Plastic and Reconstructive Surgery Unit, Department of Burns and Plastic Surgery, Fourth Medical Center, PLA General Hospital, Beijing, China.
Department of Ophthalmology of The Third Medical Center of Chinese PLA General Hospital, Beijing, China.
Aesthet Surg J. 2023 Feb 3;43(2):NP77-NP83. doi: 10.1093/asj/sjac270.
Necrosis of frontotemporal skin and/or the ipsilateral scalp with subsequent alopecia after hyaluronic acid (HA) filler injection into the temple is rare complications with superficial temporal artery embolization are suspected as the major pathological mechanism. The main treatment currently is intralesional hyaluronidase (HAase) injection, but the effectiveness of percutaneous superficial temporal arterial HAase injection still lacks consensus.
To investigate the effectiveness of superficial temporal arterial HAase injection in dissolving HA filler-induced necrosis of frontotemporal skin and/or the ipsilateral scalp with subsequent alopecia.
Five recent clinical cases with necrosis of frontotemporal skin and/or the ipsilateral scalp with subsequent alopecia after HA filler injection into the temple were analyzed retrospectively. The patients underwent HAase injection via superficial temporal artery combined with adjunctive treatments, and the clinical progress was observed.
Significant improvement was observed in terms of necrosis of frontotemporal skin and the ipsilateral scalp after treatment, and the patients were relieved of their clinical symptoms. Alopecia occurred approximately 1 to 2 weeks after HA filler injection, and the well-defined alopecia areas were formed 15 to 20 days after HAase injection. Patients were followed for 3 to 6 months. During follow-up, the skin lesions of all patients were restored to near normal appearance. Hair regrowth was observed 2 to 3 months after HAase treatment, and hair density nearly reached the normal level 3 to 4 months later.
Percutaneous superficial temporal arterial HAase injection is an effective treatment option for HA filler-induced necrosis of frontotemporal skin and/or the ipsilateral scalp with subsequent alopecia.
透明质酸（HA）填充剂注射到太阳穴后，出现额颞部皮肤和/或同侧头皮坏死伴随后脱发是罕见的并发症，推测其主要的病理机制是颞浅动脉栓塞。目前主要的治疗方法是病灶内透明质酸酶（HAase）注射，但经皮颞浅动脉 HAase 注射的有效性仍缺乏共识。
探讨经皮颞浅动脉 HAase 注射治疗 HA 填充剂诱导的额颞部皮肤和/或同侧头皮坏死伴随后脱发的疗效。
回顾性分析 5 例因 HA 填充剂注射到太阳穴后出现额颞部皮肤和/或同侧头皮坏死伴随后脱发的近期临床病例。所有患者均接受 HAase 经颞浅动脉注射联合辅助治疗，并观察临床进展。
治疗后额颞部皮肤和同侧头皮的坏死明显改善，患者的临床症状得到缓解。脱发大约在 HA 填充剂注射后 1 至 2 周发生，在 HAase 注射后 15 至 20 天形成明确的脱发区域。患者随访 3 至 6 个月。在随访期间，所有患者的皮肤病变均恢复到接近正常外观。HAase 治疗后 2 至 3 个月观察到头发再生，3 至 4 个月后头发密度几乎达到正常水平。
经皮颞浅动脉 HAase 注射是治疗 HA 填充剂诱导的额颞部皮肤和/或同侧头皮坏死伴随后脱发的有效治疗选择。
