title: Complications of collagen fillers.
abstract: As the skin ages, a deficiency in collagen occurs, thus injectable collagen products have become a sensible and popular option for dermal filling and volume enhancement. Several types of collagen have been developed over the years, including animal sources such as bovine and porcine collagen, as well as human-based sources derived from pieces of the patient's own skin, cadaver skin, and later cultured from human dermal fibroblasts. While collagen overall has a relatively safe, side effect profile, there are several complications, both early and late onset, that practitioners and patients should be aware of. Early complications, occurring within days of the procedure, can be divided into non-hypersensitivity and hypersensitivity reactions. The non-hypersensitive reactions include injection site reactions, discoloration, maldistribution, infection, skin necrosis, and the very rare but dreaded risk of vision loss, whereas the hypersensitivity reactions present usually as delayed type IV reactions, but can also rarely present as an immediate type I reaction. Late complications, occurring within weeks to even years after injection, include granuloma formation, foreign body reactions, and infection secondary to atypical mycobacteria or biofilms. This review will give a detailed overview of the complications secondary to cutaneous collagen injections.
authors.affiliation: Department of Dermatology, Albert Einstein College of Medicine/Montefiore Medical Center, New York, New York.
authors.forename: Patricia
authors.initials: P
authors.lastname: Lucey
authors.affiliation: Skin Laser and Surgery Specialists of NY/NJ, New Jersey.
authors.forename: David J
authors.initials: DJ
authors.lastname: Goldberg
mesh_terms: D001672:Biocompatible Materials / Q000009:adverse effects*; D003094:Collagen / Q000009:adverse effects*; D003357:Cosmetic Techniques; D004342:Drug Hypersensitivity / Q000209:etiology; D004487:Edema / Q000139:chemically induced; D004890:Erythema / Q000139:chemically induced; D005148:Facial Dermatoses / Q000139:chemically induced*; D006099:Granuloma / Q000139:chemically induced*; D006801:Humans; D007267:Injections / Q000009:adverse effects; D009336:Necrosis / Q000139:chemically induced; D012867:Skin / Q000473:pathology*; D015595:Skin Aging; D017192:Skin Diseases, Bacterial / Q000139:chemically induced
chemical_list: D001672:Biocompatible Materials; D003094:Collagen