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Rapid response needed for rare filler injection complications



Filler products are not interchangeable

Again, because of passive data collection, it is not clear whether the differences between products is a true representation of relative risk. Nevertheless, Dr. Galadari cautioned that these products are not necessarily interchangeable, advising clinicians to avoid products without an established safety track record.

There are a wide variety of fillers, including biostimulatory products, such as poly-L-lactic acid and calcium hydroxyapatite, and permanent fillers, such as silicone, in addition to collagen and hyaluronic acid, which function as temporary fillers, according to Dr. Galadari. He emphasized that the specific risks of each filler vary, but clinicians should always respond quickly whenever there is an adverse reaction or evidence of vascular compromise.

Cheryl Burgess, MD, president and founder of the Center for Dermatology and Dermatologic Surgery, Washington, DC.

Dr. Cheryl Burgess

In flushing out filler, Cheryl M. Burgess, MD, of the Center for Dermatology and Dermatologic Surgery, Washington, who spoke at the meeting, also emphasized a prompt response. She too employs hyaluronidase injections to break down excess hyaluronic acid in the event of complications related to this filler.

Importantly, Dr. Burgess pointed out that hyaluronic acid can be considered safe for darker skin types, including Fitzpatrick skin types IV, V, and VI, but she added that speed of injection might be a particularly important variable for cosmetic procedures in skin of color.

“There is less postinflammatory hyperpigmentation with slower injection times and more with serial or multiple puncture injection technique,” she cautioned.

She further concurred with the value of cannulas over needles in most instances for facial contouring applications with filler, but she encouraged clinicians not to be overly ambitious and to move gradually toward goals.

“The desired outcome may require multiple sessions with conservative measures,” she said, indicating that conservative measures also represent a strategy to avoid adverse events.


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