Evaluation of Current Literature on Complications Secondary to Lip Augmentation Following Dermal Filler Injection.

Background: The current popularity of dermal filler treatments as an alternative to invasive surgical cosmetic procedures has led to an increase in filler-related complications. Lip filler treatments are among the most sought-after injectable treatments and a thorough understanding of the complications of lip filler injections, and their management, is essential for any practitioner. Objective: The aim of this review is to evaluate the current literature on complications secondary to lip augmentation following non-permanent dermal fillers. Methods: A thorough MEDLINE literature search of keywords, including lip filler, augmentation, injection, filler, dermal filler, and complications, was completed to collate cases of complications secondary to lip filler injections. Results: Of our 53 cases that were studied, 82 complications were reported. Our review and evaluation of these cases showed that HA filler was most commonly used in this region, alone or in combination with other soft tissue fillers. The majority of complications resulted from HA involvement, however its frequency of use likely accounts for this. Across all three filler types, the most common complication was nodule formation. Other complications, such as migration, discoloration and herpetic outbreaks, have been linked with filler placement in the lip area. Conclusion: It is clear that filler treatments carry a variety of risks, thus it becomes of utmost importance to truly understand the product we are working with, its properties, its associated risks, and how to manage those risks. We have to ensure that patients are adequately informed about the risks associated, and understand what those risks entail.

Case Series and Review on Managing Abscesses Secondary to Hyaluronic Acid Soft Tissue Fillers with Recommended Management Guidelines.

With the number of aesthetic soft tissue filler treatments rapidly increasing, we have witnessed an increase in complications associated with such treatments. While rare, abscesses can arise as a result of these treatments, and current detailed guidelines do not exist detailing exactly how to manage them. OBJECTIVE: Our aim was to develop evidence-based and experience-based guidelines on how to, specifically, manage abscesses secondary to hyaluronic acid dermal fillers. METHODS: A thorough MEDLINE literature search of keywords, including abscess, abscess management/treatment, hyaluronic acid, dermal fillers, and soft tissue fillers, was completed to collect specific cases of abscesses secondary to soft tissue filler. Inclusion criteria involved papers published from 2010 to 2020 that focused specifically on soft tissue fillers in the face. In addition, we looked at papers that discussed abscesses secondary to soft tissue fillers in general and their management. We also reported three cases of abscesses secondary to hyaluronic acid dermal fillers that have been described by three different practitioners, detailing their history, examination, management, and outcomes. Experience and evidence have been collated to produce management guidelines. RESULTS and CONCLUSION: It is clear that each case is unique, but there is no current universal consensus on the risk assessment before treatment nor general management of abscesses secondary to soft tissue filler. The majority of the reports and cases discussed in the paper suggested the use of co-amoxiclav along with a macrolide or quinolone for at least two weeks. Incision and drainage are universally accepted as gold standard management. Microbiology, sensitivities, and cultures are also recommended. Hyaluronidase use, while controversial, is encouraged in effectively managing abscesses secondary to hyaluronic acid dermal filler.

A Prospective Study on Safety, Complications and Satisfaction Analysis for Tear Trough Rejuvenation Using Hyaluronic Acid Dermal Fillers.

BACKGROUND: Tear trough (TT) treatment with hyaluronic acid soft tissue fillers is an increasingly popular aesthetic procedure. The traditional needle technique is cited many times in the literature with no studies looking at the results, complications and satisfaction rate with the use of the cannula device instead. The aims of this study are to describe the experience of 4 aesthetic doctors in the treatment of TT deformity and assess complications and side effects, overall satisfaction and improvement. METHODS: Twenty-four patients were included (48 TTs) that fulfilled the inclusion and exclusion criteria and they were assessed over a 4-week period, looking at the complications, side effects, satisfaction rate, and others with the cannula technique for the medial TT. RESULTS: Twenty-two women and 2 men each had the medial TT filler supra-periosteally using a cannula device. They were all reviewed at the 2-week stage +/- the 4-week stage. 100% of patients noted an overall improvement to the TTs and 75% were satisfied with their results with the other 25% requiring further filler to be satisfied. There were no major complications and only a small number of minor side effects like mild bruising and swelling that lasted up to 4 weeks. CONCLUSIONS: TT treatment, if performed using a cannula with a maximum of 1ml used in one sitting between both eyes, according to this study, is a safe treatment with a very low pain rating and with no major complications and high patient satisfaction.

Communication aid requirements of intensive care unit patients with transient speech loss.

Alert and transiently nonvocal intensive care unit (ICU) patients are dependent on augmentative and alternative communication (AAC). Unfortunately, the literature demonstrates that existent AAC devices have not been widely adopted, and unaided methods are often the primary modalities used despite being insufficient, and frustrating. We present the results of a qualitative semi-structured interview study with 8 ex-ICU patients, 4 ICU patient relatives, and 6 ICU staff, exploring their AAC needs and requirements. Participants identified important AAC hardware, software, and content requirements. Salient factors impacting on AAC adoption in the ICU setting were also highlighted and included the need for staff training and bedside patient assessment. Based on the study results, we propose a series of recommendations regarding the design and implementation of future AAC tools specifically targeted at this group.

An unusual origin of a breast lump: a case report.

True axillary artery aneurysms are rare. This case report describes one such aneurysm referred as a breast lump. This is the first report of such a presentation.