Subconjuctival mobile mass after hyaluronic acid filler injection.
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ABSTRACT:
SUBMITTER: Hayat H
PROVIDER: S-EPMC9663311 | biostudies-literature | 2022 Dec
REPOSITORIES: biostudies-literature
Publications
Subconjuctival mobile mass after hyaluronic acid filler injection.
Hayat Hagay H Masarwa Dua D Sapir Shawn S Kaiserman Igor I
JAAD case reports 20220921
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Project description:Blindness from hyaluronic acid filler injections is an uncommon but devastating complication. We present a case of blindness related to a "skin booster." It is often assumed that skin boosters have no risk of visual problems, and this case underlines the need to understand products' rheology and chemistry. Given the lack of agreed consensus in bedside and secondary care management, it is important to report and describe all cases of vision loss caused by fillers, including assessment and management, to allow understanding of what may give rise to better outcomes.
| S-EPMC11578212 | biostudies-literature
Project description:BackgroundBeauty standards vary by race and region, which must be accounted for in creating beauty. Chinese have unique features, including a depressed nose, flat midface, and small chin, and have different cosmetic concerns. We performed a consensus study on filler injections based on the Chinese standard of beauty due to a lack of such study.MethodsWe organized the YVOIRE Consensus Group, including 5 plastic surgeons. We discussed common problematic areas seen in Chinese and described techniques based on our experience with hyaluronic acid fillers, while considering peer-reviewed articles, followed by multiple consensus-developing sessions.ResultsChinese faces are characterized by retruded forehead, chin, and low nasal bridge, with certain features believed to bring good fortune. Therefore, profiles of the forehead, nose, lip, and chin have substantial effects on attractiveness. The demand for cosmetic procedures is high among the young generation who particularly desire nose and chin augmentation. Attractive Chinese facial shapes are characterized by a long, slender facial shape and pointed chin. Lips are narrow and thick. When injecting fillers for Chinese, it is necessary to apply special methods that produce results consistent with these characteristics.ConclusionsUnderstanding the concept and demand of beauty depending on race and region is important. Patients should be evaluated before aesthetic procedures. Maintaining hygiene during the procedure is crucial. Moreover, methods for preventing pain are essential. Fillers should be injected into the correct anatomical site and layer to minimize side effects and maximize effectiveness.
| S-EPMC7647603 | biostudies-literature
Project description:BackgroundThe ongoing expansion of the cosmetic armamentarium of facial rejuvenation fails to uncover the inherent risks of cosmetic interventions. Informed consent to all risks of cosmetic filler injections and potential sequelae, including ocular and neurological complications, should be carefully ensured. We present two cases of complications following facial hyaluronic acid filler injections.Case presentationsCase 1: A 43-year-old woman presented with monocular vision loss of the left eye, associated ptosis, ophthalmoplegia, periocular pain and nausea, cutaneous changes of the glabella region and forehead, and sensory impairment in the left maxillary branch dermatome (V2) after receiving a hyaluronic acid (HA) filler injection into the left glabellar area. On ophthalmological examination, an ophthalmic artery occlusion (OAO) was diagnosed upon identification of a "cherry-red spot". Magnetic resonance imaging (MRI) revealed a left ischemic optic neuropathy. Supportive therapy and hyaluronidase injections were initiated. A follow-up MRI of the head performed two months after presentation corresponded to stable MRI findings. The patient had irreversible and complete vision loss of the left eye, however, the ptosis resolved. Case 2: A 29-year-old woman was admitted to hospital a few hours after a rhinoplasty and cheek augmentation with hyaluronic acid, presenting with acute monocular vision loss in the right eye, retrobulbar pain, fatigue and vomiting. In addition, the patient presented a harbinger of impending skin necrosis and a complete oculomotor nerve palsy on the right side, choroidal ischemia and vision impairment. Supportive treatment and hyaluronidase injections into the ischemic tissue were initiated. A small scar at the tip of the nose, vision impairment and an irregular pupillary margin on the right side persisted at follow-up.ConclusionThese two case reports and the literature review emphasize the pathophysiological mechanisms leading to potentially devastating complications. In order to reduce the risk of vision loss secondary to cosmetic filler injections, practitioners should possess a thorough knowledge of anatomy and preventive strategies.
| S-EPMC9290300 | biostudies-literature
Project description:Performing rhinoplasty using filler injections, which improve facial wrinkles or soft tissues, is relatively inexpensive. However, intravascular filler injections can cause severe complications, such as skin necrosis and visual loss. We describe a case of blepharoptosis and skin necrosis caused by augmentation rhinoplasty and we discuss the patient's clinical progress. We describe the case of a 25-year-old female patient who experienced severe pain, blepharoptosis, and decreased visual acuity immediately after receiving a filler injection. Our case suggests that surgeons should be aware of nasal vascularity before performing an operation, and that they should avoid injecting fillers at a high pressure and/or in excessive amounts. Additionally, filler injections should be stopped if the patient complains of severe pain, and appropriate measures should be taken to prevent complications caused by intravascular filler injections.
| S-EPMC5533056 | biostudies-other
Project description:BackgroundFull-face aesthetic treatment involving several treatment modalities may improve facial aesthetic outcome.ObjectiveTo evaluate clinical outcomes and patient perceptions of monotherapy with either abobotulinumtoxinA (ABO) or hyaluronic acid (HA) filler followed by full-face combination treatments of ABO, HA filler, and skin-boosting HA (RSB).Materials and methodsSubjects aged 35 to 50 years were randomized to monotherapy with 50 s.U ABO in the glabella or ≤1 mL HA filler in the nasolabial folds (NLFs)/cheeks. At Month 6 and Month 12, all subjects received combination treatment with ≤50 s.U ABO in the glabella, ≤2 mL HA filler in the NLFs/cheeks (and other facial areas as applicable), and ≤1 mL RSB (additional RSB treatment at Month 7). Assessments included global facial aesthetic appearance and improvement, first impression, perceived age, wrinkle severity, satisfaction questionnaires, and adverse events.ResultsRepeated full-face combination treatment with ABO, HA filler, and RSB was associated with considerably higher levels of aesthetic improvement and subject satisfaction than monotherapy with ABO or HA filler. Improvement rate of glabellar lines was increasing with each treatment.ConclusionRepeated combination treatment achieved greater change in global facial aesthetic appearance than monotherapy. Aesthetic improvement and subject satisfaction was high and increased with each treatment. All treatments were well tolerated.
| S-EPMC7147415 | biostudies-literature
Project description:Background:VYC-12L is a hyaluronic acid (HA) injectable gel designed to treat fine cutaneous lines and improve skin quality attributes such as hydration and elasticity. Objective:Expert consensus was sought on VYC-12L injection technique and primary treatment target areas. Methods:A multinational group of aesthetic medicine clinicians (n = 128) attended product training and each identified ~10 patients for VYC-12L. After treating their first and last patients, the clinicians completed a survey on preferred injection methodology/technique, including injection angle, volume, and spacing. An expert panel (n = 12) discussed survey results and their clinical experiences to obtain consensus on VYC-12L technique and appropriate treatment areas. Results:Recommendations included micro-depot injections of VYC-12L into the deep dermis with a 32G ½ inch needle inserted at <45º to the skin, spaced 0.5?1.0 cm apart, with 0.01?0.05 mL volume per injection (full-face total volume: ~2 mL). Recommended primary treatment areas were the malar, perioral, neck, and décolletage regions. Injection techniques for different treatment areas/demographic characteristics were similar, with some variability in treatment approach. Patient selection criteria, pre- and post-treatment guidelines, and managing patient expectations are important components of treatment. Conclusion:These consensus recommendations may assist clinicians in optimizing the treatment of fine lines with VYC-12L.
| S-EPMC7152505 | biostudies-literature
Project description:BackgroundUsing high resolution sonography, soft tissue thickness with detailed soft tissue layers can be measured accurately to assess volumizing effects of fillers.MethodsIn this prospective study, 1cc of monophasic stabilized hyaluronic acid (mS-HA) filler was injected utilizing subdermal scrapping fanning injection technique (ssFIT) into the dorsal superficial lamina (DSL) and dorsal intermediate lamina(DIL) for 20 patients, and the results were measured utilizing sonographic evaluation of soft tissue thickness, topographic computer analysis (TCA) of skin roughness, stratum corneum hydration (SCH) at 1-week,1,2,3,6-months.ResultsThe hand appearance and skin roughness improved in all patients. Soft tissue thickness in sonography was increased by 4.52mm(immediately-post-treatment), 5.52mm(1week), 4.89mm(1month), 4.25mm(2m), 4.08mm(3m), and 3.86mm(6m) from the pre-treatment baseline of 3.20mm. Roughness evaluated by TCA in 50(10) magnification dermascope photos, was reduced by 15.39(16.17)% at 1-month post-treatment, 21.5(18.12)% at 2-months, 22.7(23.91)% at 3-months, 27.16(38.12)% at 6-months, indicating improvements in fine wrinkles after the procedure. SCH on hand dorsum also improved during the follow up.ConclusionsDetail subdivided 9-layers of hand dorsum were established in author's sonography study for the first time. Soft tissue thickness was increased more than 207% during follow-up after 1-session of the treatment, and placed HA materials was confirmed in DSL and DIL. The hand appearance and skin roughness improved in all patients. Veins and tendons became less apparent after the single injection, showing volumizing effects lasting more than 6 months. All patients stated that their skin became more moisturized with increased SCH, youthful and smooth during the follow-up period after only 1-session of ssFIT.
| S-EPMC10666936 | biostudies-literature
Project description:BackgroundLip augmentation procedure with hyaluronic acid (HA) fillers can make patients younger with more attractive. After the injection on the lips, the result is temporary. Physicians and patients wonder how long the HA filler last on the lips.ObjectivesThe main goal of this study is to determine how much volume of HA is reduced after injection on the lips utilizing a "9-point" injection technique.MethodsIn this prospective study, 25 females were injected using HA filler and evaluated using noninvasive 3-dimensional-scanner analysis before, 1 h, 1 week, 1 month, 6 months, and 9 months after injection. The changes in projection of lips were evaluated using sonography. The patients were treated as usual manner in a single clinic. Using 29-gauge needle, 20 mg/mL of HA filler was injected into the lips. Default injection amount was 1 cc. HA filler was injected submucosally using linear thread and fanning technique.ResultsTwenty-three patients were followed up. The mean age was 34.8 years (range, 20-48 years). The volume of lips became 181.34% (±61.14) at 1 h, 91.18% (±10.12) at 1 week, 75.09% (±11.02) at 1 month, 55.36% (±10.48) at 6 months, and 39.21% (±4.54) at 9 months. The projection of upper lip areas increased 25.3% at 1 h, 22.8% at 1 week, 17.7% at 1 month, 14.8% at 6 months, 11.5% at 9 months in sonography. The projection of lower lip areas increased 23.1% at 1 h, 20.7% at 1 week, 15.9% at 1 month, 13.9% at 6 months, and 10.6% at 9 months in sonography.ConclusionsLip augmentation with HA showed improved shape during 9 months. The volume of HA decreased at a constant rate after injection, except for the first week. Injected HA was absorbed at a constant rate, and more than half was absorbed after 9 months utilizing a "9-point" injection technique.Level of evidence 4 therapeutic
| S-EPMC11635368 | biostudies-literature
Project description:BACKGROUND:The incidence of vascular complications varies among different fillers. The main purpose of this study was to compare the risk of embolism between PMMA (Artecoll) and hyaluronic acid (HA, Restylane) after artery injection. METHODS:Rabbit ears were injected via the central artery with 0.1 ml PMMA (group A), 0.1 ml HA (group B), 0.2 ml PMMA (group C), or 0.2 mL HA (group D), respectively. The formation of transparent emboli was monitored right after injection. Tissue necrosis and histopathological changes were analyzed on day 7. RESULTS:With 0.1 ml injected volume, PMMA was dispersed within a few minutes and only 5% of the injected ears had mild necrosis on day 7, while HA tended to form obvious transparent emboli, an indication of blood vessel clotting, and 60% of injected ears showed necrosis on day 7. With 0.2 ml injected volume, PMMA had a risk of complete blood vessel clotting in between 0.1 ml PMMA group and 0.1 ml HA group, and 30% of injected ears had necrosis; in contrast, 100% of 0.2 ml HA-injected ears showed transparent emboli and necrosis. The necrosis areas were significantly increased in the HA groups compared with PMMA groups at the same injection volumes. HA injection also caused dilation of small blood vessels. CONCLUSION:At the same injection volume, PMMA had less risk of embolism compared with HA. With increased injection volume, there were increased risks of embolism and necrosis for both PMMA and HA. NO LEVEL ASSIGNED:This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
| S-EPMC6522461 | biostudies-literature
Project description:HA (Hyaluronic acid) filler, the most commonly used dermal filler, causes several side effects. HA-PN (Hyaluronic acid-Polynucleotide), a new composite filler, has excellent biocompatibility and induces tissue regeneration. In this study, we compare the efficacies and safety profiles of these fillers. The characteristics of HA and HA-PN fillers were compared using scanning electron microscopy and rheometry. No morphological difference was noted between the fillers. However, the latter had higher viscosity and elasticity values. The HA-PN filler induced higher cell migration than the HA filler in a wound healing assay. It was also found to stimulate better collagen synthesis in human and mouse fibroblasts. The HA and HA-PN fillers were injected into SKH1 hairless mice to determine changes in their volume for up to 24 weeks. Increased cell migration and collagen synthesis were observed in mice injected with the HA-PN complex filler. Although the safety and durability of the HA and HA-PN fillers were similar, the latter induced a lower transient receptor potential vanilloid 4 expression and caused less stimulation upon injection. In conclusion, HA-PN complex fillers can stimulate fibroblast growth and facilitate volume growth and skin regeneration.
| S-EPMC7083941 | biostudies-literature