Working on mistakes: complications of contouring

Contour plasty is sometimes accompanied by complications. There are many reasons for this. However, there are some mistakes that cosmetologists most often make. How to fix them, and even better — prevent, says plastic surgeon Andrey ISKORNEV.

Andrey Alexandrovich Iskornev
plastic surgeon,
President of The Platinental Aesthetic Lounge

Technique for correcting complications after contouring

I would conditionally divide all complications after contour plastic surgery into aesthetic and general medical ones. The latter include almost all cases, ranging from allergic reactions to the drug and ending with hematomas, edema and acute inflammation.

With GC, this sort of thing happens relatively infrequently. But on the other hand, everything can be here: fibrosis that has arisen due to a reaction to a poor-quality drug (low degree of purification, pharmacological supplements, etc.), and hypercorrection (contouring of the drug, the formation of unnatural creases on the face), and swelling when a large amount is injected HA into the infraorbital zone.

Especial care must be taken when working with preparations based on calcium hydroxyapatite, which are either injected into the subcutaneous layer with cannulas, or — bolus periosteum. Too superficial administration of drugs of this group is fraught with the formation of calcifications and coarse fibrous bands along the wrinkle.
I am not a big fan of the introduction of dense HA into wrinkles and furrows in the forehead. But if you still choose such a correction technique, make sure

Minimize injury

I would like to point out the typical mistakes in contouring that cosmetologists should avoid.

It is very painful to inject preparations for contour plastics into the area of ​​the nasolabial triangle or infraorbital zone without anesthesia. However, the use of the infiltration technique of anesthesia is also not welcome, because due to edema it is not always possible to adequately assess the volume of the injected drug. I prefer to use conduction anesthesia, which requires a minimum amount of anesthetic and blocks fairly large areas on the face.
Any growths and birthmarks on the face from the injection should be avoided. Especially dangerous is the injury of suspicious neoplasms with a diameter of more than 0.5 mm, asymmetric shape and multi-colored color.
It is not necessary to immediately inject large volumes of collagen-stimulating fillers (Radiesse, Sculptra), as this always causes prolonged swelling in the correction area.
For the correction of the infraorbital and midface, try to choose fillers based on polylactic acid or calcium hydroxyapatite, as they do not attract water. At the same time, these drugs are not injected into the lips.

Complications such as vascular embolism are quite rare and are usually associated with the introduction of an inadequate amount of HA into the lip area. To minimize trauma, you can use the application of ice compresses before starting the procedure in the lip area. Aesthetic complications associated with asymmetry after contouring, of course, are associated only with the insertion technique. Constant practice will help here.

Contraindications for contouring

Individual intolerance to the drug by the patient. It will be necessary to select an analogue by trial and error, which is quite easy, given the wide range of medicines.
Pregnancy. You never know the threshold of pain that such a patient will feel. In addition, no one has yet studied the effects of drugs on the fetus.
Patients should not be taken for contouring if they have previously been injected with polyacrylamide gel (PAAG) into the correction area. Not a biopolymer, namely PAAG,
because his reaction is unpredictable. Even five to ten years after the introduction, it is a thick mushy mass in a capsule, which, after additional correction and massage, can break, the gels can migrate and, most likely, provoke an acute reaction. In such patients, I first perform the surgical removal of the old synthetic preparation, and after a couple of months I already introduce a biodegradable gel.
Try not to overload older patients with HA shots. It usually looks unnatural. Such procedures do not look younger, but, on the contrary, make the face heavier. It is better to do a surgical facelift, and then finish the work with contouring, because deep nasolabial folds after SMAS-lifting may not completely straighten out.

Source estet-portal.com