Hyaluronic Acid Injections as Nonsurgical Alternative in case of Delayed Diagnosis of Malar Arch Fracture: Case Report and Literature Review

Background. In this article, we describe a nonsurgical approach based on hyaluronic acid filler injection to restore the facial features of a delayed diagnosis of malar fracture. We analyze the differences between surgical and nonsurgical solution: in case of early detection, the surgical approach is the gold standard of treatment. However, in cases of delayed facial fracture diagnosis without functional impairment, nonsurgical procedures could be considered an alternative tool as we show in the present case report. Aims. The aim of this study is to underline the importance of a complete aesthetic restoration in patients treated for noncosmetic purposes. Patients/Methods. We present a case of a 26-year-old male patient with a delayed diagnosis of malar fracture without functional impairment that was treated with hyaluronic acid (HA) filler injections. Results. The patient was followed up for 1 year showing stable results for the first 8 months; at the 12-month follow-up, a touch-up was suggested due to partial resorption of the filler. Conclusion. This is the first case describing a facial fracture treated with HA injections for only recontouring purposes. We assess that nonsurgical cosmetic procedures could be considered a “new” tool in the process of facial rehabilitation but only when functional problems are not associated with facial trauma.

Download Full-text

Delayed skin necrosis following hyaluronic acid filler injection: A case report

Journal of Cosmetic Dermatology ◽

10.1111/jocd.13287 ◽

2020 ◽

Vol 19 (3) ◽

pp. 582-584

Author(s):

Daniel Cassiano ◽

Tatiana Miyuki Iida ◽

Ana Lúcia Recio ◽

Samira Yarak

Keyword(s):

Hyaluronic Acid ◽

Case Report ◽

Skin Necrosis ◽

Filler Injection

Download Full-text

A Safe Doppler Ultrasound–Guided Method for Nasolabial Fold Correction With Hyaluronic Acid Filler

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa153 ◽

2020 ◽

Cited By ~ 1

Author(s):

Won Lee ◽

Ji-Soo Kim ◽

Hyoung-Jin Moon ◽

Eun-Jung Yang

Keyword(s):

Hyaluronic Acid ◽

Doppler Ultrasound ◽

Rating Scale ◽

Vascular Complications ◽

Facial Artery ◽

Nasolabial Fold ◽

Filler Injection ◽

Ultrasound Evaluation ◽

Filler Injections ◽

Nasolabial Folds

Abstract Background Injection of hyaluronic acid filler, a common procedure for nasolabial fold correction, poses a risk of vascular compromise, which can result in skin necrosis and blindness. Objectives The aim of this study was to examine the facial arterial pathway in real time by Doppler ultrasound to avoid arterial complications during filler injections. Methods The facial artery pathway of 40 patients (80 nasolabial folds; 2 men and 38 women; mean age, 46.5 years; range, 28-72 years) was examined by Doppler ultrasound before hyaluronic acid filler injection. On the basis of this ultrasound evaluation, the filler injection targeted the subdermal, subcutaneous, and deep to submuscular layers by bypassing the facial artery. The efficacy of the filler injection was evaluated for each patient. Results The facial artery was detected lateral to the nasolabial fold in 31% of patients; it was detected beneath the nasolabial fold in the other patients as follows: subdermal layer, 13%; subcutaneous layer, 29%; muscular layer, 24%; and submuscular layer, 4%. The mean [standard deviation] Wrinkle Severity Rating Scale score was 3.68 [0.76] before injection and 2.28 [0.78] at 3 months after injection. Two patients experienced unilateral bruising of the nasolabial fold, which resolved after 2 weeks without treatment. Conclusions Doppler ultrasound can be considered as pretreatment tool for the prevention of vascular complications during filler injections to correct nasolabial folds. Level of Evidence: 4

Download Full-text

Limb threatening thigh hematoma diagnosis accelerated by emergency physician bedside ultrasound

SAGE Open Medical Case Reports ◽

10.1177/2050313x19848589 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1984858

Author(s):

John J Eicken ◽

Dustin Morrow

Keyword(s):

Case Report ◽

Compartment Syndrome ◽

Delayed Diagnosis ◽

Signs And Symptoms ◽

Physical Exam ◽

Bedside Ultrasound ◽

First Case ◽

Pathologic Processes ◽

Definitive Management ◽

Guide Care

Introduction: Compartment syndrome is a serious condition that requires prompt diagnosis, specialty consultation, and definitive management to prevent significant morbidity. Traditionally, compartment syndrome is identified by physical exam findings including the presence of pain, pallor, paresthesia, pulselessness, and paralysis involving the affected limb. Identifying the presence of compartment syndrome prior to the onset of signs that portend a poor outcome (i.e. pallor, pulselessness, and paralysis) can be challenging since many other less serious traumatic conditions can lead to paresthesia and pain in a limb. Bedside ultrasound is increasingly being utilized by emergency providers to expedite identification of various emergent diagnoses and guide care for patients who present to emergency departments. Bedside ultrasound allows emergency providers to visualize pathologic processes occurring that may be difficult to identify through traditional physical exam findings. This case report highlights the use of bedside ultrasound to promptly identify the presence of a traumatic thigh hematoma, which led to expedited advanced imaging and specialty consultation for compartment syndrome prior to the onset of physical exam findings consistent with compartment syndrome. Conclusion: The identification of compartment syndrome in the early stages is challenging given the overlap of signs and symptoms with other less emergent conditions. Early diagnosis of compartment syndrome is important to decrease morbidity, which can result from a delayed diagnosis of compartment syndrome. To our knowledge, this is the first case report to describe the use of bedside ultrasound to aid in the diagnosis of compartment syndrome and accelerate the care for a patient who presented with a traumatic thigh hematoma, which rapidly progressed to compartment syndrome and required emergent operative intervention.

Download Full-text

A Case Report of Capsular Contracture Immediately Following Covid-19 Vaccination

Aesthetic Surgery Journal Open Forum ◽

10.1093/asjof/ojab021 ◽

2021 ◽

Author(s):

Richard J Restifo

Keyword(s):

Hyaluronic Acid ◽

Case Report ◽

Immune System ◽

Foreign Body ◽

Immune Cells ◽

Rapid Development ◽

Capsular Contracture ◽

Inflammatory Reactions ◽

Rich Variety ◽

First Case

Abstract Capsular contracture is fundamentally an immunological/inflammatory response to the implant, treating it as a foreign body in need of exclusion from the immune system. The capsule surrounding the implant is populated by a rich variety of immunologically active cells such as macrophages, T lymphocytes, and myofibroblasts. Vaccination in general and the Covid-19 vaccine in particular result in specific and nonspecific activation of the immune system, including those immune cells in proximity to the implant. This phenomenon has been previously demonstrated in delayed inflammatory reactions to previously implanted hyaluronic acid fillers following Covid 19 vaccination. This report is what is believed to be the first case of the rapid development of severe ipsilateral capsular contracture in the immediate aftermath of the second dose of the BNT162b2(Pfizer) vaccine.

Download Full-text

A Consensus on Minimizing the Risk of Hyaluronic Acid Embolic Visual Loss and Suggestions for Immediate Bedside Management

Aesthetic Surgery Journal ◽

10.1093/asj/sjz312 ◽

2019 ◽

Vol 40 (9) ◽

pp. 1009-1021 ◽

Cited By ~ 5

Author(s):

Greg J Goodman ◽

Mark R Magnusson ◽

Peter Callan ◽

Stefania Roberts ◽

Sarah Hart ◽

...

Keyword(s):

Hyaluronic Acid ◽

Best Practice ◽

Visual Loss ◽

Adverse Reactions ◽

Level Of Evidence ◽

Early Management ◽

Initial Management ◽

Filler Injection ◽

Filler Injections ◽

Review Current

Abstract Background Hyaluronic acid fillers have a satisfactory safety profile. However, adverse reactions do occur, and rarely intravascular injection may lead to blindness. Currently there is no internationally recognized consensus on the prevention or management of blindness from hyaluronic acid filler. Objectives The authors sought to give guidance on how to minimize the risk and optimize the management of this rare but catastrophic adverse reaction. Methods A multinational group of experts in cosmetic injectables from multiple disciplines convened to review current best practice and develop updated consensus recommendations for prevention and bedside intervention if visual loss occurs after cosmetic injection of hyaluronic acid filler. Results The consensus group provided specific recommendations focusing on the consenting process, prevention, and early management of visual impairment related to intravascular hyaluronic acid filler injection. Conclusions Although visual loss due to filler injections is rare, it is important that both patient and physician be aware of this risk. In this paper the authors describe methods and techniques available to reduce the risk and also document suggested initial management should a clinician find themselves in this situation. Level of Evidence: 5

Download Full-text

An unusual and delayed complication of hyaluronic acid filler injection: a case report

Case Reports in Plastic Surgery and Hand Surgery ◽

10.1080/23320885.2020.1769481 ◽

2020 ◽

Vol 7 (1) ◽

pp. 68-72

Author(s):

Narges Horriat ◽

Tina R. Woods ◽

Abelardo Medina

Keyword(s):

Hyaluronic Acid ◽

Case Report ◽

Filler Injection ◽

Delayed Complication

Download Full-text

Hyaluronic Acid Filler Injection as an Alternative to Surgery for the Correction of Canine Entropion

Pakistan Veterinary Journal ◽

10.29261/pakvetj/2021.001 ◽

2021 ◽

Vol 41 (01) ◽

pp. 173-175

Author(s):

Ha-Eun Lee

Keyword(s):

Hyaluronic Acid ◽

Old English ◽

Clinical Signs ◽

Intact Female ◽

Filler Injection ◽

Associated Symptoms ◽

Filler Injections ◽

English Bulldog

A 3-year-old intact female Old English Bulldog and 5-month-old spayed female Chow Chow were diagnosed with entropion. Instead of surgery, hyaluronic acid (HA) filler injections were performed to correct the entropion and relieve the associated symptoms. We used the layered feathering technique, which was effective for the administration of the HA into the tissues for the correction of canine entropion. The eyelid positions were maintained for 6-8 months after the procedures. These cases demonstrate that HA filler injections relieve clinical signs quickly and effectively, though temporarily, in patients with entropion

Download Full-text

Asymptomatic Stroke After Hyaluronic Acid Filler Injection: Case Report and Literature Review

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa381 ◽

2020 ◽

Author(s):

Ryan M Moore ◽

Melissa A Mueller ◽

Allison C Hu ◽

Gregory R D Evans

Keyword(s):

Hyaluronic Acid ◽

Vision Loss ◽

Facial Soft Tissue ◽

Tissue Ischemia ◽

Filler Injection ◽

Intraarterial Injection ◽

Facial Filler ◽

Vascular Compromise ◽

Filler Injections ◽

Soft Tissue Filler

Abstract Vascular compromise and blindness are reported but rare complications of facial soft tissue filler injections. Stroke is an even rarer complication resulting from intraarterial injection of fillers. We present a case of a patient suffering all three complications following hyaluronic acid filler injection: forehead skin vascular compromise, unilateral blindness, and ipsilateral subclinical strokes. Were it not for a stroke workup protocol, the incidental strokes may have otherwise gone undetected, suggesting the incidence of stroke from intraarterial injection may be higher than reported. Further, we review the literature and recommendations for prevention and management of threatened tissue ischemia and vision loss from facial filler injection.

Download Full-text