Infected Facial Tissue Fillers Caused by Dental Infection

Injectable dermal fillers are widely used for facial rejuvenation; they help reshape the facial contours by treating volume loss due to aging changes. Facial fillers may become infected following a dental infection. In this report, we present a case of a 44-year-old female patient who presented with a swelling in her upper right buccal region following dental treatment of her second maxillary right premolar. After a thorough history, clinical, and radiological examinations, the diagnosis of infected dermal filler was made. The lesion was treated by association of two antibiotics (ciprofloxacin IM and clindamycin tablets 300 mg), and a complete healing was observed two months after the end of the dental treatments.

Dermal fillers and biofilms: implications for aesthetic clinicians

Biofilms have been linked to dermal filler complications. Gillian Murray and Dr Cormac Convery explain their role and what clinicians can do to identify biofilm, as well as how to manage and treat them

Comparative Physicochemical Analysis among 1,4-Butanediol Diglycidyl Ether Cross-Linked Hyaluronic Acid Dermal Fillers

(1) Background: Injectable hyaluronic acid (HA) dermal fillers are used in several chirurgical practices and in aesthetic medicine. HA filler stability can be enhanced through different cross-linking technologies; one of the most frequently cross-linker used is 1,4-butanediol diglycidyl ether (BDDE), also present in the HA-BDDE dermal filler family of the company Matex Lab S.p.A. (Brindisi, Italy). Our overview is focused on their characterization, drawing a correlation between matrix structure, rheological and physicochemical properties related to their cross-linking technologies. (2) Methods: Four different injectable HA hydrogels were characterized through optical microscopic examination and rheological behavior investigation. (3) Results: The cross-linked HA dermal fillers showed a fibrous “spiderweb-like” matrix structure and an elastic and solid-like profile. (4) Conclusions: The comparative analysis represents a preliminary characterization of these injectable medical devices in order to identify their best field of application.

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

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.

In vivo inducing collagen regeneration of biodegradable polymer microspheres

Biodegradable polymer particles have been used as dermal fillers for pre-clinical and clinical trials. The impact of material properties of polymers is very important to develop products for aesthetic medicine such as dermal fillers. Herein, eight biodegradable polymers with different molecular weights, chemical compositions or hydrophilic-hydrophobic properties were prepared and characterized for systematical study for aesthetic medicine applications. Polymer microspheres with 20-100 nm were prepared. The in vitro degradation study showed that poly (L-lactic-co-glycolic acid) 75/25 (PLLGA75/25) microspheres degraded the fastest while PLLA microspheres with intrinsic viscosity of 6.89 ([η]=6.89) with the highest molecular weight showed the slowest degradation rate. After these microspheres were fabricated dermal fillers according to the formula of Sculptra®, they were injected subcutaneously into the back skin of rabbits. In vivo results demonstrated that the degradation rate of microspheres strongly correlated with the foreign body reaction and collagen regeneration was induced by microspheres. The microspheres with faster degradation rate induced inflammatory response and the collagen regeneration maintained in shorter time. PLLA ([η]=3.80) microsphere with a moderate molecular weight and degradation rate could strongly regenerate type I and III collagen to maintain a long-term aesthetic medicine effect. These properties of size, morphology and degradation behavior would influence the foreign body reaction and collagen regeneration.