Background: Nonresorbable substances are still injected to enhance soft-tissue volumes and fill subcutaneous defects. Inflammatory reactions (often termed granulomas) to these materials can be functionally and socially disabling. Most therapeutic options used until now are nonspecific antiinflammatory treatments, targeting an ill-defined immune reaction of undefined cause. The minimally invasive intralesional laser treatment can remove the foreign substance and the inflammatory reaction with an 808-nm diode laser. Methods: Two hundred nineteen consecutive patients referred from September of 2006 until June of 2013 for inflammatory reactions to permanent facial fillers and treated with this technique at the authors' institution with a minimum 6-month follow-up were studied. All patients were screened with an ultrasound soft-tissue examination and the lesions were classified as either cystic (implants inserted by bolus injections) or infiltrating (as in microdeposit injection). The authors' therapeutic approach is summarized in an algorithm: infiltrating patterns were treated with intralesional laser treatment alone, whereas cystic distribution cases were also drained through stab wound incisions. The mean patient age was 49 years (range, 23 to 72 years); 204 patients were women. Results: Partial improvement was obtained in 30 percent of patients, whereas 8 percent discontinued the treatment because of a lack of satisfaction. Lesions disappeared completely in 62 percent. Complications included transient swelling in all cases, hematoma in 2 percent, secondary sterile abscess in 9.5 percent, and minimal scarring in 10 percent. Conclusion: A problem-oriented systematic approach to inflammatory complications from permanent fillers is proposed, based on the comprehensive work from the past 7 years, with an overall improvement rate of 92 percent.

Management of complications caused by permanent fillers in the face: A treatment algorithm / Cassuto, Daniel; Pignatti, Marco; Pacchioni, Lucrezia; Boscaini, Giulia; Spaggiari, Antonio; DE SANTIS, Giorgio. - In: PLASTIC AND RECONSTRUCTIVE SURGERY. - ISSN 0032-1052. - 138:2(2016), pp. 215-227. [10.1097/PRS.0000000000002350]

Management of complications caused by permanent fillers in the face: A treatment algorithm

PIGNATTI, MARCO;PACCHIONI, LUCREZIA;BOSCAINI, GIULIA;SPAGGIARI, Antonio;DE SANTIS, Giorgio
2016

Abstract

Background: Nonresorbable substances are still injected to enhance soft-tissue volumes and fill subcutaneous defects. Inflammatory reactions (often termed granulomas) to these materials can be functionally and socially disabling. Most therapeutic options used until now are nonspecific antiinflammatory treatments, targeting an ill-defined immune reaction of undefined cause. The minimally invasive intralesional laser treatment can remove the foreign substance and the inflammatory reaction with an 808-nm diode laser. Methods: Two hundred nineteen consecutive patients referred from September of 2006 until June of 2013 for inflammatory reactions to permanent facial fillers and treated with this technique at the authors' institution with a minimum 6-month follow-up were studied. All patients were screened with an ultrasound soft-tissue examination and the lesions were classified as either cystic (implants inserted by bolus injections) or infiltrating (as in microdeposit injection). The authors' therapeutic approach is summarized in an algorithm: infiltrating patterns were treated with intralesional laser treatment alone, whereas cystic distribution cases were also drained through stab wound incisions. The mean patient age was 49 years (range, 23 to 72 years); 204 patients were women. Results: Partial improvement was obtained in 30 percent of patients, whereas 8 percent discontinued the treatment because of a lack of satisfaction. Lesions disappeared completely in 62 percent. Complications included transient swelling in all cases, hematoma in 2 percent, secondary sterile abscess in 9.5 percent, and minimal scarring in 10 percent. Conclusion: A problem-oriented systematic approach to inflammatory complications from permanent fillers is proposed, based on the comprehensive work from the past 7 years, with an overall improvement rate of 92 percent.
2016
138
2
215
227
Management of complications caused by permanent fillers in the face: A treatment algorithm / Cassuto, Daniel; Pignatti, Marco; Pacchioni, Lucrezia; Boscaini, Giulia; Spaggiari, Antonio; DE SANTIS, Giorgio. - In: PLASTIC AND RECONSTRUCTIVE SURGERY. - ISSN 0032-1052. - 138:2(2016), pp. 215-227. [10.1097/PRS.0000000000002350]
Cassuto, Daniel; Pignatti, Marco; Pacchioni, Lucrezia; Boscaini, Giulia; Spaggiari, Antonio; DE SANTIS, Giorgio
File in questo prodotto:
File Dimensione Formato  
Management of Complications Caused 2016.pdf

Accesso riservato

Tipologia: Versione pubblicata dall'editore
Dimensione 1.32 MB
Formato Adobe PDF
1.32 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
PRS-D-15-01415_R2.pdf

Open access

Tipologia: Versione dell'autore revisionata e accettata per la pubblicazione
Dimensione 4.18 MB
Formato Adobe PDF
4.18 MB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1107332
Citazioni
  • ???jsp.display-item.citation.pmc??? 6
  • Scopus 32
  • ???jsp.display-item.citation.isi??? 27
social impact