Objectives: Contributory factors to complications include failure to recognized anatomic danger zones, poor injection technique, failure to understand the rheology of fillers, wrong depth of injection, failure to use canulae in danger zone, and failure to indentify risk factors in patients.
Introduction: Dermal fillers can cause mild to severe complications. The most serious complication is blindness. Some complications are unpredictable while others can be prevented if correct techniques are used.
Materials / method: Fillers can be divided into temporary (e.g. HA), semi-permanent (calcium hydroxyapatite) and permanent (silicone) types. Complications from filler can occur in the absence of any identifiable host factors and flawless technique.
Results: Temporary fillers cause less complications than semi-permanent/permanent fillers. Complications following temporary fillers e.g. HA often occur early, may resolve spontaneously, and are usually easy to treat. Complications that occur from semi-permanent or permanent fillers can appear months to years after augmentation
Acute/Immediate reactions include pain, swelling and bruising from injection, Late complications include foreign body granulomas and non-inflammatory fibrotic nodules e.g. silicone granulomata.
Conclusion: Complications from fillers can be persistent and difficult to treat. Those injecting fillers should have a good knowledge of human anatomy, the rheology of the fillers and understand risk factors to avoid.
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