Objectives: The objective is to show 3 interesting cases of complications with fillers - one with a cannula , one with a needle and an allergic one .

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Objectives: The importance of disinfection prior to a filler treatment

Introduction: To date, it is unknown why some individuals develop late-onset inflammatory adverse events in response to soft tissue fillers. Previous studies show that these can be caused by various factors including soft tissue filler material, genetic immunological profile and bacterial contamination.

Materials / method: We included 29 patients, of whom 13 experienced late-onset inflammatory adverse events to fillers (Inflammation group) and 16 who did not (Reference group). Before taking the biopsy, we acquired skin swabs in 25 of the 29 patients. We used a new and very sensitive method to detect microbiota, the IS-pro method. IS-pro can detect bacteria at low abundances and identify them up to species level. To exclude contamination from skin microbiota we compared the microbiota found on skin swabs with that found in the corresponding biopsies

Results: In the sample of 29 patients, a relatively high level of Gram-positive bacteria was found in biopsies of soft tissue fillers, predominantly in patients from the inflammation group. This suggests that these bacteria were introduced during the filler injection treatment. The composition of the microbiota found in skin swabs differed markedly from that of the corresponding soft tissue filler (9% similarity on average). This indicates that our results were not affected by contamination during our sampling process.

Conclusion: Our results suggest that bacteria adherent to soft tissue fillers may be a causative factor in adverse events. Contamination of samples in the biopsies with skin microbiota was excluded.

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请注明名称（个人，公司，学会等等）: This study was supported by a grant from ZonMw (Dutch Ministry of Health)

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Objectives: This talk will highlight the importance of risk mitigation while acknowledging the emerging demand for solutions.

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这项工作没有任何直接或间接的资金支持。由作者自己承担责任。