title: Avoiding and treating dermal filler complications.
abstract: All fillers are associated with the risk of both early and late complications. Early side effects such as swelling, redness, and bruising occur after intradermal or subdermal injections. The patient has to be aware of and accept these risks. Adverse events that last longer than 2 weeks can be attributable to technical shortcomings (e.g., too superficial an implantation of a long-lasting filler substance). Such adverse events can be treated with intradermal 5-fluorouracil, steroid injections, vascular lasers, or intense pulsed light, and later with dermabrasion or shaving. Late adverse events also include immunologic phenomena such as late-onset allergy and nonallergic foreign body granuloma. Both react well to intralesional steroid injections, which often have to be repeated to establish the right dose. Surgical excisions shall remain the last option and are indicated for hard lumps in the lips and visible hard nodules or hard granuloma in the subcutaneous fat.
authors.affiliation: Division of Plastic Surgery, University of California, USA.
authors.forename: Gottfried
authors.initials: G
authors.lastname: Lemperle
authors.forename: Peter P
authors.initials: PP
authors.lastname: Rullan
authors.forename: Nelly
authors.initials: N
authors.lastname: Gauthier-Hazan
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D001327:Autoimmune Diseases / Q000209:etiology; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000009:adverse effects* / Q000145:classification; D002417:Cattle; D002921:Cicatrix / Q000628:therapy; D000075202:Contraindications; D003869:Dermabrasion; D048909:Diabetes Complications; D004342:Drug Hypersensitivity / Q000209:etiology / Q000517:prevention & control; D004438:Ecchymosis / Q000209:etiology / Q000517:prevention & control; D004487:Edema / Q000209:etiology / Q000517:prevention & control; D004890:Erythema / Q000209:etiology / Q000517:prevention & control; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use; D015745:Granuloma, Foreign-Body / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D039682:HIV-Associated Lipodystrophy Syndrome / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D007271:Injections, Intradermal / Q000009:adverse effects / Q000379:methods; D007279:Injections, Subcutaneous / Q000009:adverse effects / Q000379:methods; D053685:Laser Therapy; D008405:Massage; D010789:Phototherapy; D012060:Rejuvenation; D015595:Skin Aging; D014182:Transplantation, Autologous
chemical_list: D000305:Adrenal Cortex Hormones; D001672:Biocompatible Materials; D005472:Fluorouracil