title: Understanding the safety and tolerability of facial filling therapeutics.
abstract: BACKGROUND
  Aesthetic medicine represents an emerging field for many specialties. Nowadays, a plethora of approaches are available to rejuvenate the human body and face, the latter being a frequent target for the placement of filling substances to correct wrinkles and volume loss. Nevertheless, based on the many products on the market, treating clinicians must pay specific attention to the properties of the respective materials, their associated side effects and any specific handling requirements to prevent potential short- and long-term adverse events.
  
  
  METHODS
  Types of filling materials, including biodegradable and non-biodegradable products, related complications, their conservative and invasive treatment options, as well as prevention strategies are described in this review.
  
  
  CONCLUSIONS
  A profound knowledge of the facial anatomy as well as extensive experience with the various filling techniques and suitable materials for the respective areas remains crucial to prevent adverse events associated with filling procedures to the human face. Since side effects such as malar edema and foreign body granuloma do affect patients physically and psychologically to a significant extent and their successful treatment still remains challenging, further in depth studies on the tolerability of many filling materials utilized are required.
authors.affiliation: Ludwig Maximilian University, Department of Dermatology and Allergology, Munich, Germany , Frauenlobstr. 9-11, 80337 Munich , Germany +011 49 89 5160 6010 ; +011 49 89 5160 6002 ; daniela.kulichova@med.uni-muenchen.de.
authors.forename: Daniela
authors.initials: D
authors.lastname: Kulichova
authors.forename: Alyona
authors.initials: A
authors.lastname: Borovaya
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruzicka
authors.forename: Peter
authors.initials: P
authors.lastname: Thomas
authors.forename: Gerd G
authors.initials: GG
authors.lastname: Gauglitz
mesh_terms: D001672:Biocompatible Materials / Q000008:administration & dosage / Q000009:adverse effects; D003357:Cosmetic Techniques / Q000009:adverse effects*; D004487:Edema / Q000209:etiology / Q000473:pathology; D005145:Face; D015745:Granuloma, Foreign-Body / Q000209:etiology / Q000473:pathology; D006801:Humans; D012060:Rejuvenation; D015595:Skin Aging; D013997:Time Factors
chemical_list: D001672:Biocompatible Materials
keywords: aesthetic medicine; complications; dermal fillers; foreign body granulomas; malar edema