ABSTRACT
The use of enzyme hyaluronidase to treat the complications of different brands of hyaluronic acid (HA) dermal fillers is increasing in the same proportion as the number of nonsurgical cosmetic procedures. Guidelines for diagnosing and treating complications remain controversial and are primarily based on anecdotal reports and small case series. We proposed approaching HA-related complications based on our clinical research and observations of treating more than 200 patients and providing a practical guide for the thoughtful use of hyaluronidase according to adverse events. Standardization of hyaluronidase dose and concentration is beneficial for better outcomes and future comparative analyses of the results of this treatment worldwide. The use of hyaluronidase is increasing for the reversal of the clinical manifestations of complications caused by HA fillers, although a consensus is lacking. We propose using different doses and concentrations of hyaluronidase to focus on selected anatomic areas considering properties of the product and pathogenesis of each complication.
ABSTRACT
INTRODUCTION: The use of hyaluronic acid (HA) as a dermal filler is considered safe. However, as new brands come to the market, reports of adverse events are becoming more and more common. OBJECTIVE: To describe a particular type of adverse effect that, unlike the erythematous, indurated, and painful nodules described in the literature as "angry red bumps," is characterized by noninflammatory, stony-like nodules that appear in sites previously treated with HA. METHODS: The report of four patients who presented this complication, and the occurrence of two HA syringes from the same batch that had hardened the product inside at the time of filling. CONCLUSION: The authors propose the nomenclature "happy bump" to group adverse reactions to HA that translate into noninflammatory nodules, with a stony consistency, appearing up to 4 weeks (recent) or after one month (late) in sites previously treated with AH.
Subject(s)
Cosmetic Techniques , Dermal Fillers , Humans , Hyaluronic Acid/adverse effects , Cosmetic Techniques/adverse effects , Pain/etiology , Syringes , Dermal Fillers/adverse effectsABSTRACT
BACKGROUND: In recent years, fillers procedures with hyaluronic acid (HA) have grown significantly. Despite HA relative safety, the number of cases of complications after injections has grown, and in many of which, we are not aware of or have little control over. AIMS: In this article, the authors describe a new adverse reaction after filling with HA injection, the sterile abscess. PATIENTS/METHODS: We present eight patients with similar clinical, laboratory, and ultrasound characteristics for sterile abscess and report a new therapeutic modality for it. RESULTS: All cases were treated with "Munhoz-Cavallieri Lavage Protocol" procedure with complete resolution. CONCLUSIONS: "Munhoz-Cavallieri Lavage Protocol" serves as a guideline in diagnosis and management of sterile abscess.
Subject(s)
Cosmetic Techniques , Dermal Fillers , Humans , Hyaluronic Acid/adverse effects , Abscess/diagnostic imaging , Abscess/etiology , Injections , Dermal Fillers/adverse effects , Cosmetic Techniques/adverse effectsABSTRACT
The use of lasers and intense pulsed light (IPL) technology has become an established practice in dermatology and aesthetic medicine. The use of laser therapy and IPL in the treatment of pigmented melanocytic lesions is a controversial issue. We report clinical, dermoscopic and histological changes of a completely regressed pigmented melanocytic nevus after hair removal treatment with the LightSheer™ Diode Laser (Lumenis Ltd, Yokneam, Israel).
