Facial Fillers Research Articles

Aplicação do bioestimulador Hidroxiapatita de Cálcio em pescoço

Modern Dentistry has a relevant role in the area of Orofacial Harmonization aiming face rejuvenation. There are four types of injectable collagen biostimulators in the market with the ability to stimulate neocollagenesis, leaving the skin firmer, with a more defined contour, with texture and glow. Among them is Calcium Hydroxyapatite. Calcium Hydroxyapatite (CaHA) has been used as a facial filler since the 2000s, and is currently the second most popular soft tissue filler in the world, after hyaluronic acid. The potential uses of products that stimulate collagen production represent a promising perspective for improving skin quality and its mechanical properties by introducing a new concept of therapeutic approach in the treatment of changes caused by skin aging. The present work aims to present a case report whose patient underwent treatment with Hydroxyapatite in the neck region.

Visual loss after aesthetic facial filler injection: a literature review on an ophthalmologic issue.

Dermal filler injection is among facial rejuvenation treatments that have been increasingly used. Despite being a minimally invasive procedure, it can lead to severe complications such as blindness. A review of all cases of filler- -induced visual loss in the world literature was conducted to summarize the mechanisms, anatomical considerations, and clinical ophthalmologic course, current strategies of prevention and management, and trends over the years. We identified 233 cases of filler-induced visual loss, and 172 patients had a severe visual impairment in at least one eye. The typical patients are young women who received injections of hyaluronic acid or autologous fat in the glabella or nose, and the typical presentations were sudden ocular pain, ptosis, and ophthalmoplegia due to vascular occlusion. The findings of this study also suggest an increase in the number of unlicensed professionals performing the procedure. Even though the continued development of dermal fillers has improved the treatment options available, further studies and strategies are necessary to reduce the incidence and minimize the consequences of filler-induced visual loss.

Adverse Events Following COVID-19 Vaccine in Patients Previously Injected with Facial Filler: Scoping Review and Case Report

The “Vaccines and Related Biological Products Advisory Committee 17 December 2020 Meeting Briefing Document”, formulated by the FDA, reported three cases of swelling in areas previously injected with HA filler, introducing the possible relationship between a COVID-19 vaccine and adverse events in areas previously injected with HA fillers. The aim of this research is to report a case of an adverse event following a COVID-19 vaccine in a patient previously injected with facial filler. Furthermore, a scoping review on the same topic was performed. The research was carried out on the electronic databases PubMed, Cochrane Library, Web of Science, Google Scholar and Scopus. The selection process identified four articles as eligible for inclusion in the review. Nineteen patients, including the described case report, who experienced an adverse event following a COVID-19 vaccine in areas previously injected with facial filler were identified. Adverse events following a COVID-19 vaccine in patients previously injected with facial filler appear to be rare. A high BDDE cross-linking rate and/or a low-molecular-weight hyaluronic acid filler may have a higher tardive adverse event rate when triggered.

Safety and Effectiveness of Hyaluronic Acid Filler, VYC-20L, via Cannula for Cheek Augmentation: A Randomized, Single-Blind, Controlled Study.

Using cannulas to deliver facial fillers may reduce adverse events (AEs) compared with needle injection. To evaluate the safety and effectiveness of VYC-20L (20 mg/mL hyaluronic acid gel with lidocaine) via cannula for midface age-related volume deficit. This multicenter, evaluator-blind, randomized, within-subject, controlled study enrolled adults with moderate to severe Mid-Face Volume Deficit Scale (MFVDS) scores. VYC-20L was administered in one cheek via cannula (with optional needle use in the zygomaticomalar region) and in the other cheek via needle. The primary effectiveness end point was the mean (95% confidence interval [CI]) paired difference between treatments in MFVDS score change from baseline to Month 1; an upper CI limit of less than 0.5 determined noninferiority. Injection-site responses (ISRs), procedural pain, and AEs were assessed. Of 60 randomized and treated subjects, the mean change in MFVDS score from baseline to Month 1 was -1.8 with cannulas and -1.9 with needles, providing a mean (95% CI) paired difference of 0.1 (-0.05 to 0.25). Most ISRs were mild/moderate and resolved within 2 weeks. Procedural pain was minimal, and no serious AEs were reported. VYC-20L for cheek augmentation was safe and effective using a cannula and noninferior to needle injection.

Complications of Nonpermanent Facial Fillers: A Systematic Review.

Background:A variety of complications after injection of nonpermanent fillers for facial rejuvenation have been reported so far. However, to date, the overall complication rate is still a matter of debate. The aim of this study was to perform a systematic review of literature to assess the type and severity of associated complications following injections in different anatomical regions of the face.Methods:The entire PubMed/Medline database was screened to identify case reports and clinical studies describing complications that have occurred after injection of nonpermanent fillers in the face. These complications have been reviewed and analyzed according to their occurrence in different anatomical regions of the face.Results:Forty-six articles including a total of 164 patients reported on a total of 436 complications during the time period between January 2003 and February 2020. The majority of the complications were reported after injections to the nose and the nasolabial fold (n = 230), the forehead and the eyebrows (n = 53), and the glabellar region (n = 36). Out of 436 complications, 163 have been classified as severe or permanent including skin necrosis (n = 46), loss of vision (n = 35), or encephalitis (n = 1), whereas 273 complications were classified as mild or transient, such as local edema (n = 74), skin erythema (n = 69), and filler migration (n = 2). The most severe complications were observed in treatments of nose, glabella, and forehead.Conclusions:Nonpermanent facial fillers are associated with rare but potentially severe complications. Severity and impact of complications depend on the anatomical region of the face and eventually require profound knowledge of facial anatomy.

452 Dermal Filler Injection Leading to Facial Cellulitis: A Case Report

Abstract Background Aesthetic medicine is a rapidly expanding field that is progressively becoming a normal part of society’s health and beauty regime. Hyaluronic Acid dermal filler injections are the second most widely performed aesthetic procedure, following Botulinum Toxin type A. Although serious complications are rare, they can have a detrimental impact on aesthetic outcome and general health. Infections following dermal fillers can be difficult to treat and have the potential to require hospital admission, intravenous antibiotics and surgical intervention. Case description We present a case of a 41-year-old female who suffered from facial cellulitis as a consequence of palpebro-malar groove dermal filler injections. The patient had 0.1ml of Monalisa dermal filler injected over her right malar prominence and suffered complications 6 days later, which eventually lead to the need for hospital admission on day 12 following the procedure for intravenous antibiotics. The management of this aesthetic procedure complication is outlined to highlight the risks and serious complications of these procedures. Conclusions Facial cellulitis is a rare adverse event following facial filler injection; however, it is an important risk factor to discuss during the consent process for these procedures. In addition, it is important that a highly trained and skilled professional performs these injections using a sterile non-touch technique due to the potential for serious complications and the anatomical proximity to vital structures.

High Yield Injection Targets and Danger Zones for Facial Filler Injection.

High Yield Injection Targets and Danger Zones for Facial Filler Injection.

A case of cheek phlegmon caused by an infection in facial filler

A case of cheek phlegmon caused by an infection in facial filler

The use of hyaluronic acid in individuals with cleft lip and palate

Since the Resolution 198/2019 of Brazilian Dental Council, which regulates orofacial harmonization as a dental specialty, and the advent of various uses of facial fillers, such as hyaluronic acid (HA), it is possible to perform both esthetic and functional corrections in individuals. Individuals with cleft lip and palate (CLP) present lip irregularities even after orofacial rehabilitation with an interdisciplinary team with several corrective surgeries, interfering with the esthetics, which can cause problems in self-esteem and social insertion. Thus, facial filling is an innovation that, together with dentistry, contributes to the individual's esthetics and well-being. Considering the patient safety and health, more research is progressively being conducted to make such procedures less invasive. This work conducted a literature review on the use of HA as a facial filler to correct lip scars in patients with CLP. By a literature and transverse search in Scientific Electronic Library Online and PubMed databases using specific descriptors, the studies that met the inclusion criteria were selected, from 1990 to 2020. It can be concluded that the use of HA as a facial filling material in the correction of lip scars from reparative surgeries related to CLP has been shown to be effective both for correction of facial asymmetry and to improve the quality of life of patients who used the procedure.

The 10-Point Plan 2021: Updated Concepts for Improved Procedural Safety During Facial Filler Treatments.

Dermal filler treatments require constant reassessment for improving and safeguarding the rapidly evolving aesthetic field. Suboptimal injection technique, patient selection and product knowledge have touted a concerning increase in filler complications, with new challenges such as the COVID-19 pandemic leading to new paradigms in the understanding, prevention, diagnosis and treatment of complications. The updated 10-point plan has been developed to curtail complications through consideration of causative factors, categorized as patient, product, and procedure-related. Patient-related factors include a preprocedural consultation with careful elucidation of skin conditions (acne, rosacea, dermatitis), systemic disease (allergies, autoimmune disease, underlying bacterial and viral disease (herpes simplex virus, COVID-19 infection), medications (antineoplastic drugs, recreational drugs) and previous cosmetic procedures (including fillers and energy-based devices). Patient assessment should include standardized photography and also evaluate the role of social media, ethnicity, gender, generational, and LGBTQ+ needs. Specified informed consent for both adverse events and their treatment is essential due to the increase in vascular complications, including the risk of blindness. Product-related factors include the powerful advantage of reversibility when using hyaluronic acid (HA) products. Product characteristics such as molecular weight and filler degradation should be understood. Product layering over late or minimally degradable fillers is still inadvisable due to the initial filler being teased into reactivity. Procedural factors such as consistent photographic documentation, procedural planning, aseptic non-touch technique (ANTT), knowledge of topographical anatomy and angiosomes, and technical dexterity including pinch anatomy and needle skills are of pivotal importance. The final section is dedicated to algorithms and checklists for managing and treating complications such as allergic hypersensitivity reactions, vascular events, infection, edema and late-onset adverse events (LOAEs). The updated 10-point plan is a methodical strategy aimed at further minimising the risk of dermal filler complications.

Cutaneous and Ganglion Sarcoidosis Induced by Polycaprolactone Facial Filler: A New Expression of ASIA Syndrome?

Dermal fillers are applied using a minimally invasive technique with a good safety profile. However, they can have side effects. We present the case of a patient who, 2 months after undergoing polycaprolactone (Ellansé®) injections, developed nodular facial and nodal lesions that were compatible with sarcoidosis on histology. This complication has not been previously described for polycaprolactone and could be the expression of an autoimmune syndrome induced by adjuvants.LEARNING POINTSAutoimmune/autoinflammatory syndrome induced by adjuvants (ASIA) is a recently devised umbrella term for autoimmune diseases caused by adjuvants.Aesthetic procedures, which are increasingly common, may be a cause of ASIA syndrome.Polycaprolactone is a bioabsorbable polymer with a safe profile but can have adverse events, including systemic sarcoidosis.

Fillers for aesthetics on the face – Newer perspectives

Dermal fillers are a cornerstone of the aesthetic treatments of the face. They have evolved over many aspects since their initial use. Facial fillers are not just used for anti-aging to restore volume, but are now also used for contouring, enhancing facial features, and changing the emotional attributes of the face. Newer techniques and approaches have been proposed for greater predictability of results and minimum complications. Newer composite filler materials and a resurgence of older materials have taken place with better understanding of the science behind them. With more use of facial fillers comes the reporting of newer complications with recommendations and guidelines to avoid them. A new perspective is seen in guidelines for their use in the COVID-19 pandemic. This article is a review of the insight into the latest perspectives of facial fillers for aesthetic indications.

Advances in iatrogenic eye complications caused by facial cosmetic injections

Facial cosmetic injections refer to a medical cosmetology approach that applies percutaneous injection method to inject filler materials or drugs into the target position of the face to repair and remodel the face. Common facial cosmetic injections include facial filler injection and botulinum toxin injection. A number of iatrogenic eye complications following facial cosmetic injections have been reported, such as ptosis, ophthalmoplegia, vision loss. This article reviews the cosmetic iatrogenic eye complications of the two selected common facial cosmetic injections techniques, i.e. facial filler injection and botulinum toxin injection. (Chin J Ophthalmol, 2021, 57: 391-395).

Considerations for the Use of Minimally Invasive Aesthetic Procedures for Facial Remodeling in Transgender Individuals.

There is increasing demand among transgender individuals for minimally invasive aesthetic procedures, such as injectable facial fillers and neurotoxins, for facial remodeling and transformation. These procedures may increase transgender individuals’ satisfaction with their appearance and allow them to more effectively harmonize their physical appearance with their perception of self. There is currently a lack of information in the medical literature regarding guidelines for the use of these products in transgender patients. In this report, the authors provide experience-based treatment considerations and recommendations for use of minimally invasive facial aesthetic procedures in transgender patients, including case studies illustrating the use of these procedures for both male-to-female and female-to-male transitioning patients. This report highlights the success of minimally invasive methods for assisting transgender patients in achieving their facial remodeling goals. Clinicians play an integral role in the transitioning process for transgender patients, and facial transformation is a key element of this process. When conducted with sensitivity and attention to individual patient goals at varying stages of transition, facial procedures can be of great benefit in enhancing patients’ self-perception and overall quality of life.

Commentary on: Long-term Outcomes of Ophthalmic and Retinal Artery Occlusion After Cosmetic Facial Filler Injection.

Commentary on: Long-term Outcomes of Ophthalmic and Retinal Artery Occlusion After Cosmetic Facial Filler Injection.

Cerebral Embolism as a Result of Facial Filler Injections: A Literature Review.

BackgroundWith the growth in the popularity of facial filler injections, increased numbers of severe adverse events, such as cerebral embolism, have been reported.ObjectivesThe aim of this article was to summarize the clinical manifestations and proposed mechanisms of filler-induced cerebral embolism (FICE).MethodsA literature review was performed with the search keywords “filler injection,” “hyaluronic acid,” “fat graft,” “cerebral infarction,” “cerebral embolism,” “stroke,” “cerebrovascular infarction,” “disorders of consciousness,” and “hemiplegia.”ResultsAmong the 43 cases of FICE enrolled from 35 articles, 37 patients were female, and 6 were male. Twenty-nine of these patients had received fat grafting, and 12 hyaluronic acid injection. Most FICE patients had been injected in the glabella, followed by the temporal, forehead, and nasal areas. Among 30 patients injected under local anesthesia, 43.33% presented with neurologic symptoms during the procedure. The main symptoms were consciousness disorders and hemiplegia. Most of the embolization sites were in the middle cerebral artery, followed by frontal lobe infarction and anterior cerebral artery infarction. Three patients developed cerebral hemorrhage after embolism. Twenty-six patients presented with newly acquired vision loss. The management for FICE cases included embolectomy, thrombolysis, decompressive craniectomy, antiplatelet/anticoagulant therapy, and symptomatic and nutritional treatment. Nearly half of the patients recovered or exhibited improved neurologic manifestations but not visual loss. Five patients died.ConclusionsFICE is a severe complication following facial filler injection. Careful prevention, timely identification, and treatment are crucial to decreasing the morbidity and mortality of FICE.Level of Evidence: 4

The clinical spectrum of periorbital vascular complications after facial injection.

Serious complications due to periorbital vascular occlusion can occur after facial injections, including skin necrosis, ophthalmoplegia, blepharoptosis, and visual loss. Visual loss after facial filler injection is particularly rare, but it is known to have a poor prognosis despite treatment. This study aimed to describe the prognosis and various clinical features of periorbital vascular complications after facial injection of cosmetic filler or local anesthetic. This single-center retrospective study included 10 consecutive patients who presented with occluded periorbital vessels after facial injection. Nine patients were injected with cosmetic facial fillers: seven with hyaluronic acid, one with collagen, and one with poly-Llactic acid. The other patient was injected with lidocaine mixed with epinephrine. Injection sites included the glabella (n=5), nasal dorsum (n=4), and temporal fossa (n=1). Presumed arteries affected included the central (n=2) or branch (n=3) retinal artery, ophthalmic artery (n=4), and angular artery (n=1). Nine patients (90%) had purpura and blisters, and eight patients (80%) had ophthalmoplegia at presentation, but all of them recovered within 3months. Six patients (60%) were blind at the last follow-up, and five of them had occlusion of the central retinal artery or ophthalmic artery. There was a patient with sequelae of phthisis bulbi, which was cosmetically managed with retrobulbar filler injections. Facial injections can cause periorbital arterial occlusion, and the clinical features are diverse according to the site and extent of vascular occlusion and injection materials. Visual prognosis was associated with the site of vascular occlusion and initial visual acuity. Other common complications, such as skin lesions, blepharoptosis, and limited extraocular movement, can fully resolve only with supportive treatments in most cases.

Commentary on: Long-term Outcomes of Ophthalmic and Retinal Artery Occlusion After Cosmetic Facial Filler Injection.

Commentary on: Long-term Outcomes of Ophthalmic and Retinal Artery Occlusion After Cosmetic Facial Filler Injection Claudio DeLorenzi, MD, FRCS Claudio DeLorenzi, MD, FRCS Corresponding Author: Dr Claudio DeLorenzi, 150 Edna Street, Kitchener, Ontario N2H 6S1, Canada. E-mail: fillercomplication@gmail.com Search for other works by this author on: Oxford Academic PubMed Google Scholar Aesthetic Surgery Journal, sjab136, https://doi.org/10.1093/asj/sjab136 Published: 19 March 2021 Article history Editorial decision: 01 March 2021 Published: 19 March 2021 Corrected and typeset: 26 April 2021

Comment on: “Efficacy and Safety of Lyophilized Articular Cartilage Matrix as an Injectable Facial Filler”

Comment on: “Efficacy and Safety of Lyophilized Articular Cartilage Matrix as an Injectable Facial Filler”

Lipofilling after Laser-Assisted Treatment for Facial Filler Complication: Volumetric and Regenerative Effect.

Nonresorbable substances are still injected to enhance soft-tissue volumes and fill subcutaneous defects. The minimally invasive intralesional laser treatment can remove foreign substances and the inflammatory reaction, eventually leaving depression and scar tissue in the treated area. Fat grafting can restore volume loss and improve scar tissue. From March of 2010 to February of 2017, 33 patients were studied. All of them had suffered from inflammatory reactions to permanent facial fillers and had been treated with the 808-nm diode laser at the authors' institution. The evacuation of material had left facial asymmetry and visible depression. To restore facial aesthetic units, fat grafting was performed. The minimum follow-up was 6 months. Volume restoration was recognized (according to the Global Aesthetic Improvement Scale) as significantly improved in 22 patients, moderately improved in eight patients, and slightly improved in three patients. Improvement in atrophic and scarred tissues (with an apparent thickening of the skin or even elimination of scars) was also assessed with the following results: 25 patients were very much improved and eight were moderately improved. This is the first study on filler-induced complications of the face treated by intralesional laser treatment followed by lipofilling. A systematic approach to volume restoration is proposed to patients who had filler removal of the face. There was a high degree of patient satisfaction with this technique. Therapeutic, IV.