Jordan David R, Stoica Bazil
Department of Ophthalmology, University of Ottawa, Ottawa, Ontario, Canada.
Ophthalmic Plast Reconstr Surg. 2015 Jul-Aug;31(4):257-62. doi: 10.1097/IOP.0000000000000368.
To report 3 representative cases of soft tissue filler identified in locations other than their intended injected sites (possible migration) and review the literature on pathogenesis of filler migration.
Soft tissue fillers are continuing to increase in popularity throughout North America and worldwide as a means of volume restoration and contour enhancement. With increasing recognition of their value in restoring a more youthful appearance and the ease of office injection, soft tissue fillers have become one of the most commonly performed nonsurgical cosmetic procedures. Soft tissue fillers are also foreign bodies in our system and therefore have the potential for a myriad of complications both immediately after the injection and potentially months or years later. Filler migration is one such complication and has a number of potential mechanisms.
The authors reviewed the medical records of 3 patients with filler located in areas other than their intended injected sites possibly as a result of migration. All patients were from the practice of 1 individual (DRJ). A MEDLINE search of the English-language literature on filler migration was conducted to investigate the various causes responsible for migration of filler.
Clinical manifestations of the possible filler migration in the 3 cases included eyelid swelling in 2 patients and a noninflammatory mass adjacent to the area of filler injection in the third patient. Surgery was performed on 1 patient, and filler was visualized in the tissue and dissolved with hyaluronidase. Hyaluronidase was also used to dissolve the suspected filler in a second patient, and the third patient has elected to continue with observation.
Filler migration is one of the potential complications associated with the injection of soft tissue fillers. It is important all physicians assessing nodules/masses/swelling in the facial area be aware that soft tissue fillers may migrate to a location away from their intended site of injection by several mechanisms and persist in the tissue even years later. A delayed reaction to the filler may occur months to years later and at times subject the patient to unnecessary investigations in attempt to identify it.
报告3例软组织填充剂出现在预期注射部位以外（可能发生迁移）的典型病例，并回顾有关填充剂迁移发病机制的文献。
作为一种一种一种一种恢复容积和改善轮廓的手段，软组织填充剂在北美和全球范围内越来越受欢迎。随着人们越来越认识到其在恢复更年轻外观方面的价值以及办公室注射的便利性，软组织填充剂已成为最常见的非手术美容手术之一。软组织填充剂在我们的系统中也是异物，因此在注射后即刻以及数月或数年之后都有可能引发无数并发症。填充剂迁移就是这样一种并发症，并且有多种潜在机制。
作者回顾了3例填充剂可能因迁移而出现在预期注射部位以外区域的患者的病历。所有患者均来自同一位医生（DRJ）的诊所。对关于填充剂迁移的英文文献进行了MEDLINE检索，以调查导致填充剂迁移的各种原因。
3例可能的填充剂迁移的临床表现包括2例患者出现眼睑肿胀，第3例患者在填充剂注射区域附近出现非炎性肿块。对1例患者进行了手术，在组织中看到了填充剂并用透明质酸酶将其溶解。透明质酸酶也用于溶解第2例患者中疑似的填充剂，第3例患者选择继续观察。
填充剂迁移是与软组织填充剂注射相关的潜在并发症之一。所有评估面部结节/肿块/肿胀的医生都应认识到，软组织填充剂可能通过多种机制迁移到远离其预期注射部位的位置，并且甚至在数年之后仍会留在组织中。对填充剂的迟发性反应可能在数月至数年之后出现，有时会使患者接受不必要的检查以试图识别它。
