How to deal with complications of filler injections

and are relatively rare. This is not surprising since the overall rate of serious complications with filler injections is estimated to be less than one hundredth of a percent. These are mostly minor, not at all terrible complications, but a few serious side effects have been reported. Bruising, transient erythema, and transient swelling represent the majority of documented problems. The exception is alarming reports of cases of blindness or tissue necrosis.

On estet-portal.com read more about

and how to deal with them. What are the complications of injections

Because most complication reports are written by the treating physician and not by the injector, conclusions about needle type, injection technique, and even material used are often difficult. We know from reports published by actual users of dermal fillers that sudden pain, blanching, and ecchymosis at the injection site are all danger signs of ischemia and necrosis.

Impaired blood supply to the skin in cases of filler injection can be caused either by intravascular embolism or compression of small vessels by the filler.

Ophthalmalgia and loss of vision for several minutes are signs of a retinal embolism. Other signs of ocular vascular embolism include immediate diaphoresis, nausea, headache, ophthalmoplegia, and ptosis.

Tracking the Mistakes: Complications of Contouring Complications of injections: how to prevent trouble

Some physicians recommend aspiration before injection of the filler to avoid vascular embolism. But in the experience of many physicians, this is not always a feasible practice with questionable benefits. Most excipients are thick gels, so creating enough negative pressure to aspirate blood requires a lot of effort. Even in experienced hands, when someone aspirates and then injects the filler, the needle is already in the wrong place, making the test useless.

• needles should be as small as possible to keep the filler flow rate low;

• fillers should always be injected slowly and at low pressure, especially in the nasal area. Complications of blindness occur because the filled embolus has been injected with sufficient force to overcome systolic blood pressure and penetrate the ocular vasculature. Gentle injection technique should prevent this complication;

• the needle should be slowly advanced through the skin, and the filler should only be injected when the needle exits the skin. Thus, even if at some point the tip of the needle is inside the lumen of the vessel, only a small amount of filler will enter the vessel, as the needle will come out at the next moment;

• small volumes of filler should be administered per injection;

• apply ice before injection as it relieves pain and constricts blood vessels, making them less likely to be punctured.

Telegram! Some authors recommend using blunt-tipped cannulas for all filler injections as a way to reduce complications and discomfort. However, this is not always a good idea. The weakness of cannulas is their inaccuracy. It is much easier to know the exact location of the tip of the needle than the tip of a cannula that bends easily as it is advanced through the tissue.

If a physician suspects that an ischemic complication is developing, there are immediate steps he or she should be prepared to take. First, the injection must be stopped immediately. This area should be vigorously massaged to restore blood flow, and then injected with hyaluronidase 50-80 units. Even if a non-hyaluronic acid filler was used, hyaluronidase is useful because it dissolves some of the native hyaluronic acid and reduces intercellular pressure, improving blood flow.

The aesthetic medicine specialist's optimal safety kit includes hyaluronidase, nitroglycerin paste, aspirin, triamcinolone and methylprednisolone.

2% nitroglycerin paste – it is an excellent vasodilator that acts very quickly. In situations of potential ischemia, a small amount of paste is applied to the affected area for 15 minutes.

If the skin becomes dark, nitroglycerin paste and hyaluronidase are reapplied, and oral steroid therapy with methylprednisolone is given. If this does not help, the patient should be referred to a plastic surgeon.

Warned – means armed: complications after the introduction of collagen fillers

Share: