Gholamreza MAJLESI 医师
医学博士
Treatment of filler-induced ischemia and necrosis by laser therapy
Objectives: In this study it is found that laser therapy started at the onset of symptoms of arterial obstruction after filler injection can be an effective modality in treatment and decreases symptoms and makes a better outcome.
Introduction: Arterial obstruction in filler injection although rarely happens can be considered a catastrophic complimcation. An effective intervention in ischemic phase can decrease the severity of pathology and therefore prohibit tissue necrosis completely or partially to have no scar or a smaller and more desirable one.
In addition to formal treatment we tried laser therapy. Known photobiomodulative effects of low power laser such as increasing circulation and ATP production and decreasing inflammation can be effective in treatment.
Materials / method: We asked colleagues to refer their probable complicated cases of filler injection to our office two years ago to add laser therapy to their usuall medical treatment ( hyaluronidase, vasodilator and antibiotic therapy) Treatment protocol for laser therapy was:
pulsed wave infrared 6J/Cm²
Continuous wave infrared 4J/Cm²
And on the wound (if had) 1J/Cm²
5 days per week
For 10 to 15 sessions.
Results: In comparison with the same cases of usuall treatment (without laser therapy), course of treatment in cases of this study had less pain and edeme.
Evaluating final result, the most important factor is scar formation due to necrosis. In these cases some had no necrosis although at the onset we expected to have it. In more severe cases that necrosis happened and scar formation was inevitable scar surface was smaller because laser therapy prohibited progression of necrotic area. In addition Appearance of scars was dramatically desirable an no more interventions such as CO2 laser was needed.
Conclusion: If laser therapy begins soon with suitable protocol it can dramatically affect course of treatment and final result. As it is noninvasive with no side effect (if used properly), significantly decreases symptoms and enhances final result can be a main part of treatment protocol for filler induced arterial obstruction.
