Pròspere Facial Institute, No 300, Avenida Moema.
Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
J Craniofac Surg. 2022;33(1):e76-e78. doi: 10.1097/SCS.0000000000008012.
The use of hyaluronic acid (HA) fillers in lip augmentation represents today 1 of the most widely used nonsurgical aesthetic procedures in the world. Regarding the severe complications are rare, insufficient professional experience for recognizing signs of vascular impairment and inadequate technique could lead to severe lip skin necrosis complications. Several of existing treatment protocols in the literature to treat vascular complication are mainly based on the use of hyaluronidase. Nevertheless, there is no consensus on dosage, interval between doses and complementary protocol among the aforementioned studies. This case aims to present a conservative approach for the clinical management of serious vasculature complications with HA injection. A high dose of hyaluronidase(11500 IU) with additional multimodal treatment was performed to the upper lip, nasolabial fold, and nose that successfully reversed a vascular complication process. The present findings suggest that the use of high doses of hyaluronidase with the complementary protocol used herein might be a promising approach in the treatment of severe vascular complication in the lips caused by HA filling.
透明质酸（HA）填充剂在丰唇中的应用是当今世界上最广泛使用的非手术美容程序之一。尽管严重并发症较为罕见，但由于缺乏识别血管损伤迹象的专业经验和技术不足，可能会导致严重的唇部皮肤坏死并发症。目前文献中存在的几种治疗血管并发症的方案主要基于透明质酸酶的使用。然而，上述研究之间在剂量、剂量间隔和补充方案方面尚未达成共识。本案例旨在提出一种针对 HA 注射严重血管并发症的临床保守治疗方法。在上唇、鼻唇沟和鼻子上使用了高剂量的透明质酸酶（11500IU）和额外的多模式治疗，成功逆转了血管并发症过程。本研究结果表明，使用高剂量透明质酸酶并辅以本文中使用的补充方案可能是治疗由 HA 填充引起的唇部严重血管并发症的一种有前途的方法。
