Journal of Dermatologic Surgery and Oncology 2013-10-01

Delayed-onset complications of facial soft tissue augmentation with permanent fillers in 85 patients.

Jonathan A Kadouch, Daniel J Kadouch, Shai Fortuin, Leo van Rozelaar, Refaat B Karim, Rick Hoekzema

Index: Dermatol. Surg. 39(10) , 1474-85, (2013)

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Abstract

To evaluate factors influencing the onset and type of adverse events in patients injected with permanent fillers in the face and to propose a therapeutic strategy for these complications.A prospectively attained series of 85 patients with delayed-onset complications after facial injection with permanent fillers underwent clinical follow-up and treatment of the complications.Lag times until onset and type of delayed-onset complication varied according to filler material. In 28% (n = 24) of the cases, patients reported the onset of complications after dental procedures, additional injections with fillers, or other invasive treatments in the facial area. Forty-eight (57%) patients required invasive treatment. Abscess formation was significantly more frequent in patients with human immunodeficiency virus infection and facial lipoatrophy (p = .001).The intrinsic characteristics of the injected filler and the immune status of the patient play important roles in the diversity of time of onset and type of delayed-onset adverse events observed. It seems that invasive facial or oral procedures in the vicinity of filler depots can provoke such complications. We propose a strategy for treating these complications and advise great caution when using permanent filling agents.© 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.