Management of complications and sequelae with temporary injectable fillers

BACKGROUND: Injectable nonpermanent soft-tissue augmentation materials are extremely well-tolerated products that can be used safely in virtually all patients who are candidates for facial augmentation. In this article, the authors review the management of the few common and minor undesirable effects that may be associated with temporary fillers; in addition, the authors mention the rare incidence of serious complications. METHODS: The authors conducted a MEDLINE-based (1990 to 2005) review of complications and side effects of nonpermanent injectable filler materials. This review was supplemented with evidence presented at recent plastic surgery and dermatology scientific meetings and unpublished information made available to the authors. RESULTS: Nonpermanent injectable soft-tissue augmentation materials are extremely safe substances that are unlikely to cause more than mild injection discomfort, transient redness and swelling, and occasional short-term bruising when used for facial augmentation. Symmetry can usually be maintained with judicious bilateral use of injectant, and injection-site necrosis is rare and treatable. Proper technique minimizes the already very low risk of visible implants, nodule formation, and hypersensitivity reactions. Other serious effects are exceedingly rare, and retinal artery thrombosis, previously associated with injectable collagen, has not been seen with newer fillers. CONCLUSIONS: Injectable nonpermanent fillers are extremely safe substances. Attention to injection technique further minimizes the low risk of adverse events, which are usually minor, spontaneously resolving, and easily treated.