ± 7.28 up to 7.33 ± 6.82 after the therapeutic endpoint, reaching to 6.44 ± 7.09 after 6 months of follow-up with p value = 0.008 and 0.014, respectively. There was a significant positive correlation between the duration of the lesion and the improvement assessed by the ultrasound, with p value = 0.01. Regarding adverse effects, all patients reported having pain during platelet-rich plasma injection; transient edema of the face was reported by four patients (45%), and only two patients showed transient erythema. Conclusion Autologous platelet-rich plasma is a safe technique with great aesthetic outcomes for filling up the contour defects and correcting both hyper and hypopigmentation, in addition to softening the indurated lesions.
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Affiliation(s)
- Esraa Elnaquip
- Dermatology, Andrology & STIs Department, Ras Eltin General Hospital, Alexandria, Egypt
| | - Mahmoud Makki
- Dermatology, Andrology & STIs Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Mofreh Mansour
- Dermatology, Andrology & STIs Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Abdelhfeez Moshrif
- Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
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4
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Botha VE, Insull EA. Causes and management of sight threatening complications of dermal filler injections: A review. Clin Exp Ophthalmol 2024; 52:365-373. [PMID: 38380782 DOI: 10.1111/ceo.14362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/16/2023] [Accepted: 01/05/2024] [Indexed: 02/22/2024]
Abstract
Injectable dermal fillers continue to increase in popularity in aesthetic medicine. Although rare, vision loss secondary to filler injections is a devastating complication associated with a poor visual prognosis. The mechanism for vision loss is thought to be related to retrograde embolization of the dermal filler from peripheral vessels in the face into the ophthalmic arterial system. Early recognition and prompt management are essential if vision is to be salvaged. The use of retrobulbar hyaluronidase is still contentious, however when administered by a specialist, this treatment gives the best chance at visual recovery and should be considered for all cases.
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Affiliation(s)
- Verona E Botha
- Department of Ophthalmology, Te Whatu Ora Waikato, Hamilton, New Zealand
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Tsai MF, Yu CM, Chen YF, Chung TY, Lin GH, Lee AL, Yang CY, Yu CM, Huang HY, Liu YC, Huang WC, Tung KY, Yao WT. Laser Speckle Contrast Imaging Guides Needling Treatment of Vascular Complications from Dermal Fillers. Aesthetic Plast Surg 2024; 48:1067-1075. [PMID: 37816946 DOI: 10.1007/s00266-023-03629-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/07/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Although laser Doppler imaging (LDI) accurately delineates a hypoperfused area to help target hyaluronidase treatment, laser speckle contrast imaging (LSCI) is more appropriate for assessing microvascular hemodynamics and has greater reproducibility than LDI. This study investigated the use of LSCI in the evaluation and treatment of six patients who developed vascular complications after facial dermal filler injections. METHODS The areas of vascular occlusion were accurately defined in real time by LSCI and were more precise than visual inspections or photographic evidence for guiding needling and hyaluronidase treatment. RESULTS All patients had achieved satisfactory outcomes as early as Day 2 of treatment and no procedure-related complications were reported after a median follow-up of 9.5 (7-37) days. CONCLUSION LSCI accurately and noninvasively delineated vascular occlusions in real time among patients experiencing complications of facial dermal filler injections. Moreover, LSCI was more accurate than visual and photographic evaluations. Clinicians can use LSCI to reliably follow-up therapeutic outcomes after salvage interventions for vascular occlusions. LEVEL OF EVIDENCE IV 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 .
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Affiliation(s)
- Ming-Feng Tsai
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei City, 10449, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, 25245, Taiwan
- Graduate Institute of Medical Science and Technology, Taipei Medical University, Taipei City, 101, Taiwan
| | - Chia-Meng Yu
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei City, 10449, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, 25245, Taiwan
| | - Yu-Fan Chen
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei City, 10449, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, 25245, Taiwan
| | - Tzu-Yi Chung
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei City, 10449, Taiwan
| | - Guan-Heng Lin
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei City, 10449, Taiwan
| | - An-Li Lee
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei City, 10449, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, 25245, Taiwan
| | - Chin-Yi Yang
- Department of Dermatology, New Taipei Municipal TuCheng Hospital, New Taipei City, 236, Taiwan
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, 333, Taiwan
- Department of Cosmetic Science, Chang Gung University of Science and Technology, Linkuo, Taoyuan, 333, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Chieh-Ming Yu
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei City, 10449, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, 25245, Taiwan
| | - Hsuan-Yu Huang
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei City, 10449, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, 25245, Taiwan
| | - Ying-Chun Liu
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei City, 10449, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, 25245, Taiwan
| | - Wen-Chen Huang
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei City, 10449, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, 25245, Taiwan
| | - Kwang-Yi Tung
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei City, 10449, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, 25245, Taiwan
| | - Wen-Teng Yao
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei City, 10449, Taiwan.
- Department of Medicine, MacKay Medical College, New Taipei, 25245, Taiwan.
- Department of Materials Science and Engineering, National Taiwan University, Taipei, 106, Taiwan.
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Felis-Giemza A, Matusiewicz A, Wajda A, Olesińska M. Safety of esthetic procedures in rheumatic patients: single-center survey of patients. Rheumatol Int 2024; 44:357-362. [PMID: 37847387 PMCID: PMC10796409 DOI: 10.1007/s00296-023-05481-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 09/25/2023] [Indexed: 10/18/2023]
Abstract
The popularity of esthetic medicine is growing every year, also among patients with autoimmune inflammatory rheumatic diseases (AIRD). The objective of this study was to evaluate the safety of esthetic medicine (AM) procedures in patients with AIRD. A semi-structured, anonymous questionnaire regarding rheumatic and concomitant diseases and AM procedures was distributed among adult patients hospitalized in the rheumatology department or attending outpatient clinic in the National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw. The main outcome was the occurrence of an adverse event. A number of 512 patients took part in the survey and 15 were excluded (AM procedure preceded the diagnosis of AIRD). The study group consisted of 497 patients, of whom 47 had undergone AM procedures. The procedures performed included: tattooing (22 patients), piercing (16 patients), hyaluronic acid (7 patients), botulinum toxin (5 patients) injections, laser procedures (6 patients), plastic surgery (4 patients), mesotherapy (3 patients) and others. The vast majority of patients had these performed during remission or low disease activity. 70.2% of patients received treatment with disease-modifying antirheumatic drugs (DMARDs) during the AM procedure, with TNF-alfa inhibitors being the most common (63.6%). Adverse events occurred in 15% of patients. All were mild and transient site reactions. Most patients would like to repeat the AM procedure in the future. The use of esthetic medicine procedures in patients with AIRD, including those treated with biologic DMARDs, was associated with a risk of mild site reactions. Most of the patients expressed satisfaction with the results of the AM procedure.
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Affiliation(s)
- Anna Felis-Giemza
- Biologic Therapy Center, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Agata Matusiewicz
- Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637, Warsaw, Poland.
| | - Anna Wajda
- Department of Molecular Biology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Marzena Olesińska
- Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637, Warsaw, Poland
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Kroumpouzos G, Treacy P. Hyaluronidase for Dermal Filler Complications: Review of Applications and Dosage Recommendations. JMIR DERMATOLOGY 2024; 7:e50403. [PMID: 38231537 PMCID: PMC10836581 DOI: 10.2196/50403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/17/2023] [Accepted: 12/11/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Hyaluronidase (Hyal) can reverse complications of hyaluronic acid (HA) fillers, which has contributed substantially to the popularity of such procedures. Still, there are differing opinions regarding Hyal treatment, including dosage recommendations in filler complication management. OBJECTIVE We aimed to address unanswered questions regarding Hyal treatment for HA filler complications, including timing and dosage, skin pretesting, properties of various Hyals and interactions with HA gels, and pitfalls of the treatment. METHODS PubMed and Google Scholar databases were searched from inception for articles on Hyal therapy for filler complications. Articles were evaluated regarding their contribution to the field. The extensive literature review includes international leaders' suggestions and expert panels' recommendations. RESULTS There are limited controlled data but increasing clinical experience with Hyal treatment. The currently used Hyals provide good results and have an acceptable safety profile. Nonemergent complications such as the Tyndall effect, noninflamed nodules, and allergic or hypersensitivity reactions should be treated with low or moderate Hyal doses. Hyal should be considered with prior or simultaneous oral antibiotic treatment in managing inflammatory nodules. Hyal may be tried for granulomas that have not responded to intralesional steroids. Emergent complications such as vascular occlusion and blindness require immediate, high-dose Hyal treatment. Regarding blindness, the injection technique, retrobulbar versus supraorbital, remains controversial. Ultrasound guidance can increase the efficacy of the above interventions. CONCLUSIONS Hyal is essential in aesthetic practice because it can safely treat most HA filler complications. Immediate Hyal treatment is required for emergent complications. Aesthetic practitioners should be versed in using Hyal and effective dosage protocols.
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Affiliation(s)
- George Kroumpouzos
- GK Dermatology, PC, South Weymouth, MA, United States
- Department of Dermatology, Warren Alpert Medical School at Brown University, Providence, RI, United States
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Choi SY, Shin SH, Seok J, Yoo KH, Kim BJ. Management strategies for vascular complications in hyaluronic acid filler injections: A case series analysis. J Cosmet Dermatol 2023; 22:3261-3267. [PMID: 37694495 DOI: 10.1111/jocd.15990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/08/2023] [Accepted: 08/28/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND As hyaluronic acid (HA) filler injections have become increasingly popular in the esthetic field, so have their side effects. Vascular complications, which can lead to skin necrosis or permanent scarring, are a particularly dangerous complication and occur when the filler is injected directly into a blood vessel or when an adjacent blood vessel is compressed by the filler material. OBJECTIVE To assess the clinical prognosis based on post-procedural management and clinical findings of HA filler vascular complications. METHODS Herein, we present a case series of vascular complications due to HA filler and evaluate their clinical prognosis based on post-procedural management and clinical findings. Clinical assessments were performed using Doppler ultrasound, thermography, and laboratory tests. RESULTS Factors including white blood cell count, the time of treatment initiation, and time of hyaluronidase injection influenced the clinical outcomes. Early recognition and prompt hyaluronidase injection proved crucial in preventing further damage and improving prognosis. CONCLUSION This case series highlights the importance of early detection and appropriate management of HA filler complications. Physicians should be aware of the potential risks associated with fillers and promptly address any adverse effects to achieve optimal clinical outcomes. Further studies are warranted to confirm these findings and refine treatment strategies for the HA filler complications.
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Affiliation(s)
- Sun Young Choi
- Department of Dermatology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si, Republic of Korea
| | - Sun Hye Shin
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Joon Seok
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Kwang Ho Yoo
- Department of Dermatology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si, Republic of Korea
| | - Beom Joon Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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Milhomem AC, Gomes RS, Tomé FD, Dos Santos Arruda F, Franco PIR, da Costa EL, Pereira JX, Vinaud MC, de Souza Lino Júnior R. Polymethylmethacrylate Microspheres are Immunologically Inert in Mouse Tissues. Aesthetic Plast Surg 2023; 47:2813-2822. [PMID: 36607354 DOI: 10.1007/s00266-022-03243-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/18/2022] [Indexed: 01/07/2023]
Abstract
Nowadays, aesthetic concerns have gained attention, especially by patients looking for a less invasive alternative to minor facial corrections. Polymethylmethacrylate (PMMA) is widely used as a soft tissue filler; the demand for this polymer has increased, and along with it, there are some reports of adverse reactions. Such adverse reactions stem from consequences of immune and inflammatory reactions to PMMA. Some animal models have been used to unravel the causes of these reactions, among other factors involving the management of PMMA. The aim of this study was to determine the immunogenic profile of PMMA implantation in different anatomical planes of mice, over up to 360 experimental days. In this study, BALB/c mice were divided into 30 groups for immune evaluation of the interaction between the organism and the polymer; 2% PMMA was implanted subcutaneously, 10% intramuscularly and 30% in periosteal juxtaposition and followed during five experimental days (7, 30, 90, 180 and 360 days after implantation-DAI). Pro- and anti-inflammatory cytokines (IL-2, IL-4, IL-6, IFN-gamma, TNF, IL-17A, IL-10 and TGF-beta) were quantified in all experimental days. There was no statistical difference between the groups analyzed considering the evaluated parameters. Therefore, at all implanted depths, PMMA behaved inertly in a murine model.No Level Assigned This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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 .
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Affiliation(s)
- Anália Cirqueira Milhomem
- Department of Biosciences and Technology , Institute of Tropical Pathology and Public Health (IPTSP), Federal University of Goias (UFG), Rua 235, s/n.º - Setor Leste Universitário, Goiânia, Goiás, Brazil
| | - Rodrigo Saar Gomes
- Department of Biosciences and Technology , Institute of Tropical Pathology and Public Health (IPTSP), Federal University of Goias (UFG), Rua 235, s/n.º - Setor Leste Universitário, Goiânia, Goiás, Brazil
| | - Fernanda Dias Tomé
- Department of Biosciences and Technology , Institute of Tropical Pathology and Public Health (IPTSP), Federal University of Goias (UFG), Rua 235, s/n.º - Setor Leste Universitário, Goiânia, Goiás, Brazil
| | - Felipe Dos Santos Arruda
- Department of Biosciences and Technology , Institute of Tropical Pathology and Public Health (IPTSP), Federal University of Goias (UFG), Rua 235, s/n.º - Setor Leste Universitário, Goiânia, Goiás, Brazil
| | - Pablo Igor Ribeiro Franco
- Department of Biosciences and Technology , Institute of Tropical Pathology and Public Health (IPTSP), Federal University of Goias (UFG), Rua 235, s/n.º - Setor Leste Universitário, Goiânia, Goiás, Brazil
| | - Eduardo Luiz da Costa
- Bioplastia Brasil, Rua T-55, nº 938, sala 1009; Edifício EBM Walk Bueno - Setor Bueno, Goiânia, Goiás, Brazil
| | - Jonathas Xavier Pereira
- Department of Biosciences and Technology , Institute of Tropical Pathology and Public Health (IPTSP), Federal University of Goias (UFG), Rua 235, s/n.º - Setor Leste Universitário, Goiânia, Goiás, Brazil
| | - Marina Clare Vinaud
- Department of Biosciences and Technology , Institute of Tropical Pathology and Public Health (IPTSP), Federal University of Goias (UFG), Rua 235, s/n.º - Setor Leste Universitário, Goiânia, Goiás, Brazil
| | - Ruy de Souza Lino Júnior
- Department of Biosciences and Technology , Institute of Tropical Pathology and Public Health (IPTSP), Federal University of Goias (UFG), Rua 235, s/n.º - Setor Leste Universitário, Goiânia, Goiás, Brazil.
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10
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Zargaran D, Zargaran A, Terranova T, Khaledi H, Robinson A, Davies J, Weyrich T, Mosahebi A. Profiling UK injectable aesthetic practitioners: A national cohort analysis. J Plast Reconstr Aesthet Surg 2023; 86:150-154. [PMID: 37717299 DOI: 10.1016/j.bjps.2023.06.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION The United Kingdom (UK) injectables market has been growing rapidly with a lack of robust regulation and to date, no information regarding the profile of practitioners has been published. AIM We aim to provide a descriptive and qualitative analysis of the advertised practitioners in the United Kingdom. METHODS We performed a systematic search using the internet search engine Google to perform a qualitative descriptive analysis of aesthetic practitioners in the UK. For each contiguous country in the UK: England, Scotland, and Wales, five searches were performed. The list of practitioners was then cross-referenced with professional regulatory bodies, with extraction of registration number, date of registration and presence or absence from the Specialist Register or General Practitioner Register. RESULTS 3000 websites were visited and evaluated. 1224 independent clinics with 4405 practitioners were identified. 738 were identified as those in business support functions and the remaining 3667 practitioners were undertaking injectable practice. The profile of professions were doctors 32%, nurses 13%, dentists 24% and dental nurses 8%. Of the 1163 doctors identified 481 were on the specialist register (41%) and 219 were on the GP register (19%). 27 specialties were represented in this cohort analysis. Plastic Surgery formed the majority of those who were on the specialist register at 37%, followed by Dermatology at 18%. CONCLUSION This paper is the first to describe the range of practitioners, their professional backgrounds and experience who perform non-surgical aesthetic interventions. The range of backgrounds may have an impact on the potential risks to patients and will be an important consideration in proposed legislation to introduce licensing to the industry.
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Affiliation(s)
- David Zargaran
- Department of Plastic Surgery, University College London, London, UK.
| | | | - Tom Terranova
- QUAD A - American Association for the Accreditation of Ambulatory Plastic Surgery Facilities (AAAAPSF), IL, USA
| | - Helia Khaledi
- Department of Plastic Surgery, University College London, London, UK
| | | | - Julie Davies
- UCL Global Business School for Health, University College London, London, UK
| | - Tim Weyrich
- Department of Computer Science, University College London, London, UK; Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Germany
| | - Afshin Mosahebi
- Department of Plastic Surgery, University College London, London, UK
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11
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Liu M, Lu F, Feng J. Therapeutic potential of adipose tissue derivatives in skin photoaging. Regen Med 2023; 18:869-883. [PMID: 37743749 DOI: 10.2217/rme-2023-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Photoaging, the primary cause of exogenous skin aging and predominantly caused by ultraviolet radiation, is an essential type of skin aging characterized by chronic skin inflammation. Recent studies have shown that oxidative stress, inflammation, skin barrier homeostasis, collagen denaturation and pigmentation are the main contributors to it. As a composite tissue rich in matrix and vascular components, adipose tissue derivatives have been recently gaining attention as potential therapeutic agents for various human diseases with fat-processing technology upgrades. This review analyzes both 'minimally treated' and 'nonminimally treated' fat derivatives to give an overview of the preclinical and clinical relevance of adipose tissue derivatives for antiphotoaging application, highlighting their good clinical prospects as well as discussing their safety and potential risks.
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Affiliation(s)
- Meiqi Liu
- Department of Plastic & Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong 510515, PR China
| | - Feng Lu
- Department of Plastic & Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong 510515, PR China
| | - Jingwei Feng
- Department of Plastic & Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong 510515, PR China
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12
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Ianhez M, Luz ARCA, Palermo EC, Miot HA. Dermal Filler Injections in Patients with Autoimmune and Immune-Mediated Diseases: A Survey with Dermatologists. Aesthetic Plast Surg 2023:10.1007/s00266-023-03639-x. [PMID: 37704857 DOI: 10.1007/s00266-023-03639-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/13/2023] [Indexed: 09/15/2023]
Affiliation(s)
- Mayra Ianhez
- Hospital of Tropical Diseases-GO, Rua Piquiri, Quadra AH6, Lote 1, Alphaville Araguaia, Goiânia, GO, 74883092, Brazil.
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13
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Abstract
Dermal filler and botulinum toxin injections are among the most performed non-invasive procedures for rejuvenation and contouring, internationally. Although most dermal fillers and approved botulinum toxins are well tolerated with a high safety profile, adverse events and/or complications can happen. Injection-related sequelae and side effects are usually rare, mild, transient, and self-limiting in nature. However, devastating and life-changing complications, such as intravascular occlusion, skin necrosis, permanent visual impairment, and stroke, have been reported. Risk reduction measures include an in-depth knowledge of anatomy, physiology, and pharmacology, correct patient selection, correct identification of clinical indications, and, fundamentally, the importance of appropriate skill and training. In this paper, some of the complications are discussed and advice on how to minimise adverse events and complications from these injectables is provided.
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Affiliation(s)
- Souphiyeh Samizadeh
- Souphiyeh Samizadeh BDS, BSc, MJDF RCS (Eng.), PGCert (Clinical Education), MSc (Aesthetic Medicine), FHEA Visiting Clinical Teacher, King's College London, London, UK; Honorary Clinical Lecturer, University College London, London, UK; Founder and Director, Great British Academy of Aesthetic Medicine, London, UK
- Koenraad De Boulle MD Consultant Dermatologist and Director Aalst Dermatology Clinic, Aalst Belgium Associate Professor, University College London, London, UK
| | - Koenraad De Boulle
- Souphiyeh Samizadeh BDS, BSc, MJDF RCS (Eng.), PGCert (Clinical Education), MSc (Aesthetic Medicine), FHEA Visiting Clinical Teacher, King's College London, London, UK; Honorary Clinical Lecturer, University College London, London, UK; Founder and Director, Great British Academy of Aesthetic Medicine, London, UK
- Koenraad De Boulle MD Consultant Dermatologist and Director Aalst Dermatology Clinic, Aalst Belgium Associate Professor, University College London, London, UK
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14
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Pieretti G, Rafaniello C, Fraenza F, Donniacuo M, Cuomo R, Lanzano G, Ciccarelli F, Capuano A, Nicoletti G. Hyaluronic acid-based fillers in patients with autoimmune inflammatory diseases. J Cosmet Dermatol 2023; 22:2420-2423. [PMID: 37128806 DOI: 10.1111/jocd.15751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 05/03/2023]
Abstract
The use of hyaluronic acid (HA)-based aesthetic therapies is growing steadily, and according to the International Society of Aesthetic Plastic Surgery, more than 4.3 million aesthetic procedures using HA were performed in 2019, an increase of 15.7% than 2018. More people are offering these types of services, often without proper training or qualifications. Therefore, there is an increasing number of reports in the literature relating to possible adverse events, with subsequent therapeutic problems and more or less serious consequences for patients. The aim of this research is to carry out a review of the literature in order to evaluate the impact of hyaluronic acid-based fillers in patients with autoimmune inflammatory diseases, in particular scleroderma and Systemic Lupus Erythematosus (SLE). Although HA plays a central role in the inflammatory process, the use of HA-based fillers in patients with autoimmune inflammatory diseases is still controversial. HA, in fact, in inflamed tissues helps to propagate the inflammatory response and, injected in the form of a dermal filler, could potentially promote reactivation of the underlying disease. For this reason, many specialists do not perform HA-based aesthetic treatments in patients with scleroderma or SLE. However, recent scientific evidence suggests that the use of HA-based fillers in patients with scleroderma can lead to improvement of skin lesions, with satisfactory results. In the literature, there are no clinical studies that contraindicate the administration of HA-based dermal fillers in patients with inflammatory disease.
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Affiliation(s)
- Gorizio Pieretti
- Multidisciplinary Department of Medical Surgery and Dental Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Concetta Rafaniello
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Federica Fraenza
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Donniacuo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Roberto Cuomo
- M.D. Plastic Surgery Unit - Department of Medicine, Surgery and Neuroscience - University of Siena, Siena, Italy
| | - Giuseppe Lanzano
- M.D. Plastic and Reconstructive Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Annalisa Capuano
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gianfranco Nicoletti
- Multidisciplinary Department of Medical Surgery and Dental Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
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15
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Kroumpouzos G, Harris S, Bhargava S, Wortsman X. 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. [PMID: 37002059 DOI: 10.1016/j.bjps.2023.01.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/30/2022] [Accepted: 01/29/2023] [Indexed: 03/09/2023]
Abstract
An ever-increasing interest in perioral rejuvenation with dermal fillers reflects the esthetic importance of this region. However, filler injections in the lips and perioral area have been associated with various complications. Such complications are classified according to severity (mild, moderate, severe) or by the time of onset: immediate (within 24 h after injection), early (24 h to 4 weeks post-procedure), and late or delayed (>4 weeks after injection). While most complications are mild and manageable, vascular compromise, infections, and the development of delayed-onset nodules may significantly undermine the ultimate esthetic outcome and cause substantial morbidity. These more serious complications often require more invasive treatment modalities. This article details the prevention and management of such adverse events and discusses safe filler injection principles, including safety recommendations for the lips. Lastly, we highlight the use of ultrasound guidance in complication prevention (vascular mapping, filler identification, location, and extent), assessment (identification of intravascular embolus or external vascular compression by the filler implant), and management (real-time imaging of hyaluronidase or other drug injection in the affected area). Esthetic practitioners should be versed in injection anatomy, and the prevention, recognition, and management of filler complications in the perioral area.
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Affiliation(s)
- George Kroumpouzos
- Department of Dermatology, Warren Alpert Medical School at Brown University, Providence, RI, USA.
| | | | - Shashank Bhargava
- Department of Dermatology, R.D. Gardi Medical College and C.R. Gardi Hospital, Ujjain, India.
| | - Ximena Wortsman
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile; Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Department of Dermatology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
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16
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Sanchez B, Ferraro S, Josset-Lamaugarny A, Pagnon A, Hee CK, Nakab L, Sigaudo-Roussel D, Fromy B. Skin Cell and Tissue Responses to Cross-Linked Hyaluronic Acid in Low-Grade Inflammatory Conditions. Int J Inflam 2023; 2023:3001080. [PMID: 37663889 PMCID: PMC10474960 DOI: 10.1155/2023/3001080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 07/18/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
Hyaluronic acid (HA), used in a variety of medical applications, is associated in rare instances to long-term adverse effects. Although the aetiology of these events is unknown, a number of hypotheses have been proposed, including low molecular weight of HA (LMW-HA) in the filler products. We hypothesized that cross-linked HA and its degradation products, in a low-grade inflammatory microenvironment, could impact immune responses that could affect cell behaviours in the dermis. Using two different cross-linking technologies VYC-15L and HYC-24L+, and their hyaluronidase-induced degradation products, we observed for nondegraded HA, VYC-15L and HYC-24L+, a moderate and transient increase in IL-1β, TNF-α in M1 macrophages under low-grade inflammatory conditions. Endothelial cells and fibroblasts were preconditioned using inflammatory medium produced by M1 macrophages. 24 h after LMW-HA fragments and HA stimulation, no cytokine was released in these preconditioned cells. To further characterize HA responses, we used a novel in vivo murine model exhibiting a systemic low-grade inflammatory phenotype. The intradermal injection of VYC-15L and its degradation products induced an inflammation and cell infiltration into the skin that was more pronounced than those by HYC-24L+. This acute cutaneous inflammation was likely due to mechanical effects due to filler injection and tissue integration rather than its biological effects on inflammation. VYC-15L and its degradation product potentiated microvascular response to acetylcholine in the presence of a low-grade inflammation. The different responses with 2D cell models and mouse model using the two tested cross-linking HA technologies showed the importance to use integrative complex model to better understand the effects of HA products according to inflammatory state.
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Affiliation(s)
- Benjamin Sanchez
- Laboratoire Biologie Tissulaire et Ingénierie Thérapeutique, Centre national de la recherche scientifique (CNRS), UMR 5305, LBTI, 7 Passage du Vercors, F-69367 Lyon cedex 7, France
- University of Lyon 1, UMR 5305, LBTI, 7 Passage du Vercors, F-69367 Lyon cedex 7, France
| | - Sandra Ferraro
- Laboratoire Biologie Tissulaire et Ingénierie Thérapeutique, Centre national de la recherche scientifique (CNRS), UMR 5305, LBTI, 7 Passage du Vercors, F-69367 Lyon cedex 7, France
- University of Lyon 1, UMR 5305, LBTI, 7 Passage du Vercors, F-69367 Lyon cedex 7, France
| | - Audrey Josset-Lamaugarny
- Laboratoire Biologie Tissulaire et Ingénierie Thérapeutique, Centre national de la recherche scientifique (CNRS), UMR 5305, LBTI, 7 Passage du Vercors, F-69367 Lyon cedex 7, France
- University of Lyon 1, UMR 5305, LBTI, 7 Passage du Vercors, F-69367 Lyon cedex 7, France
| | - Aurélie Pagnon
- NOVOTEC, ZAC du Chêne Europarc, 11 Rue Edison, 69500 Bron, France
| | - Charlie K. Hee
- Allergan Aesthetics, An AbbVie Company, 2525 Dupont Dr., Irvine, CA 92612, USA
| | - Lauren Nakab
- Allergan Aesthetics, An AbbVie Company, 2525 Dupont Dr., Irvine, CA 92612, USA
| | - Dominique Sigaudo-Roussel
- Laboratoire Biologie Tissulaire et Ingénierie Thérapeutique, Centre national de la recherche scientifique (CNRS), UMR 5305, LBTI, 7 Passage du Vercors, F-69367 Lyon cedex 7, France
- University of Lyon 1, UMR 5305, LBTI, 7 Passage du Vercors, F-69367 Lyon cedex 7, France
| | - Bérengère Fromy
- Laboratoire Biologie Tissulaire et Ingénierie Thérapeutique, Centre national de la recherche scientifique (CNRS), UMR 5305, LBTI, 7 Passage du Vercors, F-69367 Lyon cedex 7, France
- University of Lyon 1, UMR 5305, LBTI, 7 Passage du Vercors, F-69367 Lyon cedex 7, France
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17
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Sullivan DA, da Costa AX, Del Duca E, Doll T, Grupcheva CN, Lazreg S, Liu SH, McGee SR, Murthy R, Narang P, Ng A, Nistico S, O'Dell L, Roos J, Shen J, Markoulli M. TFOS Lifestyle: Impact of cosmetics on the ocular surface. Ocul Surf 2023; 29:77-130. [PMID: 37061220 PMCID: PMC11246752 DOI: 10.1016/j.jtos.2023.04.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/17/2023]
Abstract
In this report the use of eye cosmetic products and procedures and how this represents a lifestyle challenge that may exacerbate or promote the development of ocular surface and adnexal disease is discussed. Multiple aspects of eye cosmetics are addressed, including their history and market value, psychological and social impacts, possible problems associated with cosmetic ingredients, products, and procedures, and regulations for eye cosmetic use. In addition, a systematic review that critically appraises randomized controlled trial evidence concerning the ocular effects of eyelash growth products is included. The findings of this systematic review highlight the evidence gaps and indicate future directions for research to focus on ocular surface outcomes associated with eyelash growth products.
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Affiliation(s)
| | | | - Ester Del Duca
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | | | | | - Sihem Lazreg
- Lazreg Cornea and Ocular Surface Center, Blida, Algeria
| | - Su-Hsun Liu
- University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | | | | | | | - Alison Ng
- Centre for Ocular Research & Education, School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - Steven Nistico
- Department of Dermatology, University Magna Graecia, Catanzaro, Italy
| | | | | | - Joanne Shen
- Department of Ophthalmology, Mayo Clinic in Arizona, Scottsdale, AZ, USA
| | - Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
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18
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Neamatallah T. Delayed inflammatory reaction to hyaluronic acid lip filler after the Pfizer-BioNTech COVID-19 vaccine: A case report. Heliyon 2023; 9:e18274. [PMID: 37539264 PMCID: PMC10395472 DOI: 10.1016/j.heliyon.2023.e18274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023] Open
Abstract
Hypersensitivity reactions can be a side effect to any vaccine, but they are usually rare. The COVID-19 vaccination may cause hypersensitivity, and several cases of delayed hypersensitivity (DH) to hyaluronic acid (HA) dermal filler have been documented. The current report presents a case of a 36-year-old female patient with DH to HA dermal filler after receiving the Pfizer-BioNTech COVID-19 vaccine. Symptoms, including dryness, swelling, and a painless nodule, appeared after the first and second doses of the vaccine. The patient was treated with intralesional hyaluronidase and triamcinolone in the outpatient clinic. Although HA is relatively safe and routinely used in aesthetic medicine, DH reactions must be considered. Therefore, an appropriate patient history should be obtained, and physicians should provide counselling on the potential reactions to avoid these adverse effects.
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19
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Al Mashhrawi YM, AlNojaidi TF, Alkhaldi RA, Alshami NS, Alhadlaq AS. Awareness and Knowledge of the Adverse Effects of Dermal Fillers Among the Saudi Population: A Cross-Sectional Study. Cureus 2023; 15:e40322. [PMID: 37448388 PMCID: PMC10337987 DOI: 10.7759/cureus.40322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction Dermal filling for aesthetics and facial rejuvenation is one of the most common aesthetic procedures, with hyaluronic acid (HA) being the most commonly used filler due to its high safety profile. Nevertheless, adverse effects have been reported that people should be aware of before the procedure. This study aims to assess Saudi Arabians' awareness of dermal fillers, their side effects, and information sources. Methods This cross-sectional study used an online questionnaire to determine participants' level of knowledge, from January 2, 2022, to February 19, 2023. Statistical analysis and ordinal logistic regression were used to assess the respondents' knowledge of dermal fillers and other parameters. Results Of the 1,208 respondents, 290 reported using fillers, and 44% reported that complications were mentioned to them before the procedure. The results also showed that the primary source of information was social media (44.8%), followed by the Internet, physicians, and books. Respondents to whom physicians explained complications reported bruising, bluish discoloration at the injection site, redness, swelling, and accumulation of body cells under the skin, as discussed with them. Bruising and bluish discoloration were the significantly reported complications in people who received fillers, whereas lumps, epistaxis, ulceration/loss of skin, and swelling/accumulation were reported in those who did not receive fillers. Conclusion Although some adverse effects may occur with HA, its enormous advantages led to its use in facial rejuvenation. With social media as a major source of information, many respondents reported unlikely adverse effects as common ones, suggesting that information sources need to be corrected by physicians to raise awareness of the adverse effects of cosmetic procedures and enhance informed decision-making by patients.
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Affiliation(s)
| | - Taif F AlNojaidi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Raghad A Alkhaldi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
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20
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López PV, García PT, López-Pitalúa JA, Pinto H. Side effects after hyaluronic acid facial injection in adults during COVID-19 pandemic. J Cosmet Dermatol 2023; 22:1714-1719. [PMID: 37082890 DOI: 10.1111/jocd.15780] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/06/2023] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Different causes may be responsible for delayed inflammatory reactions after hyaluronic acid injections, among them several mechanisms of SARS-CoV-2. AIMS The study's objective was to assess the percentage of adverse reactions after hyaluronic acid injections in a cohort of adult patients with a test for SARS-CoV-2 or vaccinated during the COVID-19 pandemic. PATIENTS/METHODS An observational, retrospective, comparative, multi-center, non-interventional in a real-life setting study was carried out with patients treated with facial injections of hyaluronic acid from May to September 2021, with a test to discard SARS-COV 2 or that had been vaccinated. RESULTS Sixty-three patients were included. Seven (11.1%) were vaccinated patients without a test for SaRS-CoV-2 and 56 (88.9%) with antigenic or PCR screening tests (18 [32.1%] negative and 39 [69.6%] positives for COVID-19). The mean age was 51.3 (SD 12.71; range 23-70), and 57 (90.5%) were female. Twenty-three patients (36.5%) had a history of adverse events with hyaluronic acid injections. During the study, 15 adverse events were reported; 11 patients (73.3%) had a history (p = 0.0018); two patients (13.3%) had been vaccinated; 13 (86.7%) had performed a SARS-CoV2 test (six [46.2%] negatives, and seven [53.8%] with a positive result; p = 0.5969). All adverse study events were resolved, and none had sequelae. CONCLUSION Adverse events after hyaluronic acid facial injections were higher among patients with a history but not among those diagnosed with COVID-19. The new scenario related to COVID-19 infections or vaccinations would require readapting criteria for applying hyaluronic acid injections.
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Affiliation(s)
| | | | | | - Hernán Pinto
- i2e3 Biomedical Research Institute, Barcelona, Spain
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21
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Colon J, Mirkin S, Hardigan P, Elias MJ, Jacobs RJ. Adverse Events Reported From Hyaluronic Acid Dermal Filler Injections to the Facial Region: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e38286. [PMID: 37261136 PMCID: PMC10226824 DOI: 10.7759/cureus.38286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/25/2023] [Indexed: 06/02/2023] Open
Abstract
Dermal filler injections are one of the most popular cosmetic procedures in the United States. Of the many options available, hyaluronic acid (HA) dermal fillers like Juvederm or Restylane are often used. Despite their use and popularity, adverse events are known to occur from these procedures. Although most outcomes may be mild and resolve over time, rare instances of severe complications cannot be ignored, as these effects may be irreversible. Healthcare practitioners and patients must be aware of these risks, as these cosmetic procedures can affect the patient's quality of life. The aim of this study was to evaluate the incidence of adverse events (AEs) reported from the use of hyaluronic acid dermal fillers in the facial region. A systemized search of randomized controlled trials was conducted using Cochrane Central, Embase, Medical Literature Analysis and Retrieval System Online (MEDLINE), and the Web of Science databases. After screening for eligibility and conducting a critical appraisal of the articles, 19 studies were retained for the final review. The meta-analysis results included different side effects by facial location, i.e., nasolabial fold (NLF) vs. other (midface, perioral line, and lip region). The midface includes the anteromedial cheek region, the zygomaticomalar region, and the submalar region. The adverse events were swelling, pain, erythema, bruising, lumps and bumps, firmness, tenderness, itching, and skin discoloration. A significant difference was found in the proportion of individuals experiencing swelling, lumps or bumps, and firmness at the nasolabial fold site versus the midface, perioral line, and lip region. There was no significant difference in the proportion of individuals experiencing pain, erythema, bruising, tenderness, itching, or skin discoloration at the nasolabial fold site versus the other sites. The study highlights the prevalence of common AEs that can result from HA dermal fillers like Juvederm or Restylane, thus emphasizing the importance of healthcare professionals explaining the risk and benefits to patients.
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Affiliation(s)
- Jessica Colon
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Sophia Mirkin
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Patrick Hardigan
- Health Professions Division, Nova Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, Fl, USA
| | | | - Robin J Jacobs
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
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22
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Sun Y, Jin M, Wang G, Xie H. Early warm compress treatment can promote recanalization of vascular embolisms and reduce tissue necrosis after polymethyl methacrylate injection. Sci Rep 2023; 13:1872. [PMID: 36725881 PMCID: PMC9892021 DOI: 10.1038/s41598-023-29043-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/30/2023] [Indexed: 02/03/2023] Open
Abstract
Injection of fillers for soft tissue augmentation can lead to a variety of complications, among which vascular occlusion caused by intravascular injection of filler will induce severe or permanent damage. The treatment strategies for intravascular embolization caused by injection include warm compress application, but the exact beneficial effects of this therapy have not been confirmed. The purpose of this study is to construct an intravascular injection embolism model and observe the effectiveness of warm and cold compress through a randomized, controlled trial. Thirty rabbit's sixty ears were randomly divided into warm compress group, cold compress group, and control group. Polymethyl methacrylate (PMMA) was slowly injected into the central ear artery (CEA) to cause vascular embolism. Warm compress and cold compress treatment were performed respectively. The vascular recanalization and other related indexes were observed at 30 min, 1 day, and 7 days after injection, and the tissue necrosis was analyzed at 7 days. In the early stage of vascular embolization, warm compress can immediately promote vascular dilatation, blood circulation and partial blood flow recovery. One day after intravascular injection, warm compress can reduce intravascular embolization and reduce the incidence of tissue necrosis. At 7 days after intravascular injection, the vessels in the cold compress and control groups were still embolized while the percentage of recanalization in the warm compress group was 47.4% (P < 0.000). Early-stage warm compress after intravascular PMMA injection is conducive to recanalization of vascular embolization and reducing tissue necrosis.
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Affiliation(s)
- Yimou Sun
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing, 100191, China
| | - Mengying Jin
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing, 100191, China
| | - Guanhuier Wang
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing, 100191, China
| | - Hongbin Xie
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing, 100191, China.
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23
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Steenen SA, Bauland CG, de Lange J, van der Lei B. Complications After Botulinum Neurotoxin Type A and Dermal Filler Injections: Data From a Large Retrospective Cohort Study. Aesthet Surg J 2023; 43:NP56-NP63. [PMID: 35953448 PMCID: PMC9830985 DOI: 10.1093/asj/sjac228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 01/18/2023] Open
Affiliation(s)
- Serge A Steenen
- Corresponding Author: Dr Serge A. Steenen, Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers/Academic Center for Dentistry (ACTA), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands. E-mail: ; Instagram: @dr_steenen
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24
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Baharlou S, De Boulle K, van Heijningen I, Cervini I, Termohlen P. Standards for aseptic techniques in medical aesthetic practices in the Benelux: Consensus recommendations. J Cosmet Dermatol 2023; 22:289-295. [PMID: 35545887 PMCID: PMC10086968 DOI: 10.1111/jocd.15077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/05/2022] [Indexed: 01/24/2023]
Abstract
INTRODUCTION While the demand for aesthetic procedures is rising, complications are rising alongside. Infection is a frequent complication, there is therefore an increased need for strict aseptic technique, particularly in procedures breaching the skin. The level of training of practitioners carrying out these procedures varies and there are no comprehensive guidelines on aseptic aesthetic practice in the Benelux region. OBJECTIVE Developing a step-by-step procedure for achieving and maintaining a high standard of aseptic conditions in a standard aesthetic practice in the Benelux region. METHODS A consensus group of 10 aesthetic medical practitioners (dermatologists, plastic surgeons, and cosmetic physicians) representing the Benelux region convened to discuss best practice for aseptic techniques in medical aesthetics. Step-by-step procedures were recommended to achieve optimal aseptic practice in private facilities and define important considerations for reducing infection risk. Recommendations were based on current evidence and extensive clinical experience. RESULTS Recommendations were made to achieve and maintain a high standard of asepsis and infection control. Guidance included maintaining high standard aseptic conditions of the injecting room, the injecting area on the patient, the injection procedure, the materials, and procedures commonly used to achieve aseptic conditions. CONCLUSIONS This expert consensus summary publication recommends aseptic procedures, setting a standard with the goal of minimizing rates of complications in aesthetic clinical practice in the Benelux region.
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Shen Y, Shi L, Deng L, Zhao X. Analysis of Risk Factors and Protective Strategies for Tube Blockage in Patients with Drug-Induced Liver Failure Based on Artificial Liver Therapy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2023; 2023:8201776. [PMID: 37089717 PMCID: PMC10118878 DOI: 10.1155/2023/8201776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 04/25/2023]
Abstract
Objective To analyse the influencing factors of tube blockage during the treatment of artificial liver in patients with drug-induced liver failure and explore effective patient protection strategies. Methods In this study, 49 patients with pharmacological (antituberculosis drugs, antibiotics, proprietary Chinese medicine, gastric drugs, and antihyperthyroid drugs) liver failure admitted to our hospital from June 2015 to December 2021 were selected for prospective analysis. Clinical indicators and general data of all patients were collected and collated, risk factors leading to the obstruction of artificial liver treatment were analysed, and corresponding protective measures were proposed. Results The incidence of tube blockage was 5.32% (10 times) in 49 patients with pharmacological liver failure treated 188 times with artificial liver therapy. The incidence of tube blockage was significantly higher in patients in the PDF mode than in those in the PP and PE modes (P < 0.05), and there were differences in the location of blocked tubes between the treatment modes. Blocked tubes occurred more often in the venous cauldron of the circuit in the PDF mode and in the plasma separator of the circuit in the PP mode. The incidence of tube blockage was significantly lower in patients with no more than 3 treatments than in those with 3 to 5 treatments and those with more than 5 treatments (p < 0.05). The incidence of catheter blockage was higher in patients with PTA values ≤20% than in those with PTA values between 20% and 30%, and higher than in those with PTA values above 30% (P < 0.05). Conclusion The risk factors of tube plugging in patients with liver failure treated with artificial liver include different treatment modes, different treatment times, and different PTA values. The PDF mode has a higher rate of tube plugging than PE or PP treatment modes. The more the number of treatment times and the lower the PTA value of patients, the more tube plugging is likely to occur.
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Affiliation(s)
- Yan Shen
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China
| | - Liping Shi
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China
| | - Luxi Deng
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China
| | - Xiaoling Zhao
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China
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26
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Zhao H, Ren R, Bao S, Qian W, Ma X, Wang R, Li X, Fang R, Sun Q, Tian Y, Zhu C, Shi J. Efficacy and Safety of Polycaprolactone in Treating Nasolabial Folds: A Prospective, Multicenter, and Randomized Controlled Trial. Facial Plast Surg 2022; 39:300-306. [PMID: 36191597 PMCID: PMC10171959 DOI: 10.1055/a-1954-3986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Nasolabial folds (NLFs) are the most pronounced sign of facial aging. This study explored the efficacy and safety of polycaprolactone gel in treating Chinese patients with moderate-to-severe NLFs. Patients with moderate-to-severe NLF who wished to be treated by dermal fillers were recruited from three centers between July 2017 and September 2019. The randomizing ratio was 1:1 in the polycaprolactone group (polycaprolactone injection) or control group (sodium hyaluronate gel injection). The primary endpoint was the effectiveness rate of Wrinkle Severity Rating Score (WSRS) scores at 12 months after injection. The full-analysis set (FAS) and safety sets had 80 patients in the polycaprolactone group and control group, respectively. In the FAS, the effectiveness rate at 12 months in the polycaprolactone group was 88.8% compared with 23.8% in controls (P < 0.001). The improvement in WSRS sustained during 12 months in the polycaprolactone group, while gradually vanished in the control group since 3 months after surgery. The global aesthetic improvement scale (GAIS) by investigator assessments was improved, much improved, or very much improved in all patients during follow-up, while the proportion of patients with a "no change" assessment gradually increased during follow-up after 6 months in the control group. The rates of injection-related adverse event (AE) and serve injection-related AE were 8.8 versus 11.3% and 0 versus 1.3% in the polycaprolactone group and control groups, respectively. Polycaprolactone gel injection is effective and safe to treat moderate-to-severe NLFs in Chinese patients.
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Affiliation(s)
- Hongyi Zhao
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Rongxin Ren
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Shiwei Bao
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Wenjiang Qian
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xiaobing Ma
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Ruiyan Wang
- Department of Dermatology, Air Force Characteristic Medical Center, Beijing, People's Republic of China
| | - Xiaoxin Li
- Department of Dermatology, Air Force Characteristic Medical Center, Beijing, People's Republic of China
| | - Rouyu Fang
- Department of Dermatology, Peking Union Medical College Hospital, Beijing, People's Republic of China
| | - Qiuning Sun
- Department of Dermatology, Peking Union Medical College Hospital, Beijing, People's Republic of China
| | - Yan Tian
- Department of Dermatology, Air Force Characteristic Medical Center, Beijing, People's Republic of China
| | - Chaonan Zhu
- Huadong Medical Co. Ltd, Hangzhou, People's Republic of China
| | - Jianling Shi
- Huadong Medical Co. Ltd, Hangzhou, People's Republic of China
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Milhomem AC, de Souza Jorge IM, dos Santos Arruda F, Tomé FD, da Costa EL, Vinaud MC, Pereira JX, de Souza Lino Júnior R. Tissue Remodeling After Implantation with Polymethylmethacrylate: An Experimental Study in Mice. Aesthetic Plast Surg 2022; 47:1205-1216. [DOI: 10.1007/s00266-022-03179-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/06/2022] [Indexed: 11/26/2022]
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28
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Lee SH, Cho M, Han Y, Woo YR, Cho SH, Lee JD, Kim HS. A case of late-onset granuloma 10 years after illegal filler injection. J Cosmet Dermatol 2022; 21:6515-6517. [PMID: 35971875 DOI: 10.1111/jocd.15304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/21/2022] [Accepted: 08/12/2022] [Indexed: 12/27/2022]
Affiliation(s)
- Se Hoon Lee
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Minah Cho
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Yujin Han
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Yu Ri Woo
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Sang Hyun Cho
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Jeong Deuk Lee
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Hei Sung Kim
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.,Department of Biomedicine & Health Sciences, The Catholic University of Korea, Seoul, South Korea
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de Almeida Balassiano LK, Cavallieri FA, Munhoz G, Tembra MF, Ramos-E-Silva M. NOT SO "HAPPY BUMP": A complication due to hyaluronic acid. J Cosmet Dermatol 2022; 21:6308-6313. [PMID: 35869832 DOI: 10.1111/jocd.15266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/12/2022] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The use of hyaluronic acid (HA) as a dermal filler is considered safe. However, as new brands come to the market, reports of adverse events are becoming more and more common. OBJECTIVE To describe a particular type of adverse effect that, unlike the erythematous, indurated, and painful nodules described in the literature as "angry red bumps," is characterized by noninflammatory, stony-like nodules that appear in sites previously treated with HA. METHODS The report of four patients who presented this complication, and the occurrence of two HA syringes from the same batch that had hardened the product inside at the time of filling. CONCLUSION The authors propose the nomenclature "happy bump" to group adverse reactions to HA that translate into noninflammatory nodules, with a stony consistency, appearing up to 4 weeks (recent) or after one month (late) in sites previously treated with AH.
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Affiliation(s)
- Laila Klotz de Almeida Balassiano
- Sector of Dermatology and Post Graduation Program in Medical Clinics (Area: Dermatology) - University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda A Cavallieri
- Cavallieri Clinic, Member of the Brazilian College of Radiology and Diagnostic Imaging and the National Commission of Ultrasound - Brazilian College of Radiology and Diagnostic Imaging, Rio de Janeiro, Brazil
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30
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Aryanian Z, Balighi K, Emadi SN, Razavi Z, Hatami P, Afshar ZM. COVID-19 vaccines and filler reactions: Should it be considered as a concern? J Cosmet Dermatol 2022; 21:6564-6567. [PMID: 36181343 PMCID: PMC9539081 DOI: 10.1111/jocd.15428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/22/2022] [Accepted: 09/29/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Any implant or external material used in the body tissues can potentially be followed by autoimmune or inflammatory reactions. With the global vaccination program against COVID-19, the reports of tissue filler reactions would be increasingly demonstrated. AIM To summarize the data regarding COVID vaccination and filler reactions. METHOD We reviewed the existing data in this regard through searching on PubMed, Google Scholar and Scopus. All of the relevant papers published until March 2022, which we could access to their fulltexts were included. RESULTS Here, we summarized the data regarding COVID-19 vaccination and filler reactions and discussed its etiopathogenesis, management, and importance. CONCLUSION Although the end of pandemic was announced, the necessity of continuing COVI-D19 vaccination in future mandates gathering data regarding safety of vaccines.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran.TehranIran,Department of DermatologyBabol University of Medical SciencesBabolIran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran.TehranIran,Department of Dermatology, School of Medicine Razi HospitalTehran University of Medical SciencesTehranIran
| | - Seyed Naser Emadi
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran.TehranIran,Department of Dermatology, School of Medicine Razi HospitalTehran University of Medical SciencesTehranIran
| | - Zahra Razavi
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran.TehranIran,Department of Dermatology, School of Medicine Razi HospitalTehran University of Medical SciencesTehranIran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran.TehranIran
| | - Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza, Hospital, KermanshahUniversity of Medical SciencesKermanshahIran
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31
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Koh YG, Hong JK, Shin SH, Han HS, Mun SK, Yoo KH, Kim BJ. A case report of 595 nm pulsed dye laser for the prevention and management of scar developed after vascular complication of filler application. Dermatol Ther 2022; 35:e15764. [PMID: 35945913 DOI: 10.1111/dth.15764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/17/2022] [Accepted: 08/08/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Young Gue Koh
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jun Ki Hong
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sun Hye Shin
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hye Sung Han
- Department of Dermatology, Seoul National University, Bundang Hospital, Seongnam, Korea
| | - Seog-Kyun Mun
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kwang Ho Yoo
- Department of Dermatology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si, Gyeonggi-do, Republic of Korea
| | - Beom Joon Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
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32
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Noninvasive Correction of the Aging Forehead. Clin Plast Surg 2022; 49:399-407. [PMID: 35710155 DOI: 10.1016/j.cps.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Aging of the face is a continuous and dynamic process that occurs due to changes in layers including skin, muscle, fat, and bone. There is an increasing patient preference toward nonsurgical techniques and procedures that require minimal downtime in all aspects of cosmetic surgery. The mainstay of treatment involves the administration of injectable fillers for temple volumization, eyebrow reshaping and forehead contouring, and neuromodulation to reduce the appearance of dynamic rhytids. Surgical and nonsurgical procedures can be used in combination in order to maximize periorbital rejuvenation. This article focuses on nonsurgical rejuvenation of the brow and periorbital complex.
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Corduff N, Juniarti L, Lim TS, Lin F, Mariwalla K, Pavicic T, Quiambao A, Siew TW, Suwanchinda A, Tseng FW, Vachiramon V, Youn CS, Ho WWS. Current Practices in Hyaluronic Acid Dermal Filler Treatment in Asia Pacific and Practical Approaches to Achieving Safe and Natural-Looking Results. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:1213-1223. [PMID: 35800454 PMCID: PMC9255720 DOI: 10.2147/ccid.s363583] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/17/2022] [Indexed: 11/23/2022]
Abstract
Complications such as delayed inflammatory reactions (DIRs) and unnatural outcomes can sometimes arise from hyaluronic acid (HA) dermal filler treatments and can be challenging to address. Given the popularity of HA dermal fillers for aesthetic procedures, there is a need for preventive strategies to minimize these complications. Two hundred practitioners from 10 regions in Asia Pacific who administer HA fillers completed a survey on prevention of DIRs and unnatural outcomes. Thirteen global experts convened to evaluate the current practices and propose practical approaches for safe and appropriate use of HA dermal fillers. From the survey, the top three measures used to reduce the risk of DIRs included choosing an appropriate HA filler, aseptic technique, and patient selection. Key strategies employed to achieve natural-looking outcomes were treatment customization, understanding the rheological properties and behavior of different HA fillers, and being conservative in treatment approach. The panel developed a concise reference guide aimed at minimizing the risk of DIRs while achieving natural aesthetic outcomes. 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. The panel highlighted the need for education efforts to increase awareness of differential immunogenicity between HA fillers and to improve understanding on the importance of preserving aesthetic individuality for optimal results. These practical insights from the global experts support practitioners in optimizing safety and quality of aesthetic treatment with HA fillers.
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Affiliation(s)
- Niamh Corduff
- Cosmetic Refinement Clinic Geelong, Victoria, Australia
- Correspondence: Niamh Corduff, Cosmetic Refinement Clinic Geelong, T9 400 Pakington St, Newtown VIC, Victoria, 3220, Australia, Tel +61 407122578, Email
| | | | | | - Frank Lin
- Eastern Plastic Surgery, Victoria, Australia
| | | | - Tatjana Pavicic
- Private Practice for Dermatology & Aesthetics of Dr. Tatjana Pavicic, Munich, Germany
| | - Arnelle Quiambao
- YouPlus Intelligent Aesthetics Clinic, BGC Taguig City, Philippines
| | | | - Atchima Suwanchinda
- Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Vasanop Vachiramon
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Wilson W S Ho
- The Specialists: Lasers, Aesthetic & Plastic Surgery, Central, Hong Kong
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Wu Y, An HT, Hsu NJ, Loh D, Malaithong L, Park JY, Park K, Peng PHL, Sumaetheiwit R, Thammasunthorn A, Wibowo A, Liao YH. Expert recommendations on the assessment and management of complications due to hyaluronic acid soft tissue filler injections in Asians. J Cosmet Dermatol 2022; 21:3779-3786. [PMID: 35699355 DOI: 10.1111/jocd.15156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND The use of hyaluronic acid (HA) fillers for medical aesthetic purposes is increasing worldwide. Nonetheless, adverse events do occur because of patient-specific issues, injection technique, or product factors. It would be mandatory to consider cultural and anatomical features of Asians in preventing and managing the complications of HA injections. METHODS Literature search of studies looking at current evidence and guidelines on the management of complications following HA filler injections in Asian patients was conducted. This was followed by an expert group discussion that was convened to reach consensus recommendations on the best clinical practices. RESULTS The expert panel provided specific recommendations focusing on the safe use of soft tissue fillers in Asian patients, including early identification of adverse events and how to prevent and comprehensively manage these outcomes. CONCLUSIONS Here, we provide consensus statements of Asian experts in dermatology, plastic surgery, ophthalmology, and aesthetic medicine mainly focusing on AEs with higher risk for Asians and can be used to guide physicians in treating Asian population.
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Affiliation(s)
- Yan Wu
- Department of Dermatology, Peking University First Hospital, Beijing, China
| | - Hi-Tae An
- Yemiwon Aesthetic Clinic, Seoul, South Korea
| | - Nai-Jen Hsu
- Hsu Nai-Jen Dermatologic Clinic, Tainan, Taiwan
| | - David Loh
- David Loh Surgery, Singapore, Singapore
| | | | - Je-Young Park
- Apkoo-Jung Oracle Dermatology Center, Seoul, South Korea
| | - Kyungho Park
- Dream Dermatology and Laser Center, Seoul, South Korea
| | - Peter Hsien-Li Peng
- P-Skin Professional Clinic, Kaohsiung, Taiwan.,Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | | | | | | | - Yi-Hua Liao
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Alli N, Murdoch M, Meer S. Delayed adverse reaction to a natural dermal filler mimicking salivary gland neoplasia. BULLETIN OF THE NATIONAL RESEARCH CENTRE 2022; 46:97. [PMID: 35431534 PMCID: PMC8996220 DOI: 10.1186/s42269-022-00791-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/02/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Cosmetic dermal fillers are a sought-after procedure globally. However, despite the safety claims of filler materials by the manufacturers, adverse reactions still occur. CASE PRESENTATION This case report is of a 66-year-old female who presented with a late-onset complication of a hyaluronic acid dermal filler that clinically mimicked a salivary gland neoplasm. The patient presented with firm peri-oral swellings of short duration that clinically mimicked a pleomorphic adenoma and mucoepidermoid carcinoma. The diagnosis was that of a foreign-body granulomatous response to dermal fillers. Although other mimics of a similar nature are reported a knowledgeable clinician, careful choice of filler material, knowledge of the product, thorough pre-procedural history taking and post-procedural patient follow-up can drastically minimize a possible misdiagnosis. The reaction was treated with a combination of hyaluronidase, betamethasone and 5-flurouracil intra-lesional injections monthly for 11 consecutive months, with total clinical resolution. CONCLUSIONS Patient education of the procedure, product name and the possibility of an adverse reaction occurring, even years later or at a site distant to the initial site of placement, is vital. Further, we review the recent reported adverse association of the new mRNA COVID-19 vaccines and dermal filler placement.
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Affiliation(s)
- Nasreen Alli
- KwaMashu Community Health Centre, Durban, KwaZulu Natal South Africa
| | | | - Shabnum Meer
- Department of Oral Pathology, Faculty of Health Sciences, University of the Witwatersrand, WITS, Private Bag 3, Johannesburg, 2050 South Africa
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36
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Huang CH, Ng CY. Vitiligo associated with polycaprolactone-based collagen stimulator filler. JAAD Case Rep 2022; 24:35-37. [PMID: 35600572 PMCID: PMC9118516 DOI: 10.1016/j.jdcr.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Chun-Hsien Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Taipei, Linkou, Taiwan
| | - Chau Yee Ng
- Department of Dermatology, Chang Gung Memorial Hospital, Taipei, Linkou, Taiwan
- The School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan City, Taiwan
- Vitiligo Clinic and Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Correspondence to: Chau Yee Ng, MD, PhD, Department of Dermatology, Chang Gung Memorial Hospital, Linkou, 5, Fuxing St, Guishan Dist, Taoyuan 33305, Taiwan.
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37
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Witt J, Hooper D, Munavalli GG. Delayed inflammatory reaction to hyaluronic acid filler following Shingrix and Fluzone vaccines successfully treated with lisinopril. JAAD Case Rep 2022; 23:133-135. [PMID: 35495972 PMCID: PMC9052063 DOI: 10.1016/j.jdcr.2022.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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38
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Frequency of Complications of Aesthetic Facial Fillers in Brazil. Plast Reconstr Surg 2022; 149:599e-601e. [PMID: 35089271 DOI: 10.1097/prs.0000000000008839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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39
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Trévidic P, Kaufman-Janette J, Weinkle S, Wu R, Dhillon B, Antunes S, Macé E, Maffert P. Injection Guidelines for Treating Midface Volume Deficiency With Hyaluronic Acid Fillers: The ATP Approach (Anatomy, Techniques, Products). Aesthet Surg J 2022; 42:920-934. [PMID: 35039828 PMCID: PMC9373948 DOI: 10.1093/asj/sjac007] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Midface rejuvenation is among the most valuable indications of hyaluronic acid dermal fillers, because malar projection and full upper cheeks significantly contribute to a youthful appearance. Hyaluronic acid fillers have evolved over the past 2 decades to meet specific clinical needs such as strong projection capacity and adaptability to facial dynamism. As a result, they now represent the treatment of choice for midface rejuvenation throughout age ranges by offering the potential for noninvasive treatment, immediate results, and minimal downtime. Because the 5-layered structure of the midface plays a central role in the human face, injecting the midface area may also indirectly improve other aesthetic concerns such as infraorbital hollowing and nasolabial folds. Nonetheless, midface rejuvenation requires a tailored treatment approach and a thorough knowledge of anatomy to minimize procedural risks and achieve natural-looking results. This article provides an extensive anatomical description of the midface and of the usual course and depth of vascular structures circulating nearby to delineate a treatment area and minimize procedural risks. Furthermore, considering the differential mobility and mechanical constraints of each layer of the midface, a multilayer treatment algorithm is proposed for adapting the treatment strategy to patient specificities (including age, gender, skin type, and morphology). Emphasis is also placed on desirable filler properties to create deep structural support on the one hand and accompany facial movement on the other hand.
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Affiliation(s)
| | | | | | | | | | - Stéphanie Antunes
- Clinical and Medical Affairs Department, Teoxane SA, Geneva, Switzerland
| | - Emilie Macé
- Clinical and Medical Affairs Department, Teoxane SA, Geneva, Switzerland
| | - Pauline Maffert
- Clinical and Medical Affairs Department, Teoxane SA, Geneva, Switzerland
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Van Wicklin SA. Recommendations for Treatment of Soft-Tissue Filler Complications. PLASTIC AND AESTHETIC NURSING 2022; 42:7-12. [PMID: 36450065 DOI: 10.1097/psn.0000000000000424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- Sharon Ann Van Wicklin
- Sharon Ann Van Wicklin, PhD, RN, CNOR, CRNFA(E), CPSN-R, PLNC, FAAN, ISPAN-F, is Editor-in-Chief, Plastic and Aesthetic Nursing, and is a Perioperative and Legal Nurse Consultant, Aurora, CO
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Koren A, Sarbagil-Maman H, Litinsky I, Furer V, Artzi O. Dermal Filler Injections in Patients With Autoimmune and Inflammatory Rheumatic Diseases-The Patients' Perspective. Dermatol Surg 2022; 48:82-86. [PMID: 33337734 DOI: 10.1097/dss.0000000000002888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Injecting dermal fillers in patients with autoimmune inflammatory rheumatic diseases (AIIRDs) is controversial. OBJECTIVE To evaluate the attitudes of patients with AIIRDs regarding the use of dermal fillers and the side effects of those who underwent them. METHODS Patients with AIIRDs who attended a rheumatology outpatient clinic between 2016 and 2018 filled in a questionnaire about their attitudes toward dermal filler injections. The questionnaire evaluated information received from professionals and the factors that influenced their decision of whether or not to undergo the procedures. RESULTS Overall, 194 patients with AIIRDs (mean age 56.5 ± 14.0, 99% women) responded. Forty-two of them had previously undergone the injections and intended to repeat them (Group A), 37 had not received filler injections but intended to do so (Group B), and 114 who had never undergone them did not intend to undergo them. The major motivation for undergoing filler injections was social. Patients treated with dermal fillers refrained from informing their rheumatologist about their injections. They were, however, highly satisfied with the procedure and reported negligible side effects. CONCLUSION The use of dermal fillers was apparently safe and well received by patients with AIIRDs. Physicians' recommendations to refrain from injecting them with dermal fillers should be reconsidered and evaluated in clinical studies.
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Affiliation(s)
- Amir Koren
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hagit Sarbagil-Maman
- Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Irina Litinsky
- Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Victoria Furer
- Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ofir Artzi
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Lip Reshaping with LOVE Approach: A Prospective Analysis Based on Two Hyaluronic Acid Fillers. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3957. [PMID: 34849320 PMCID: PMC8613371 DOI: 10.1097/gox.0000000000003957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/05/2021] [Indexed: 11/26/2022]
Abstract
Aesthetic improvement of the lips with hyaluronic acid fillers is a popular procedure. A comprehensive, modular, and highly individualizable method has been developed: the Lip Omnicomprehensive Volume Enhancement (LOVE) approach. The present study assessed the safety and effectiveness of LOVE across different patient age groups.
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Complications of Nonpermanent Facial Fillers: A Systematic Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3851. [PMID: 34703713 PMCID: PMC8542164 DOI: 10.1097/gox.0000000000003851] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/13/2021] [Indexed: 01/03/2023]
Abstract
Background: A variety of complications after injection of nonpermanent fillers for facial rejuvenation have been reported so far. However, to date, the overall complication rate is still a matter of debate. The aim of this study was to perform a systematic review of literature to assess the type and severity of associated complications following injections in different anatomical regions of the face. Methods: The entire PubMed/Medline database was screened to identify case reports and clinical studies describing complications that have occurred after injection of nonpermanent fillers in the face. These complications have been reviewed and analyzed according to their occurrence in different anatomical regions of the face. Results: Forty-six articles including a total of 164 patients reported on a total of 436 complications during the time period between January 2003 and February 2020. The majority of the complications were reported after injections to the nose and the nasolabial fold (n = 230), the forehead and the eyebrows (n = 53), and the glabellar region (n = 36). Out of 436 complications, 163 have been classified as severe or permanent including skin necrosis (n = 46), loss of vision (n = 35), or encephalitis (n = 1), whereas 273 complications were classified as mild or transient, such as local edema (n = 74), skin erythema (n = 69), and filler migration (n = 2). The most severe complications were observed in treatments of nose, glabella, and forehead. Conclusions: Nonpermanent facial fillers are associated with rare but potentially severe complications. Severity and impact of complications depend on the anatomical region of the face and eventually require profound knowledge of facial anatomy.
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Lee AL, Chen YF, Yao WT, Liu YC, Yu CM, Yu CM, Tu CP, Huang WC, Tung KY, Tsai MF. Laser Doppler Imaging for Treating Vascular Complications from Procedures Involving Dermal Fillers: Case Series and Literature Review. Diagnostics (Basel) 2021; 11:diagnostics11091640. [PMID: 34573980 PMCID: PMC8468831 DOI: 10.3390/diagnostics11091640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/20/2021] [Accepted: 09/03/2021] [Indexed: 11/28/2022] Open
Abstract
Vascular occlusion is a rare but severe complication of dermal filler injections. Early treatment of this complication produces better outcomes. Current diagnostic methods for vascular occlusion in the skin are subjective and imprecise; these include capillary refill time, skin color, and reports of pain. This study aimed to assess the use of laser Doppler imaging (LDI) in the evaluation and treatment of vascular complications caused by dermal filler injections. This retrospective study used laser Doppler imaging (LDI) in 13 patients who developed vascular occlusion after facial dermal filler injections, with subsequent follow-up. The precise areas of perfusion observed on LDI were compared with the findings of clinical and photographic evaluation. The results showed that LDI accurately identified areas of vascular occlusion and improved treatment precision among these thirteen patients. The procedure was more precise than visual inspection or photographic evidence. Satisfactory outcomes were achieved for all patients, and no procedure-related complications were reported. Collectively, LDI provides fast, noninvasive, and accurate delineation of areas of vascular occlusion caused by complications of dermal filler injections and avoids several subjective shortcomings of visual and photographic evaluations. Thus, LDI effectively tracks treatment outcomes. However, large-scale studies are required to confirm the present findings.
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Affiliation(s)
- An-Li Lee
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei 10449, Taiwan; (A.-L.L.); (Y.-F.C.); (W.-T.Y.); (Y.-C.L.); (C.-M.Y.); (C.-M.Y.); (C.-P.T.); (W.-C.H.); (K.-Y.T.)
- Medical Cosmetic Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
- Burn Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
| | - Yu-Fan Chen
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei 10449, Taiwan; (A.-L.L.); (Y.-F.C.); (W.-T.Y.); (Y.-C.L.); (C.-M.Y.); (C.-M.Y.); (C.-P.T.); (W.-C.H.); (K.-Y.T.)
- Medical Cosmetic Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
| | - Wen-Teng Yao
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei 10449, Taiwan; (A.-L.L.); (Y.-F.C.); (W.-T.Y.); (Y.-C.L.); (C.-M.Y.); (C.-M.Y.); (C.-P.T.); (W.-C.H.); (K.-Y.T.)
- Medical Cosmetic Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
- Burn Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
| | - Ying-Chun Liu
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei 10449, Taiwan; (A.-L.L.); (Y.-F.C.); (W.-T.Y.); (Y.-C.L.); (C.-M.Y.); (C.-M.Y.); (C.-P.T.); (W.-C.H.); (K.-Y.T.)
- Burn Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
- Department of Surgery, Mackay Memorial Hospital, Taipei 10449, Taiwan
| | - Chia-Meng Yu
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei 10449, Taiwan; (A.-L.L.); (Y.-F.C.); (W.-T.Y.); (Y.-C.L.); (C.-M.Y.); (C.-M.Y.); (C.-P.T.); (W.-C.H.); (K.-Y.T.)
- Medical Cosmetic Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
- Burn Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
| | - Chieh-Ming Yu
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei 10449, Taiwan; (A.-L.L.); (Y.-F.C.); (W.-T.Y.); (Y.-C.L.); (C.-M.Y.); (C.-M.Y.); (C.-P.T.); (W.-C.H.); (K.-Y.T.)
- Medical Cosmetic Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
| | - Chih-Peng Tu
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei 10449, Taiwan; (A.-L.L.); (Y.-F.C.); (W.-T.Y.); (Y.-C.L.); (C.-M.Y.); (C.-M.Y.); (C.-P.T.); (W.-C.H.); (K.-Y.T.)
- Medical Cosmetic Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
| | - Wen-Chen Huang
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei 10449, Taiwan; (A.-L.L.); (Y.-F.C.); (W.-T.Y.); (Y.-C.L.); (C.-M.Y.); (C.-M.Y.); (C.-P.T.); (W.-C.H.); (K.-Y.T.)
- Medical Cosmetic Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
| | - Kwang-Yi Tung
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei 10449, Taiwan; (A.-L.L.); (Y.-F.C.); (W.-T.Y.); (Y.-C.L.); (C.-M.Y.); (C.-M.Y.); (C.-P.T.); (W.-C.H.); (K.-Y.T.)
- Medical Cosmetic Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
- Department of Surgery, Mackay Memorial Hospital, Taipei 10449, Taiwan
| | - Ming-Feng Tsai
- Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei 10449, Taiwan; (A.-L.L.); (Y.-F.C.); (W.-T.Y.); (Y.-C.L.); (C.-M.Y.); (C.-M.Y.); (C.-P.T.); (W.-C.H.); (K.-Y.T.)
- Department of Surgery, Mackay Memorial Hospital, Taipei 10449, Taiwan
- Correspondence: ; Tel.: +886-2-2543-3535; Fax: +886-2-2543-3642
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Langsdon PR, Schroeder RJ. Recognizing, Managing, and Guiding the Patient Through Complications in Facial Plastic Surgery. Facial Plast Surg Clin North Am 2021; 28:483-491. [PMID: 33010867 DOI: 10.1016/j.fsc.2020.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Complications in facial plastic surgery can occur in both surgical and nonsurgical procedures. Many complications can be prevented through thorough preprocedural evaluation, patient counseling, and close postoperative monitoring. Despite the best efforts complications will happen and identifying them early is critical to prevent long-term sequelae. It is important to know how to both manage the complication and guide the patient through the recovery process.
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Affiliation(s)
- Phillip R Langsdon
- The Langsdon Clinic, 7499 Poplar Pike, Germantown, TN, USA; Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.
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Michon A. Hyaluronic acid soft tissue filler delayed inflammatory reaction following COVID-19 vaccination - A case report. J Cosmet Dermatol 2021; 20:2684-2690. [PMID: 34174156 PMCID: PMC8447415 DOI: 10.1111/jocd.14312] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/02/2021] [Accepted: 06/16/2021] [Indexed: 12/02/2022]
Abstract
Background The use of hyaluronic acid soft tissue fillers in aesthetic medicine exploded in recent years for many reasons, including being relatively safe. Incidence of delayed inflammatory reactions (DIRs) to hyaluronic acid soft tissue fillers range between 0.3% and 4.25%. These reactions are mediated by T‐lymphocytes and can be triggered by flu‐like illnesses, including SARS‐CoV‐2 infection. Vaccination may also induce hypersensitivity. Aim In this case report, we present two cases of delayed reaction after hyaluronic acid soft tissue filler treatment of the tear trough area and following mRNA vaccination against SARS‐Cov‐2, also known as COVID‐19, months later. Patients A 39‐year old female who previously had her tear trough area treated with hyaluronic acid soft tissue filler developed swelling days after getting the mRNA Pfizer‐BioNTech COVID‐19 vaccine. Another patient, a 61‐year‐olf female, developed intermittent facial swelling in areas previously treated with hyaluronic acid soft tissue fillers days after receiving her first dose of the mRNA Pfizer‐BioNTech COVID‐19 vaccine. Results As demonstrated in our case report, vaccination against COVID‐19 may induce DIRs in patients who previously had hyaluronic soft tissue fillers. Conclusion Delayed inflammatory reactions to hyaluronic acid soft tissue fillers are uncommon and usually self‐limited, with frequent spontaneous resolution. However, considering the ongoing pandemic and the worldwide demand for vaccines against COVID‐19, the aesthetic providers should be conscious of the risks posed by the interaction of such vaccines in patients who previously had or seeking hyaluronic acid soft tissue filler injections.
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Affiliation(s)
- Alain Michon
- The Ottawa Skin Clinic, Ottawa, ON, Canada.,Institut du Savoir Montfort, Montfort Hospital, Ottawa, ON, Canada.,Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
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47
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Convery C, Davies E, Murray G, Walker L. Delayed-onset Nodules (DONs) and Considering their Treatment following use of Hyaluronic Acid (HA) Fillers. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2021; 14:E59-E67. [PMID: 34840652 PMCID: PMC8570356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Delayed-onset nodules (DONs) represent a poorly understood and generally neglected group of complications. It is not a diagnosis. The underlying pathologies and their incidences are largely unknown due to the lack of specificity in clinical signs and the challenges in accessing diagnostic tests, cost implications, or reluctance from patients to undergo them. A lack of presumptive clinical diagnosis, coupled with management ranging from "scatter-gun" polypharmacy to clinical inertia, is believed to result in chronicity and increased morbidity. This paper provides guidance on the identification and understanding of the underlying pathologies and encourages the increased utilization of a medical model of care. The more routine adoption of histopathology, inflammatory markers, and ultrasound will permit a more targeted management and a greater understanding of the incidences and evolution of the pathologies.
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Affiliation(s)
- Cormac Convery
- Dr. Convery is with The Ever Clinic Glasgow in Glasgow, Scotland
- Ms. Davies is the Clinical Director of Save Face UK
- Ms. Murray is with the Clinical Academic Kings College London in London, England
- Dr. Walker is with B City Clinic in Liverpool, England
- All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC)
| | - Emma Davies
- Dr. Convery is with The Ever Clinic Glasgow in Glasgow, Scotland
- Ms. Davies is the Clinical Director of Save Face UK
- Ms. Murray is with the Clinical Academic Kings College London in London, England
- Dr. Walker is with B City Clinic in Liverpool, England
- All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC)
| | - Gillian Murray
- Dr. Convery is with The Ever Clinic Glasgow in Glasgow, Scotland
- Ms. Davies is the Clinical Director of Save Face UK
- Ms. Murray is with the Clinical Academic Kings College London in London, England
- Dr. Walker is with B City Clinic in Liverpool, England
- All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC)
| | - Lee Walker
- Dr. Convery is with The Ever Clinic Glasgow in Glasgow, Scotland
- Ms. Davies is the Clinical Director of Save Face UK
- Ms. Murray is with the Clinical Academic Kings College London in London, England
- Dr. Walker is with B City Clinic in Liverpool, England
- All authors are founding board members of the Complications in Medical Aesthetics Collaborative (CMAC)
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Araviiskaia E, Le Pillouer Prost A, Kosmadaki M, Kerob D, Roo E. Recommendations for the use of corrective makeup after dermatological procedures. J Cosmet Dermatol 2021; 21:1554-1558. [PMID: 34021952 PMCID: PMC9291946 DOI: 10.1111/jocd.14248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 11/28/2022]
Abstract
Introduction The number of dermatological or cosmetic procedures carried out has continuously increased over the last decades. Almost all may cause transient local skin reactions such as erythema, blistering, crusts, scaling, hypo‐ or hyperpigmentation, or hemorrhagic lesions. One issue of dermatological procedures is the downtime, during which patients need to hide their skin, due to these local reactions. Aim To provide dermatologists with easy‐to‐follow recommendations for the right timing of use of corrective makeup for patients who have undergone or who plan to undergo dermatological procedures, according to the invasiveness of the dermatological procedure chosen. Methodology A group of experts in dermatological procedures met in 2019 and at the beginning of 2020 to discuss the different procedures, their local reactions and downtime, and the opportunities to use specific corrective makeup in order to hide these transient reactions. Results As a result of the discussions, the experts proposed a tabulated algorithm of use based on a classification of the different dermatological procedures according to their invasiveness and recommended timing of the first post‐procedure corrective makeup application. Conclusion Corrective makeup may be considered as a complement to certain dermatological procedures in order to minimize downtime. However, its use is conditioned by the correct understanding of skin barrier alteration and recovery time. The proposed algorithm of use of corrective makeup after procedures may help the practitioner to indicate his patient the right moment for applying corrective makeup in order to avoid local tolerance issues and post‐procedure complications.
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Affiliation(s)
- Elena Araviiskaia
- Department of Dermatology, First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | | | | | | | - Elia Roo
- Clínica Dermatologica Roo, Madrid, Spain
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Sarigul Guduk S. A case of delayed inflammatory filler reaction following vaccination with succesful response to colchicine. J COSMET LASER THER 2021; 23:52-54. [PMID: 34407723 DOI: 10.1080/14764172.2021.1967997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Delayed inflammatory reactions (DIRs) associated with hyaluronic acid injections are not rare and can be seen in up to 4.25% of patients. Although the exact mechanism is not clear, several triggering factors, including infections, trauma, and dental procedures, were reported in the literature. A 43-year-old female patient treated with HA fillers developed an inflammatory reaction following vaccination in all areas of injection, including temples, lips, and lower eyelids. Systemic steroid and ciprofloxacin were used as a first-line treatment without response. Colchicine 1 mg/day along with hyaluronidase in lower eyelids improved all lesions successfully.
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Affiliation(s)
- Sukran Sarigul Guduk
- Dermatologist, Dr. Sukran Sarigul Guduk Dermatology Clinic, Istanbul, Turkey.,Department of Dermatology, School of Medicine, Haliç University, Istanbul, Turkey
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50
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Nagendran ST, Ali MJ, Dogru M, Malhotra R. Complications and Adverse Effects of Periocular Aesthetic Treatments. Surv Ophthalmol 2021; 67:741-757. [PMID: 33933438 DOI: 10.1016/j.survophthal.2021.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
The popularity and variety of temporary and permanent periocular aesthetic treatments has increased over the past decade. Patients frequently present to eye clinics with ocular complications and side effects following these treatments, their severity ranging from ocular irritation from dry eyes to visual loss from vascular occlusion. A careful, thorough history is essential, as many patients may not associate aesthetic procedures with ocular complications, and some may be embarrassed to disclose this information. All ophthalmologists should understand the potential ocular sequelae of these treatments and be able to initiate treatment in sight-threatening cases. Wesummarises the current literature on ophthalmic complications of the most common periocular aesthetic treatments.
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Affiliation(s)
- Sonali T Nagendran
- Corneoplastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, United Kingdom
| | - Mohammad Javed Ali
- Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India
| | - Murat Dogru
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Raman Malhotra
- Corneoplastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, United Kingdom.
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