School of Medicine, Tulane University School of Medicine, New Orleans, Louisiana.
Department of Otolaryngology-Head and Neck Surgery, Mass Eye and Ear, Boston, Massachusetts.
Facial Plast Surg. 2022 Jun;38(3):250-259. doi: 10.1055/s-0041-1736390. Epub 2021 Oct 19.
Tear trough deformity is a popular target for the treatment with filler injections. The side effects are generally mild and transient. However, delayed complications may occur. We aim to perform a thorough systematic review of the published literature related to delayed complications after tear trough filler injections. A search of published literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in June 2021 and included PubMed, ScienceDirect, and Embase databases. The Medical Subject Headings (MeSH) terms used included the following terms: delayed complications, nodules, granulomas, swelling, discoloration, dermal filler, hyaluronic acid (HA), polyacrylamide, calcium hydroxyapatite (CaHA), poly-L-lactic acid (PLLA), eyelid, periorbital, periocular, and tear trough. Twenty-eight articles consisting of 52 individual cases were included in the final analysis. 98% (51/52) of patients were female and had an average age of 48.3 years. HA was the most reported product (71.2%, 37/52), followed by PLLA (4/52, 7.7%), and CaHA (4/52, 7.7%). The most common delayed complication with any dermal filler was swelling (42.3%, 22/52) followed by lumps or nodules (25.0%, 13/52). Xanthelasma-like reaction (17.3%, 9/52), migration (7.7%, 4/52), discoloration (3%, 3/52) also occurred. The average time of onset of any complication was 16.8 months with xanthelasma-like reaction appearing soonest (mean: 10 months) and discoloration appearing latest (mean: 52 months). Most swelling cases were caused by HA. Semi-permanent fillers such as PMMA and synthetic fillers such as PLLA were more likely to be associated with lumps and nodules than other complications. It is important that clinicians who perform tear trough augmentation with dermal fillers have a thorough understanding of the risks of the procedure to diagnose and manage them promptly as well as provide patients with accurate information regarding the potential adverse effects.
泪槽畸形是填充注射治疗的热门目标。副作用一般较轻且短暂。然而，可能会出现延迟性并发症。我们旨在对已发表的与泪槽填充注射后延迟性并发症相关的文献进行全面系统的综述。根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，于 2021 年 6 月对已发表的文献进行了搜索，并包括 PubMed、ScienceDirect 和 Embase 数据库。使用的医学主题词（MeSH）术语包括以下术语：延迟性并发症、结节、肉芽肿、肿胀、变色、真皮填充剂、透明质酸（HA）、聚丙烯酰胺、羟基磷灰石钙（CaHA）、聚左旋乳酸（PLLA）、眼睑、眶周、眼周和泪槽。最终分析包括 28 篇文章，共 52 个单独病例。98%（51/52）的患者为女性，平均年龄为 48.3 岁。HA 是报告最多的产品（71.2%，37/52），其次是 PLLA（4/52，7.7%）和 CaHA（4/52，7.7%）。任何真皮填充物最常见的延迟性并发症是肿胀（42.3%，22/52），其次是肿块或结节（25.0%，13/52）。类黄瘤样反应（17.3%，9/52）、迁移（7.7%，4/52）、变色（3%，3/52）也发生。任何并发症的平均发病时间为 16.8 个月，类黄瘤样反应出现最早（平均 10 个月），变色出现最晚（平均 52 个月）。大多数肿胀病例是由 HA 引起的。半永久性填充物如 PMMA 和合成填充物如 PLLA 比其他并发症更有可能与肿块和结节有关。进行真皮填充剂泪槽填充的临床医生需要充分了解该手术的风险，以便及时诊断和处理，并向患者提供有关潜在不良反应的准确信息。
