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Review

Dermal fillers in aesthetics: an overview of adverse events and treatment approaches

&
Pages 295-316 | Published online: 12 Dec 2013

Figures & data

Table 1 Characteristics of commonly used fillers and their indications

Table 2 Types of dermal filler complication by onset of adverse event

Figure 1 Bruising may be immediate or worsen over 3 days.

Figure 1 Bruising may be immediate or worsen over 3 days.

Figure 2 Acute generalized facial edema.

Figure 2 Acute generalized facial edema.

Figure 3 Malar edema.

Figure 3 Malar edema.

Figure 4 The anatomic basis of malar edema.

Notes: Pessa JE, Garza JR., Aesthet Surg J. 17(1):11–17. Copyright © 1997 by MOSBY, INC. Reprinted by Permission of SAGE Publications.Citation21
Figure 4 The anatomic basis of malar edema.

Figure 5 Erythema at site of injection.

Figure 5 Erythema at site of injection.

Figure 6 Dyschromia and visible material.

Figure 6 Dyschromia and visible material.

Figure 7 Dermal filler injection leading to herpes virus reactivation.

Figure 7 Dermal filler injection leading to herpes virus reactivation.

Figure 8 Noninflammatory nodule.

Figure 8 Noninflammatory nodule.

Figure 9 Inflammatory foreign body granuloma before and after treatment with an antibiotic, 5-FU, triamcinolone, and local anesthetic.

Abbreviation: 5-FU, 5-fluorouracil.
Figure 9 Inflammatory foreign body granuloma before and after treatment with an antibiotic, 5-FU, triamcinolone, and local anesthetic.

Figure 10 Nodularity that proved to be foreign body granuloma on surgical biopsy.

Figure 10 Nodularity that proved to be foreign body granuloma on surgical biopsy.

Figure 11 Facial artery anatomy illustrating the most common sites of vascular occlusion.

Notes: Reproduced with permission. Copyright © 2009, John Wiley and Sons. Grunebaum LD, Bogdan Allemann I, Dayan S, Mandy S, Baumann L. The risk of alar necrosis associated with dermal filler injection. Dermatol Surg. 2009;35 Suppl 2:1635–1640. Citation53
Figure 11 Facial artery anatomy illustrating the most common sites of vascular occlusion.

Figure 12 Retinal artery occlusion as a result of calcium hydroxylapatite in the central retinal artery.

Figure 12 Retinal artery occlusion as a result of calcium hydroxylapatite in the central retinal artery.

Figure 13 Skin necrosis after dermal filler injection.

Figure 13 Skin necrosis after dermal filler injection.

Figure 14 Examples of tissue necrosis after vascular compromise.

Figure 14 Examples of tissue necrosis after vascular compromise.

Figure 15 Progression of vascular compromise after an embolic event.

Figure 15 Progression of vascular compromise after an embolic event.

Table S1 Algorithm for the management of antibody-mediated or nonantibody-mediated edema

Table S2 Algorithm for the management of malar edema

Table S3 Algorithm for the management of nodular masses

Table S4 Algorithm for the management of vascular compromise