Shi Tianqi, Lin Hui, Zhang Jingjing, Wei Chengjiang, Ou Yuanbin, Wang Linna, Wen Qing
Department of Laser and Plastic Surgery, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi, People's Republic of China.
School of Basic Medical Sciences, Guangxi University of Chinese Medicine, Nanning, Guangxi, People's Republic of China.
J Cosmet Dermatol. 2025 Jul;24(7):e70314. doi: 10.1111/jocd.70314.
More and more people inject fillers to fill their glabellar wrinkles, and complications are on the rise.
A 36-year-old woman was given a local infiltration anesthetic, and then a 22G sharp needle with an empty syringe was utilized to puncture several times near the subcutaneous tissue to form a tunnel. When we squeezed the tunnel, there was no bleeding, and then the needle was replaced by a 22G dull needle. The empty syringe was replaced by a hyaluronic acid gel syringe, and a small amount of hyaluronic acid was slowly given while withdrawing the needle. Skin swelling and bruising occurred 15 h after injection. Hyaluronase was injected into the ischemic area and treated with specific electromagnetic wave and vasodilators. Epidermal erosion appeared; however, it healed within 1 week without scar.
Vascular embolism may be due to the needle piercing the blood vessel, a small amount of gel was forced into the pierced vessel, or the shear force of blood flow carried tiny gel particles into the vessel. The glabella is one of the most dangerous locations for hyaluronic acid injection because of possible vascular embolism. The use of preformed tunnels, thick dull needle, and aspiration without blood are not absolutely safe, and patients should be informed of the clinical manifestations of embolization before injection, and follow-up informed after injection.
越来越多的人注射填充剂来填充眉间纹，并发症也在增加。
一名36岁女性接受局部浸润麻醉，然后使用一支带有空注射器的22G锐针在皮下组织附近穿刺数次以形成隧道。当挤压隧道时无出血，然后将针换成22G钝针。将空注射器换成透明质酸凝胶注射器，在拔针的同时缓慢注入少量透明质酸。注射后15小时出现皮肤肿胀和瘀斑。向缺血区域注射透明质酸酶，并采用特定电磁波和血管扩张剂进行治疗。出现表皮糜烂；然而，1周内愈合且无瘢痕。
血管栓塞可能是由于针刺穿血管，少量凝胶被挤入被刺穿的血管，或者血流的剪切力将微小的凝胶颗粒带入血管。由于可能发生血管栓塞，眉间是透明质酸注射最危险的部位之一。使用预制隧道、粗钝针以及回抽无血并非绝对安全，应在注射前告知患者栓塞的临床表现，并在注射后告知随访注意事项。
