Adverse reactions caused by consecutive injections of different fillers in the same facial region: risk assessment based on the results from the Injectable Filler Safety study.
BACKGROUND
The combination of different injectable fillers in one area is considered to increase the risk of adverse reactions.


OBJECTIVE
To characterize adverse reactions in patients who received more than one filler in the same facial region.


METHODS
Data (up to July 2009) of the Injectable Filler Safety Study, a German-based registry for adverse filler reactions, was analysed descriptively. All cases were discussed individually.


RESULTS
In 22 of the 161 patients (13.7%), two or more different fillers were injected consecutively into the same facial region. All patients were female with an average age of 50.6 (SD 13.6) years. In 12 of the 22 patients (54.5%), a specific filler could be attributed to the adverse reactions whereas in the other 10 patients (45.5%), the filler was not clearly attributable to one filler substance causing the adverse reactions.


CONCLUSIONS
With the continuous changes in the filler market, the combination of different fillers in one area becomes more likely. Based on our data, there is not a lot of evidence that the combination of different injectable fillers, specifically biodegradable fillers, in the same region increases the risk of adverse reactions.
Division of Evidence Based Medicine, Department of Dermatology, Charité-Universitätsmedizin Berlin, Charité, Charitéplatz 1, Berlin, Germany. frank.bachmann@charite.de
F
F
Bachmann
R
R
Erdmann
V
V
Hartmann
P
P
Becker-Wegerich
L
L
Wiest
B
B
Rzany
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000009:adverse effects*; D003357:Cosmetic Techniques / Q000009:adverse effects*; D003879:Dermatologic Agents / Q000009:adverse effects*; D004347:Drug Interactions; D005145:Face; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects; D007279:Injections, Subcutaneous / Q000009:adverse effects; D019344:Lactic Acid / Q000009:adverse effects; D008297:Male; D008768:Methylmethacrylates / Q000009:adverse effects; D008875:Middle Aged; D011091:Polyesters; D011102:Polyhydroxyethyl Methacrylate / Q000009:adverse effects; D011108:Polymers / Q000009:adverse effects; D019904:Polymethyl Methacrylate / Q000009:adverse effects; D012042:Registries; D018570:Risk Assessment; D055815:Young Adult
D001672:Biocompatible Materials; D003879:Dermatologic Agents; D008768:Methylmethacrylates; D011091:Polyesters; D011108:Polymers; D011102:Polyhydroxyethyl Methacrylate; D019344:Lactic Acid; C033616:poly(lactide); C009931:poly(ethylmethacrylate); D006820:Hyaluronic Acid; D019904:Polymethyl Methacrylate