Di Santis Érico Pampado, Hirata Sergio Henrique, Di Santis Giulia Martins, Yarak Samira
Postgraduate Program in Evidence-Based Health, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Postgraduate Program in Evidence-Based Health, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
An Bras Dermatol. 2025 Jan-Feb;100(1):87-103. doi: 10.1016/j.abd.2024.04.007. Epub 2024 Nov 29.
To evaluate the adverse effects of facial aesthetic treatments using botulinum toxin and biomaterial implants.
The bibliographic research for this narrative review considered articles published in journals from the Medline, Pubmed, Embase and Lilacs databases with the following terms: "dermal fillers AND complications, vascular complications AND dermal fillers, adverse reaction, AND toxin botulinum and adverse reaction AND dermal fillers". Inclusion criteria were articles available in English on adverse events with the aesthetic use of botulinum toxin and dermal fillers/biostimulators.
The demonstration of complications increases simultaneously with the progressive performance of facial aesthetic procedures. Quantitative statistics of the procedures and the countries that use them are skillfully classified, as well as the prosperity trends of these procedures. Complications do not receive the same relevance. There is a deficiency in dissemination of the information by the scientific community, or in other words, there is a publication bias in favor of successful results as opposed to adverse events.
The lack of knowledge about complications arising from so widely publicized and performed procedures prevents the development of evidence-based guidelines. Complications in aesthetic procedures have become a public health problem, an epidemic that occurs under the supervision of health authorities. Mandatory reporting of adverse events occurring in aesthetic procedures that require medical care aims to fill this gap. With reliable and technical data, it will be possible to identify the causes and perform interventions capable of minimizing irreversible sequelae and deaths. Complications should be promptly recognized by the dermatologist so that, when possible, they can be reversed or adequately managed.
评估使用肉毒杆菌毒素和生物材料植入物进行面部美容治疗的不良反应。
本次叙述性综述的文献研究考虑了发表在Medline、Pubmed、Embase和Lilacs数据库期刊上的文章，使用了以下检索词：“真皮填充剂与并发症”、“血管并发症与真皮填充剂”、“不良反应与肉毒杆菌毒素”以及“不良反应与真皮填充剂”。纳入标准为以英文发表的关于肉毒杆菌毒素和真皮填充剂/生物刺激剂美容使用不良事件的文章。
随着面部美容手术的逐步开展，并发症的发生率也在同步上升。对手术及其使用国家进行了巧妙的定量统计，以及这些手术的发展趋势。并发症受到的关注程度不一。科学界在信息传播方面存在不足，换句话说，存在偏向成功结果而非不良事件的发表偏倚。
对于如此广泛宣传和开展的手术所引发的并发症缺乏了解，阻碍了循证指南的制定。美容手术中的并发症已成为一个公共卫生问题，是在卫生当局监管下发生的一种流行病。对需要医疗护理的美容手术中发生的不良事件进行强制报告旨在填补这一空白。有了可靠的技术数据，就有可能确定原因并采取能够将不可逆后遗症和死亡降至最低的干预措施。皮肤科医生应及时识别并发症，以便在可能的情况下使其得到逆转或得到妥善处理。
