Advanced laser techniques for filler-induced complications.
BACKGROUND
The increasing use of injectable fillers has been increasing the occurrence of disfiguring anaerobic infection or granulomas. This study presents two types of laser-assisted evacuation of filler material and inflammatory and necrotic tissue that were used to treat disfiguring facial nodules after different types of gel fillers.


METHODS
Infectious lesions after hydrogels were drained using a lithium triborate laser at 532 nm, with subsequent removal of infected gel and pus (laser assisted evacuation). Granuloma after gels containing microparticles were treated using an 808-nm diode laser using intralesional laser technique. The latter melted and liquefied the organic and synthetic components of the granulomas, facilitating subsequent evacuation. Both lasers had an easily controllable thin laser beam, which enabled the physician to control tissue damage and minimize discomfort and pain.


RESULTS
All 20 patients experienced reduction or complete resolution, the latter increasing with repeated treatments.


CONCLUSIONS
Laser-assisted treatment offers a successful solution for patients who have been suffering from disfiguring nodules from injected fillers-often for many years. The procedure broadens the range of treatment options in cases of untoward reactions to fillers, in line with surgical removal but with lower morbidity and less cosmetic disfigurement.
Cassuto
Daniel
D
Department of Plastic Surgery, University of Catania, Catania, Italy. daniel.cassuto@fastwebnet.it
Marangoni
Ovidio
O
De Santis
Giorgio
G
Christensen
Lise
L
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000009:adverse effects*; D005145:Face / Q000473:pathology*; D005260:Female; D015745:Granuloma, Foreign-Body / Q000139:chemically induced / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007279:Injections, Subcutaneous; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D008027:Light; D008094:Lithium; D008297:Male; D008875:Middle Aged; D012060:Rejuvenation; D015595:Skin Aging; D013997:Time Factors; D016896:Treatment Outcome
D001672:Biocompatible Materials; D008094:Lithium