scholarly journals HYALURONIC ACID FILLER INJECTION FOR COSMETIC PURPOSE: SKIN NECROSIS COMPLICATION AND TREATMENT - CASES REPORTS

2021 ◽  
Vol 506 (1-2) ◽  
Author(s):  
Vu Ngoc Lam ◽  
Nguyen Quang Duc ◽  
Le Diep Linh ◽  
Le Thi Thu Hai
Keyword(s):  
Wound Healing ◽  
Hyaluronic Acid ◽  
Skin Necrosis ◽  
Early Recognition ◽  
Complete Healing ◽  
Soft Tissue Augmentation ◽  
Filler Materials ◽  
Dermal Fillers ◽  
Filler Injection ◽  
Specific Protocol

Background: Hyaluronic acid (HA) fillers for aesthetic are generally considered safe and the use of dermal fillers for soft tissue augmentation has become a very popular technique in aesthetic practices. Dermal fillers temporarily remove the appearance of rhytids and reduce the depth of skin folds. This is one of the most effective method for facial improvement used in Viet Nam nowadays.  However, complications such as skin necrosis, blind... may happen and hence any filler injection practitioner need to be aware of such side effects, contraindications and precaution to be adopted while using fillers. Even with the most experienced of injectors, adverse effects can and do occur ranging from mild bruising to severe injection necrosis. Aims: HA filler injectors should be able to prevent and treat the severe complication of skin necrosis and detect impending necrosis after injection of a augmentation filler. Materials and Methods: Cases report of 3 patients who were HA filler injection for nose augmentation and had suffered from skin necrosis. These patients were followed for 3-6 months from time of injection of hyaluronic acid filler to complete healing of wound. Results: Complete wound healing were achieved with early recognition and institution of treatment, surgical procedures applied in some severe cases. The functional of the noses are remained but  most of the patients have bad scar on the nose. Discussion: We review cases report of injection necrosis and methods used to prevent and treat this complication. Conclusion: Early recognition of vascular necrosis with specific protocol for treatment after injection necrosis with hyaluronic acid fillers improves the outcome of wound healing.

scholarly journals Fillers and Vessels: The Story of Arterial Obstruction after Cosmetic Treatment

2021 ◽  
Vol 6 (2) ◽  
pp. 1-4
Author(s):  
Velthuis PJ
Keyword(s):  
Hyaluronic Acid ◽  
Skin Necrosis ◽  
Ultrasound Guidance ◽  
Arterial Occlusion ◽  
Calcium Hydroxyapatite ◽  
Duplex Sonography ◽  
Low Grade ◽  
Filler Injection ◽  
Retinal Artery ◽  
Cosmetic Medicine

Most popular fillers in cosmetic medicine are hyaluronic acid based. These comprise over 90% of the market and come with the advantage to be soluble in case of complications. Other fillers are contained in the group of bio-stimulatory fillers. They exert a secondary volumizing effect by provoking a low-grade inflammatory response that produces extra collagen. Examples are calcium-hydroxyapatite and L-poly-lactid acid. Finally autologous fat is being used as a filling substance (lipofilling). The gravest complications with fillers are intravascular injections. In particular when injected in arteries fillers can block blood flow and lead to skin necrosis or vison loss in case the material occludes the Central Retinal Artery (CRAO). Two opposing theories about the nature of arterial occlusion exist. One based on Ian Taylor idea of choke anastomoses assume vasoconstriction induced by the filler, both of the primary offended artery and its anastomosing vasosomes. In this case resolving the hyaluronic acid filler with the enzyme hyaluronidase at the primary occluding location would suffice. This is done under ultrasound guidance. The other theory assumes displacement of parts of the filler to end arterioles. Then, the whole affected area has to be flooded with large dosages of hyaluronidase. Obstructions with fillers based on other materials cannot be resolved. It seems logical to prevent intra-arterial filler injection by duplex sonography detection of the course of arteries prior to injection. Ultrasound has additional advantages for cosmetic doctors such as recognizing remains of previously injected filler. It also can give feedback on a physician’s ability to inject filler in the correct subdermal location.

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

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

scholarly journals In VitroEvaluation of the Biological Availability of Hyaluronic Acid Polyethylene Glycols-Cross-Linked Hydrogels to Bovine Testes Hyaluronidase

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
N. Zerbinati ◽  
R. Mocchi ◽  
H. Galadari ◽  
C. Maccario ◽  
M. Maggi ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Plastic Surgery ◽  
Standard Technique ◽  
Soft Tissue Augmentation ◽  
Colorimetric Determination ◽  
Dermal Fillers ◽  
Tyndall Effect ◽  
The Difference ◽  
American Society

During last years, hyaluronic acid- (HA-) based dermal fillers have grown rapidly and continuously, as reported by the American Society of Aesthetic Plastic Surgery (ASAPS). In fact, HA fillers are considered the gold standard technique for soft tissue augmentation, deep skin hydration, and facial recontouring, playing a key role as an alternative to plastic surgery. HA fillers are less invasive, more biocompatible, and safer and with a more natural and immediate result if compared to plastic surgery. Hence, the safety of HA-based dermal fillers plays a crucial role, mostly in terms of biocompatibility and adjustability in case of unpleasant results and side effects such as, tyndall effect, edema, or granulomas. Hyaluronidase is a naturally occurring enzyme, present in the human body, and can degrade HA fillers avoiding more severe complications. In this article, we analyzed the bioavailability of hyaluronidase degradation of five fillers of Neauvia® hydrogels line (MatexLab SA, Lugano, CH), composed of pure hyaluronic acid and based on PEGDE cross-linking (polyethylene glycol) technology that guarantees a higher biocompatibility and an optimal biointegration and rheological characteristics. The performedin vitrotesting is based on the colorimetric determination of the N-acetyl-D-glucosamine (NAG) present in solution after incubation with hyaluronidase, determined at different time points in order to assess the kinetic of each product degradation (1h, 3h, 6h, 24h, 48h, 72h, 120h, and 168h). The aim of this study was to assess,in vitro,how the difference in HA content and PEGDE concentration of the analyzed fillers can influence the product biocompatibility, intended as product enzymatic clearance and duration in time. The results demonstrated that the method was reproducible and easy to perform and that all the analyzed fillers are naturally immediately available for hyaluronidase-mediated degradation.

scholarly journals Hyaluronic Acid Fillers: Where We Have Been and Where We Are Going

2021 ◽  
Author(s):  
Alexander Daoud ◽  
Robert Weiss
Keyword(s):  
Hyaluronic Acid ◽  
Soft Tissue ◽  
The United States ◽  
Soft Tissue Augmentation ◽  
Invasive Treatment ◽  
Filler Injection ◽  
Tissue Augmentation ◽  
History Of ◽  
Vital Component ◽  
Favorable Safety

Since the approval of the United States’ first hyaluronic acid (HA) filler in December 2003, HA fillers have become mainstays of soft tissue augmentation due to their favorable safety profile and minimally invasive treatment nature. The past two decades have not only brought an expansion in the popularity of HA fillers, but also in the number of available HA filler products and indications for cosmetic enhancement. Accordingly, HA filler injection has become one of the most commonly performed cosmetic procedures worldwide. The progression of HA filler products is a study in both biomedical engineering advancements, as well as evolving concepts of beauty and cosmesis. In this chapter, we review the history of these products, including their composition and indications for use. We then explore the prospect of HA fillers for the future of esthetic medicine, as they remain a vital component of nonsurgical soft tissue augmentation.

Ischemic Oculomotor Nerve Palsy and Skin Necrosis Caused by Vascular Embolization After Hyaluronic Acid Filler Injection

2013 ◽  
Vol 71 (4) ◽  
pp. 333-334 ◽  
Author(s):  
Seung Gee Kwon ◽  
Jong Won Hong ◽  
Tai Suk Roh ◽  
Young Seok Kim ◽  
Dong Kyun Rah ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Skin Necrosis ◽  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Filler Injection

scholarly journals Early hyaluronidase use in preventing skin necrosis after treatment with dermal fillers: Report of two cases

F1000Research ◽  
2019 ◽  
Vol 7 ◽  
pp. 1388
Author(s):  
Francesco Ciancio ◽  
Maria Stella Tarico ◽  
Giuseppe Giudice ◽  
Rosario Emanuele Perrotta
Keyword(s):  
Nitric Oxide ◽  
Hyaluronic Acid ◽  
Skin Necrosis ◽  
Dermal Filler ◽  
Oral Antibiotic ◽  
Safe Procedure ◽  
Dermal Fillers ◽  
Permanent Damage ◽  
Systemic Corticosteroids ◽  
The Face

Injection of dermal fillers, like hyaluronic acid (HA), is a safe procedure, with few and transient side effects such as erythema, bruising and swelling etc. The aim of this report is to provide our protocol for the early treatment of necrotic complications after facial treatment with dermal fillers. We present two cases of skin suffering of the face after dermal infiltration of HA, treated successfully with our early protocol. Our protocol includes the early infiltration of hyaluronidase in the treated areas. We start with infiltration of hyaluronidase distributed over the area to be treated through micro-injections with dosage 40 IU per cm2. Our protocol includes the use of systemic corticosteroids for 4 days, anti-aggregation therapy, oral antibiotic, topical cream with nitric oxide and compresses with gauze and warm water. In the skin complications after dermal filler treatment, marked pain and characteristic reticulated erythema in the skin distribution of the affected vessels is often developed. Due to the implementation of our protocol in these patients, we managed to avoid an irreversible necrotic complication of the face in both cases. In this report, our protocol was compared with results published in the literature and allowed us to avoid complications such as skin necrosis with permanent damage.

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