Department of Surgery "P. Valdoni", Unit of Plastic Surgery "P. Valdoni", Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
Department of Surgery "P. Valdoni", Unit of Plastic Surgery "P. Valdoni", Sapienza University of Rome, Via Franco Sacchetti 19, 00137, Rome, Italy.
Aesthetic Plast Surg. 2022 Apr;46(2):886-894. doi: 10.1007/s00266-021-02650-4. Epub 2021 Nov 23.
Dermal fillers have been progressively used for cosmetic procedures. Concurrently, the rates of filler complications have also increased. The aim of this study is to describe the clinical management and treatment we performed in patients with complications occurred after filler injection.
From March 2000 to February 2020, 197 patients have been evaluated for complications due to filler injection. For each patient type of material, symptoms and signs were recorded. Ultrasound evaluation was used to obtain information about the type, amount and location of the injected material. Magnetic Resonance Imaging was performed in those patients who were candidate for surgery. Based on the clinical manifestations, we performed a targeted therapy.
The local and systemic medical therapy allowed us a complete remission of the clinical signs and symptoms in all patients presented with edema and erythema. We obtained optimal results with surgery, where a complete removal of the injected material was possible. In all the cases in which the complete removal of the infiltrated area could have led to functional impairments, we performed partial removal with poor outcomes.
We observed complex clinical manifestations in the patients subjected to permanent fillers. An accurate knowledge upon the effects of the materials on tissues, a specific instrumental evaluation and a targeted therapy are crucial. We suggest the use of absorbable fillers. Patient should be subjected to filler implant in authorized structures by an expert specialist with experience in filler injection and with a thorough knowledge of the anatomical structures.
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真皮填充剂已逐渐用于美容手术。同时，填充物并发症的发生率也有所增加。本研究旨在描述我们在填充物注射后发生并发症的患者中进行的临床处理和治疗。
2000 年 3 月至 2020 年 2 月，对 197 例因填充物注射引起并发症的患者进行了评估。记录每位患者的材料类型、症状和体征。超声评估用于获取有关注射材料的类型、数量和位置的信息。对有手术适应证的患者进行磁共振成像检查。根据临床表现，我们进行了针对性治疗。
局部和全身药物治疗使所有出现肿胀和红斑的患者的临床症状和体征完全缓解。我们通过手术获得了最佳效果，在这些病例中可以完全清除注射材料。在所有可能导致功能障碍的情况下，我们仅进行了部分清除，效果较差。
我们观察到接受永久性填充物的患者出现了复杂的临床表现。准确了解材料对组织的影响、进行特定的仪器评估和进行针对性治疗至关重要。我们建议使用可吸收填充物。患者应在有经验的专家在有填充物注射经验且对解剖结构有深入了解的授权机构中接受填充物植入。
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