title: Undesirable effects after treatment with dermal fillers.
abstract: BACKGROUND
  Soft tissue augmentation is one of the most frequent techniques in cosmetic dermatology. Nowadays, there are a high number of available materials. Nonanimal hyaluronic acid (HA) is one of most useful fillers for lip augmentation and for treating nasolabial folds, marionette lines, and the dynamic wrinkles of the upper face.
  
  
  OBJECTIVE
  To evaluate the type and management of undesirable effects of nonanimal reticulated or stabilized HA observed in our cosmetic unit in the past 3 years.
  
  
  METHODS
  The consecutive patients using HA attending to our clinic in the past 3 years were divided into 3 categories, according to the time of presentation of the adverse reactions: immediate, early, and late-onset complications. All patients were treated.
  
  
  RESULTS
  Twenty-three patients presented to our clinic complaining of complications after soft tissue augmentation with HA. Ten patients presented immediate-onset complications, 8 showed early-onset complications, and 5 cases complaint of late-onset complications. Treatment of the first group consisted of hyaluronidase injection, massage, and topical antibiotics. Early- and late-onset complications were treated with intralesional triamcinolone acetonide. All patients improved, with the exception of a woman with recurrent granulomas.
  
  
  CONCLUSIONS
  Generally, undesirable effects of HA (immediate, early, or late onset) are not frequent, and when present, they improve if treated properly. Physicians need to be aware of these possible adverse events in order to establish proper treatment and prevent scarring or other sequelae.
authors: Department of Medical-Surgical Dermatology, Hospital Clínico Virgen Macarena School of Medicina, University of Seville, Seville, Spain.
authors: Ana Rita
authors: AR
authors: Rodrigues-Barata
authors: Francisco M
authors: FM
authors: Camacho-Martínez
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003357:Cosmetic Techniques / Q000009:adverse effects*; D005145:Face; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects*; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage / Q000627:therapeutic use; D015552:Injections, Intralesional; D008405:Massage / Q000379:methods; D015595:Skin Aging / Q000187:drug effects*; D013997:Time Factors; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D006820:Hyaluronic Acid; D006821:Hyaluronoglucosaminidase; D014222:Triamcinolone Acetonide