Management of early complications of contouring

Contour plastic surgery, like any other cosmetic injectable procedure, is associated with complications that can occur even for experienced professionals.

Sometimes even the most thorough prevention is not enough to avoid side effects.

In this regard, the correct tactics for managing complications – it is a pledge of safety for the patient.

The purpose of this article on estet-portal.com is to help the physician to timely identify early and late complications of contouring and treat accordingly their correction.

• Early complications of contouring

1. Pain: Make Patient Comfortable
2. Erythema: fighting redness
3. Edema: related and non-hypersensitivity related
4. Bruises, hematomas, ecchymosis
5. Overcorrection sometimes worse than complications
6. Infectious complications

• Vascular complications of contouringki

Early complications of contouring

1. Pain: Comfort the patient

Pain is the most common complication of contouring and can often result from multiple needle punctures.

If severe radiation pain occurs along the vessel during filler injections or several hours after injection, this indicates a vascular complication and appropriate action should be taken.

Pain can be minimized:

• slow needle insertion;
• using a small diameter needle;
• use of long needles to reduce the number of needle sticks;
• with anesthesia;
• heating of the filler to the temperature of la.

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

2.Erythema: fighting redness

Temporary erythema

often occurs after the procedure and usually disappears without any treatment. More

prolonged erythema or persistent erythema

are more common as a result of hypersensitivity reaction to various compounds or as a result of infection. Therefore, careful evaluation and appropriate treatment is necessary.

Treatment includes

avoidance of erythema triggers

such as alcohol, exercise, and sun exposure.

Topical steroids

may be used for a short period of time to reduce erythemamu.

Dublin Protocol for the Treatment of Complications after Fillers

3.Edema: related and non-hypersensitivity related

Edema not associated with hypersensitivity
Swelling may occur immediately after injection due to manipulation and rarely persists for more than two days. You can fix it using

ice packs

.

True hypersensitivity edema
Edema can also occur after true hypersensitivity reactions to injected products.

This can occur as

angioneurotic edema

at the injection site or at distant sites. For its correction

antihistamines and systemic steroids are prescribed for several weeks

.

Delayed facial edema associated with hypersensitivity
This is a T-lymphocyte-mediated rather than antibody-mediated reaction and is accompanied by

induration

, edema, and erythema.  In this case,

oral steroids

are prescribed and it is recommended to refillep.

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4. Bruises, hematomas, ecchymosis

To prevent bruising, it is necessary that the patient refuses to take it before the procedure:

anticoagulants;

• Ginkgo Biloba;
• vitamin E;
• omega-3 fatty acids and St. John's wort;
• alcohol
• la.
The use of arnica, topical vitamin K, or bromelain also helps reduce the incidence of ecchymosis.

5. Overcorrection is sometimes worse than complications

Overcorrection may appear as

bumps, nodules or irregularities,

especially when too much filler is injected. Hyaluronic acid products can be easily eliminated with

hyaluronidase.

If another filler is used, a simple puncture with a wide-bore needle and

draining excess product may be sufficient.

A bluish discoloration, also known as the

Tyndall effect

, can occur when excess hyaluronic acid is located on the surface under the skin. It can be eliminated with

hyaluronide

ss.

6. Infectious complications

Infectious complications present clinically as

warm, tender, erythematous nodules, with or without systemic manifestations

(such as fever and malaise). In general, early infections are due to

Staphylococcus aureus

, while late manifestations are suspected of atypical mycobacterial infections. For mild cases of infection, empiric antibiotic therapy such as ciprofloxacin, clarithromycin, and amoxicillin + clavulanic acid for 2 to 4 weeks is recommended.

Incision and drainage may help with an abscess. If empiric antibiotic therapy fails,

culture-guided therapy

.

Hyaluronidase

may be used to avoid further spread of ii infections. Vascular complications of contouring

Vascular complications result from inadvertent arterial administration of filler and may result in

necrosis, blindness, or stroke.

Necrosis can also result from an excess of material causing outward compression of the vessel and therefore reduced perfusion.

Intra-arterial injection can cause mechanical obstruction and damage to endothelial cells, leading to ischemic changes in the skin.

Common areas of necrosis reported after filler injections are the glabella, alar and nasolabial folds.

Injection sites leading to necrosis

Paleness during the procedure, accompanied by severe pain

, is the first sign of injection necrosis. Stop the injection immediately and gently

massage the treated area

.

Ischemia

is usually accompanied by dark discoloration and then necrosis of the skin.

Blindness

is due to embolism of the filler in the ocular vasculature. Loss of vision usually occurs immediately and is accompanied by pain in the affected eye.

Injection sites leading to blindness

In rare cases, when more force is applied during injection, filler emboli can enter the internal carotid artery and then be pushed into the intracranial circulation, resulting in a stroke.

In cases where intravascular injection is suspected,

stop the procedure immediately,

gently massage the areaand apply warm compresses. Topical nitroglycerin paste may be used for vasodilation.

Aspirin, low molecular weight heparin, and intravenous prostaglandins

may also be used.

However, the best solution is to inject a high dose of hyaluronidase.

In case of blindness, an ophthalmologist should be consulted immediately and

retrobulbar hyaluronidase injection

. In cases of necrosis proper wound care and antibiotics are recommended to minimize scarring.

First aid for central retinal artery occlusion after filler injections

 

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