Complications with the use of hyaluronic acid in facial harmonization

Authors

DOI:

https://doi.org/10.33448/rsd-v11i5.28052

Keywords:

Dermal fillers; Adverse reaction; Hyaluronic acid.

Abstract

Hyaluronic acid is a compound found in the body responsible for attracting and absorbing high amounts of water, improving the elasticity and softness of the skin. This substance is the most used in facial fillers because it offers greater practicality in application, a good margin of safety and great biocompatibility. Filling with hyaluronic acid is intended to fill grooves, folds, improve facial contours and restore or improve tissue volume. Despite having a good safety profile, there are several complications related to the use of this substance by injection. Objective: To identify the possible complications that can occur with the use of hyaluronic acid in facial harmonization, to disseminate in an accessible way a compilation of studies. Methods: A narrative review of the literature was carried out with the collection of articles from clinical reports in the Scientific Electronic Library Online (sciELO), National Library of Medicine (PubMed) - MEDLINE and Virtual Health Library (BVS) - LILACS databases. Results: 20 articles were selected and divided according to the time in which the intercurrence occurred. The studies mainly reported vascular complications, edema, infection, nodules and granulomas caused by non-animal (synthetic) fillers. The most frequently applied places were the puppet's nose and lines. Conclusion: The wrong handling of filling with hyaluronic acid can cause several immediate, early and even late complications, and there may be no solution to the problem. Thus, it is necessary that injectors have knowledge of facial anatomy in addition to being aware of the possible risks of this procedure.

References

Almeida, A. T., Banegas, R., Boggio, R., Bravo, B., Braz, A., Casabona, G., Coimbra, D., Espinosa, S. & Martinez, C. (2017). Diagnóstico e tratamento dos eventos adversos do ácido hialurônico: Recomendações de consenso do painel de especialistas da América Latina. Surgical and Cosmetic Dermatology, 9(3), 204-213

Ansari, Z. A., Choi, C. J., Rong, A. J., Erickson, B. P. & Tse, D. T. (2019). Ocular and cerebral infarction from periocular filler injection. Orbit (London), 38(4), 322-324

Bae, I. H., Kim, M. S., Choi, H., Na, C. H. & Shin, B. S. (2018). Ischemic oculomotor nerve palsy due to hyaluronic acid filler injection. Journal of Cosmetic Dermatology, 17(6), 1016-1018

Bhojani-Lynch, T. (2017). Late-onset inflammatory response to hyaluronic acid dermal fillers. Plastic and Reconstructive Surgery - Global Open, 5(12), 1–7

Braga, J. B., Santos, C. C., Costa, F. D. & Alves, T. V. (2022). Uso do ácido hialurônico em procedimentos de harmonização facial pelo farmacêutico-esteta: uma revisão integrativa. Research, Society and Development, 11(4), 1-12

Bravo, B. S., Balassiano, L. K., Rocha, C. R., Padilha, C. B., Torrado, C. M., Silva, R. T & Avelleira, J. C (2015). Delayed-type Necrosis after Soft-tissue Augmentation With Hyaluronic Acid. Journal of Clinical and Aesthetic Dermatology, 8(12), 42-47

Cassiano, D., Iida, T. M., Recio, A. L. & Yarak, S. (2020). Delayed skin necrosis following hyaluronic acid filler injection: A case report. Journal of Cosmetic Dermatology, 19(3), 582–584

Cavallieri, F.A. Balassiano, L.K., Bastos, J.T., Fontoura, G.H., Almeida, A.T. (2017). Edema tardio intermitente e persistente ETIP: Reação adversa tardia ao preenchedor de ácido hialurônico. Surgical and Cosmetic Dermatology, 9(3), 218–222

Chen, Q., Liu, Y. & Fan, D. (2016). Serious Vascular Complications after Nonsurgical Rhinoplasty. Plastic and Reconstructive Surgery - Global Open, 4(4), e683

Chiang, Y. Z., Pierone, G. & Al-Niaimi, F. (2017). Dermal fillers: pathophysiology, prevention and treatment of complications. Journal of the European Academy of Dermatology and Venereology, 31(3), 405-413

Crocco, E. I., Alves, R. O. & Alessi, C. (2012). Eventos adversos do ácido hialurônico injetável Adverse events in injectable hyaluronic acid. Surgical & Cosmetic Dermatology, 4(3), 259-263

Daher, J. C., Silva, S. V., Campos, A. C., Dias, R. C., Damasio, A. A. & Costa, R. S. (2020). Vascular complications from facial fillers with hyaluronic acid: preparation of a prevention and treatment protocol. Revista Brasileira de Cirurgia Plástica, 35(1), 2-7

Delorenzi, C. (2013). Complications of injectable fillers, part i. Aesthetic Surgery Journal, 33(4), 561-575

Eldweik, L. (2021). Orbital infarction syndrome following hyaluronic acid filler rhinoplasty. American Journal of Ophthalmology Case Reports, 22, 101063

Escobar, M. V., Neves, I. S., Oliveira, E. R., Souza, V. J. & Silva Santiago, A. P. (2021). Complicações relacionadas ao preenchimento dos lábios com ácido hialurônico para fins estéticos: uma revisão integrativa. Research, Society and Development, 10(14), 1-9

Fang, M., Rahman, E. & Kapoor, K. M. (2018). Managing complications of submental artery involvement after hyaluronic acid filler injection in Chin Region. Plastic and Reconstructive Surgery - Global Open. 6(5), 1-4

Fitzgerald, R., Bertucci, V., Sykes, J. M. & Duplechain, K. (2016). Adverse reactions to injectable fillers. Facial Plastic Surgery, 32(5), 532–555

Guimarães, A. C., Reis, E. A., Gomes, H. S., Gonçalves, L. F., Pereira, N. M., Martins, T. M. & Amâncio, N. F. (2021). Efeitos deletérios do uso do ácido hialurônico para fins estéticos. Brazilian Journal of Health Review, 4(2), 6103-6115

Gutmann, I. E. & Dutra, R. T. (2018). Reações adversas associadas ao uso de preenchedores faciais com ácido hialurônico. Revista Eletronica Biociencias, Biotecnologia e Saúde, 2016, 7-17

Hirsch, P., Infanger, M. & Kraus, A. (2020). A case of upper lip necrosis after cosmetic injection of hyaluronic acid soft-tissue filler: Does capillary infarction play a role in the development of vascular compromise, and what are the implications?. Journal of Cosmetic Dermatology, 19(6), 1316, 1320

International Society of Aesthetic Plastic Surgery (ISAPS). (2016). The International Study on Aesthetic/Cosmetic Procedures Performed in 2016. Annual ISAPS International Survey on Aesthetic/Cosmetic Procedures, 1-18

Iverson, S. M. & Patel, R. M. (2017). Dermal filler-associated malar edema: Treatment of a persistent adverse effect. Orbit (London), 36(6), 473-475

Kim, D. Y., Eom, J. S. & Kim, J. Y. (2015). Temporary Blindness After an Anterior Chamber Cosmetic Filler Injection. Aesthetic Plastic Surgery, 39(3), 428-430

Kim, DW., Yoon, ES., Ji, YH., Park, SH., Lee, BI. & Dhong, ES. (2011). Vascular complications of hyaluronic acid fillers and the role of hyaluronidase in management. Journal of Plastic, Reconstructive and Aesthetic Surgery, 64(12), 1590-1595

Lee, J. IL., Kang, S. J. & Sun, H. (2017). Skin necrosis with oculomotor nerve palsy due to a hyaluronic acid filler injection. Archives of Plastic Surgery, 44(4), 340-343

Lima, C. F., Melo, R. B., Lima, E. D., Moraes, R.P., Gomes, M. V & Bitú, H. (2022). Utilização de ácido hialurônico para rinomodelação: Relato de caso. Research, Society and Development. 11(3), 1-15

Lima, V. G., Regattieri, N. A., Pompeu, M. F. & Costa, I. M. (2019). External vascular compression by hyaluronic acid filler documented with high-frequency ultrasound. Journal of Cosmetic Dermatology, 18(6), 1629–1631

Maruyama, S. A. (2017). Histopathologic Diagnosis of Vascular Occlusion after Injection of Hyaluronic Acid Filler: Findings of Intravascular Foreign Body and Skin Necrosis. Aesthetic Surgery Journal, 37(9), NP102–NP108

Neri, S. R., Addor, F. A., Parada, M. B. & Schalka, S. (2013). Uso de hialuronidase em complicações causadas por ácido hialurônico para volumização da face: Relato de caso. Surgical and Cosmetic Dermatology, 5(4), 64–366

Parada, M. B., Cazerta, C., Afonso, J. P. & Nascimento, D. L. (2016). Overview and management of fillers complications. Surgical and Cosmetic Dermatology, 8(4), 342–351

Parulan, M. A., Sundar, G., Lum, J .H. & Ramachandran, U. (2019). A case report on dermal filler-related periorbital granuloma formation. Orbit (London), 38(2), 169–172

Pozuelo, C. C., Dios, J. D. & Rojas, X. M. (2020). Multiple oral granulomatous nodules to hyaluronic acid filler. Journal of Cosmetic Dermatology, 19(12), 3453-3455

Ribeiro, M. R., Sommer, A. A., Andrade, R. S., Carvalho, T. A., Araújo, M. T. & Pereira, P. C. (2021). Propriedades, eficácia e segurança do uso do ácido hialurônico em harmonização orofacial. Research, Society and Development, 10(13), 1-11

Rodriguez, J. M., Xie, Y. L., Winthrop, K. L., Schafer, S., Sehdev, P., Solomon, J., Jensen, B., Toney, N. C. & Lewis, P. F. (2013). Mycobacterium chelonae Facial Infections Following Injection of Dermal Filler. Aesthet Surg J, 33(2), 265-269

Rootman, D. B., Lin, J. L. & Goldberg, R. (2014). Does the tyndall effect describe the blue hue periodically observed in subdermal hyaluronic acid gel placement?. Ophthalmic Plastic and Reconstructive Surgery, 30(6), 524-527

Rowland-Warmann, M. J. (2021). Hypersensitivity reaction to Hyaluronic Acid Dermal filler following novel Coronavirus infection – a case report. Journal of Cosmetic Dermatology, 20(5), 1557–1562

Saboia, T. P., Cabral, M. R. & Neres, L. L. (2021). O uso do ácido hialurônico na harmonização facial. Research, Society and Development, 10(14), 1-7

Santana, I. N. & Rostey, R. R. (2020). Case Report: Persistent, Intermittent Delayed Swelling (PIDS) of Hyaluronic Acid filler, triggered by COVID-19. Surgical and Cosmetic Dermatology, 12(4), 373-375

Santos, C. M., Pimenta, C. A. & Nobre, M. R. (2007). A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências. Revista Latino-Americana de Enfermagem, 15(3), 508-511

Sattler, G. & Gout, U. (2017). Guia ilustrado para preenchimentos injetáveis: bases, indicações e tratamentos. Quintessence

Shoughy, S. S. (2019). Visual loss following cosmetic facial filler injection. Arquivos Brasileiros de Oftalmologia, 82(6), 511-513

Signorini, M., Liew, S., Sundaram, H., Boulle, K, L., Goodman, G. J., Monheit, G., Wu, Y., Almeida, A. R., Swift, A. & Braz, A. V. (2016). Global Aesthetics Consensus: Avoidance and Management of Complications from Hyaluronic Acid Fillers - Evidence- and Opinion-Based Review and Consensus Recommendations. Plastic and Reconstructive Surgery, 137(6), 961e-971e

Silva Neto, J. M., Silva, J. L., Mendonça, A. J., Duarte, I. K. & Tenório Neto, J.F. (2021). O uso do ácido hialurônico na harmonização facial: Uma revisão de literatura. Revista Eletrônica Acervo Saúde, 2021, 1–11

Tamura, B. M. (2010). Anatomia da face aplicada aos preenchedores e à toxina botulínica - Parte I. Surgical and Cosmetic Dermatology, 2(3), 195-204

Urdiales-Gálvez, F., Delgado, N. E., Figueiredo, V., Lajo-Plazo, J. V., Mira, M., Ortíz-Martí, F., Rio-Reyes, R. D., Romero-Álvarez, N., Cueto, S. R., Segurado, M. A. & Rebenaque, C. V. (2017). Preventing the complications associated with the use of dermal fillers in facial aesthetic procedures: an expert group consensus report. Aesthetic Plastic Surgery, 41(3), 667-677

Vedamurthy, M. (2018). Beware what you inject: Complications of injectables - Dermal fillers. Journal of Cutaneous and Aesthetic Surgery, 11(2), 60–66

Witmanowski, H. & Błochowiak, K. (2020). Another face of dermal fillers. Postepy Dermatologii i Alergologii, 7(5), 651–659

Zhou, S. B., Xie, Y., Chiang, C. A., Liu, K. & Li, Q. F. (2016). A Randomized Clinical Trial of Comparing Monophasic Monodensified and Biphasic Nonanimal Stabilized Hyaluronic Acid Dermal Fillers in Treatment of Asian Nasolabial Folds. Dermatologic Surgery, 42(9), 1061–1068

Published

04/04/2022

How to Cite

SILVA, L. M. F. da .; BARROS, P. M. de .; BARIONI, E. D. .; CONSTANTINO, E.; HANAI-YOSHIDA , V. M. .; OLIVEIRA, R. T. D. de . Complications with the use of hyaluronic acid in facial harmonization. Research, Society and Development, [S. l.], v. 11, n. 5, p. e23111528052, 2022. DOI: 10.33448/rsd-v11i5.28052. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/28052. Acesso em: 22 dec. 2024.

Issue

Section

Review Article