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Complications of non‐hyaluronic fillers
Author(s) -
Kleinfelder Raymond E.,
Glick Brad P.
Publication year - 2020
Publication title -
dermatological reviews
Language(s) - English
Resource type - Journals
ISSN - 2637-7489
DOI - 10.1002/der2.26
Subject(s) - hyaluronic acid , granuloma formation , medicine , filler (materials) , granuloma , adverse effect , dermatology , surgery , pathology , pharmacology , materials science , composite material , anatomy
Background There are three non‐hyaluronic acid fillers available in the United States: Poly‐L‐lactic acid, calcium hydroxylapatite, and polymethylmethacrylate. Potential complications vary amongst the products. Aims To identify the most common and most concerning complications for the three FDA‐approved non‐hyaluronic acid fillers. Materials & Methods A comprehensive review of the literature was performed with key search words "complications," "non‐hyaluronic acid fillers," "poly‐l‐lactic acid," "calcium hydroxyapatite," and "polymethylmethacrylate." Results Similar to hyaluronic acid fillers, the most common adverse effects of non‐HA fillers are injection site reactions, and the most concerning events are cutaneous necrosis and blindness. Non‐HA fillers also have increased risk of papule, nodule, and granuloma formation. Discussion Papules and nodules arising early are likely to be technique‐dependent, while those arising later can be due to an immunologic foreign‐body response or infectious process. Histopathologic examination is required to diagnose a granuloma. Management of these complications requires intralesional and/or systemic corticosteroids, intralesional 5‐fluorouracil, surgical excision, and systemic antibiotics. Conclusion It is vital that injectors are experienced in proper injection technique. Even more importantly, injectors must have the knowledge to recognize and manage complications when they arise.