Background Soft tissue filler is commonly used for facial contouring. However, incorrect use can lead to severe ocular complications. Even though filler injections are quite different from fat grafts, they are considered similar procedures. However, to date, there are no proven preventive measures or treatments for blindness secondary to soft tissue filler injections. Objectives This literature review aimed to investigate visual compromise secondary to soft tissue filler injection and discuss the related vascular anatomy, pathophysiology, and prevention of ocular complications of soft tissue filler injections. Methods A literature search until July 2018 was performed for reports on visual compromise after filler injections. We evaluated the previous literature and eliminated cases using fat grafts and unknown fillers. Results A total of 50 reports of filler‐induced visual compromise were identified. Analysis of these cases showed that the procedure with greatest risk was nasal augmentation, followed by glabellar wrinkle treatment. Within the last 3 years searched, 35% of reported cases involved treatment of the nose. There were no reports of blindness from injections into the temple or chin and relatively few case reports involving forehead injections. Conclusion The most common injection site associated with blindness in a previous report was the glabella; however, the most common site currently associated with blindness due to filler injections was the nose. Extreme caution is necessary when performing nasal augmentation or glabellar wrinkle correction using soft tissue fillers to avoid the branches of the internal carotid artery.
This study yielded novel arterial systems of the forehead and provided guidance for the safe forehead augmentation.
Background: Soft tissue filler injection is a common procedure for augmentation rhinoplasty. Various techniques for augmenting the nasal dorsum using a soft tissue filler have been attempted considering the size of the needle, the anatomical layer where the filler is injected, and the vascular distribution. The purpose of this paper was to evaluate the course of the dorsal nasal artery in patients scheduled for nasal augmentation using a soft tissue filler and to propose a method of nasal augmentation that minimizes vessel damage during soft tissue filler injection by confirming the distribution pattern of blood vessels through ultrasound.Methods: Patients underwent augmentation rhinoplasty using a soft tissue filler. All patients underwent ultrasound examination before the filler injections.
Background: Hyaluronic acid (HA) filler is the most commonly used filler for soft tissue augmentation. There are numerous commercially available HA fillers in the cosmetic market, and there are guidelines for each filler as determined by the manufacturing company. The successful use of injectable fillers requires an understanding of each option available so that the most appropriate form of hyaluronic acid may be selected for patients. The purpose of this study was to determine whether newly developed HA fillers are appropriate for forehead augmentation considering their rheological properties and the anatomical site of injection. Methods: The rheological properties of new HA fillers were assessed e.t.p.q. S100, S300, S500 (Zetema®). Comparing the rheological properties, the authors chose e.t.p.q. S300® for forehead augmentation. The filler was injected into the foreheads of 40 consecutive patients for esthetic purposes.Results: e.t.p.q. S300® was determined to be an appropriate filler for the forehead. The injection procedure employed was considered to be easy and safe when applied to the preperiosteal layer using a cannula. None of the patients had complications such as vascular compromise, infections, granulomas, or migration. Conclusions: Understanding the physical properties of new fillers is necessary. As the preperiosteal layer of the forehead is an appropriate layer for the filler injection, physicians should consider injecting fillers with enough strength to withstand the shearing forces.
BACKGROUND Small-bore needles reduce the complications associated with soft tissue filler injection. Gel particles must be sized appropriately to pass through fine-bore needles with an acceptable extrusion force. However, most soft tissue filler particles are larger than the inner diameter of the needle. The authors hypothesized that the physical properties of these particles change as the gel passes through the needle. OBJECTIVE The authors aimed to investigate whether the predesigned physical and rheological properties of the filler change after passage through the small-bore needle. METHODS AND MATERIALS Particle sizes of 4 hyaluronic acid (HA) fillers were analyzed using a particle size analyzer. Five soft tissue fillers with different particle sizes were subjected to rheological characterization. All tests were performed using fillers with and without a 30-G needle. RESULTS Monophasic HA fillers with smaller particle sizes exhibited small changes between particle sizes but no differences in rheological properties. Biphasic HA fillers with larger particle sizes exhibited remarkable changes in particle size and rheological properties. Calcium fillers exhibited changes in rheological properties. CONCLUSION Injection through small-bore needles can alter the physical properties and rheological equilibrium of soft tissue fillers. The authors suggest avoiding small-bore needles as they may affect the rheological equilibrium and clinical performance of fillers.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.