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Incidence of Adverse Events Due to Improper placement of Dermal fillers.

12th August 2019 | 1 comment

Dermal fillers have seen an increasing frequency of their use across the world (British College of Aesthetic Medicine (BCAM), 2019) with the American Society of Plastic Surgeons (2019) reporting a rise from 1.8 million procedures in 2010 to 2.7 million in 2017. Although the incidence of complications with dermal fillers such as hyaluronic acid (HA) and collagen is low, the high number of procedures leads to an increase in the number of complications (Chiang, Pierone and Al-Niaimi, 2016).

Immediate/early-onset complications

The most common and immediate complication of dermal fillers is bruising (Urdiales-Gálvez, Delgado, Figueiredo, Lajo-Ortiz, Marti, Moreno et al., 2018) Skype app. Transient swelling, oedema and erythema are also very common and can be seen as procedure-related expected side effects (Bhojani-Lynch, 2017).

A more severe reaction is angioedema, which is an immunoglobulin E (IgE)-mediated immune response or a hypersensitivity reaction to the injected dermal fillers (Van Dyke, Hays, Caglia and Caglia, 2010). However, delayed hypersensitivity reactions are mediated by T cells and not antibodies (Urdiales-Gálvez et al., 2018).

Acute infections can also occur and appear as inflammation and abscesses at the site of injection with an incidence of 0.04 to 0.2% (Ferneini, Beauvais and Aronin, 2017). Dermal filler injections can also reactivate the herpes virus causing a herpetic outbreak in patients with a history of severe cold sores (Urdiales-Gálvez et al., 2018) with an incidence of 1.45% for HA fillers (Gazzola, Pasini and Cavallini, 2017) peach body.

Nerve damage can also occur and is due to direct trauma, injection of filler into the nerve or tissue compression and this happens in 0.1 to 1% of cases (Urdiales-Gálvez et al., 2018). Effects can be transient or permanent with the most common sites being the infraorbital nerve (Fitzgerald, Bertucci, Sykes and Duplechain, 2016).

Vascular compromise is an immediate and severe complication arising due to the injection of filler into an artery or vein, causing embolism and impedance of blood flow (Urdiales-Gálvez et al., 2018). This major complication appears to have a high incidence with 62% of experienced injectors having experienced at least one such case (Goodman, Roberts and Callan, 2016) Unity 2019. One of the most severe examples includes occlusion of the central retinal artery (CRA) or one of its branches (Beleznay, Carruthers, Humphrey and Jones, 2015).

Late/delayed onset complications

Abscess formation a week up to years post-treatment is extremely rare, with 0.3% of treated patients affected (Conrad, Alipasha, Thiru, and Kandasamy, 2015). Additional complications from midfacial and periorbital infections are intracerebral infections, but this occurs in extremely rare cases (Funt and Pavicic, 2015) 영화 창궐 다운로드.

Inflammatory nodules are often also due to biofilm formation, but these can also be a delayed hypersensitivity reaction (Rzany and DeLorenzi, 2015). The occurrence of delayed-onset nodules due to hypersensitivity are thought to occur in 0.6 to 0.8% of the patient (King, Bassett, Davies and King, 2016).

Foreign body granulomas usually occur after months of obtaining the dermal filler. They are also very rare with an incidence of 0.01 to 1% (King et al., 2016) and this is caused by the body’s immune system responding to the foreign body which cannot be eliminated by the usual mechanisms 프레젠테이션 다운로드.

Tissue necrosis is associated with the injection of dermal fillers and is due to vessel occlusion. Necrosis occurs with types of fillers, and in the case of collagen, this occurs in 9 out of 100,000 cases and for all other fillers in 1 out of 100,000 cases (King, 2018).


Due to their efficacy and safety, dermal fillers have gained widespread use; however, when complications do occur, these can be very severe if managed inappropriately.

American Society of Plastic Surgeons (2019) New Statistics Reveal the Shape of Plastic Surgery linux jdk. Accessed 06/08/2019.

Beleznay K, Carruthers JD, Humphrey S, Jones D (2015) Avoiding and treating blindness from fillers: a review of the world literature. Dermatology Surgery 41(10), 1097–1117

Bhojani-Lynch T (2017) Late-onset inflammatory response to hyaluronic acid dermal fillers 지니 뮤직 pc 다운로드. Plastic and Reconstructive Surgery 5(12), 1532.

British College of Aesthetic Medicine (BCAM) (2019) Dermal Fillers. Accessed 06/08/2019.

Chiang YZ, Pierone G, Al-Niaimi F (2016) Dermal fillers: pathophysiology, prevention and treatment of complications. Journal of European Academy of Dermatology and Venereology 31(3), 405 – 413.

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Ferneini EM, Beauvais D, Aronin SI (2017) An Overview of Infections Associated With Soft Tissue Facial Fillers: Identification, Prevention, and Treatment. Journal of Maxillofacial Surgery 75(1), 160-166.

Fitzgerald R, Bertucci V, Sykes JM, Duplechain JK (2016) Adverse reactions to injectable fillersFacial Plastic Surgery 32(5), 532–555

Funt D, Pavicic T (2013) Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clinical Cosmetic Investigations in Dermatology 6, 295–316.

Funt D, Pavicic T (2015) Dermal fillers in aesthetics: an overview of adverse events and treatment approaches your iCloud photo library. Plastic Surgery Nursing 35,13–32

Gazzola R, Pasini L, Cavallini M (2017) Herpes Virus Outbreaks After Dermal Hyaluronic Acid Filler Injections. Aesthetic Surgery Journal 32(6), 770 – 772

Goodman GJ, Roberts S, Callan P (2016) Experience and management of intravascular injection with facial fillers: results of a multinational survey of experienced injectors. Aesthetic Plastic Surgery 40(4), 549–555

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Homsy A, Rüegg EM, Jandus P, Pittet-Cuénod B, Modarressi A (2017) Immunological reaction after facial hyaluronic acid injection. Case Reports in Plastic Surgery and Hand Surgery 4(1), 68–72.

King M (2018) This month’s guideline: Management of Necrosis. Journal of Clinical Aesthetics in Dermatology 11(7), E53–E57.

King M, Bassett S, Davies E, King S (2016) Management of Delayed Onset Nodules. Journal of Clinical Aesthetics in Dermatology 9(11), E1–E5.

Rzany B, DeLorenzi C (2015) Understanding, avoiding, and managing severe filler complications. Plastic Reconstruction Surgery 136(5 Suppl), 196S–203S

Urdiales-Gálvez F, Delgado NE, Figueiredo V, Lajo-Ortiz JV, Marti M, Moreno A, Ortiz-Marti F, Rio-Reyes Rosa, Romero-Alvarez N, Ruiz Del Cueto S, Segurado MA, Rabenaque CV (2018) Treatment of Soft Tissue Filler Complications: Expert Consensus Recommendations. Aesthetic Plastic Surgery 42(2), 498–510.

Van Dyke S, Hays GP, Caglia AE, Caglia M (2010) Severe acute local reactions to a hyaluronic acid-derived dermal filler. Journal of Clinical Aesthetics in Dermatology 3(5), 32–35

One Comment

  • Judith M. Gunter said:

    Useful information, thank you. For example, I always recommend dermal fillers from DkDerma to my clients. They have attractive prices and incredible quality, so I highly recommend them.

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