Background Sudden loss of vision secondary to filler treatments is a rare but catastrophic complication. Objectives The aim of this study was to update the published cases of blindness after filler injection that have occurred since we published our review of 98 cases in 2015, and to discuss prevention and management strategies. Methods A literature review was performed to identify all cases of visual complications caused by filler injection identified between January 2015 and September 2018. Results Forty-eight new published cases of partial or complete vision loss after filler injection were identified. The sites that were highest risk were the nasal region (56.3%), glabella (27.1%), forehead (18.8%), and nasolabial fold (14.6%). Hyaluronic acid filler was the cause of this complication in 81.3% of cases. Vision loss, pain, ophthalmoplegia, and ptosis were the most common reported symptoms. Skin changes were seen in 43.8% of cases and central nervous system complications were seen in 18.8% of cases. Ten cases (20.8%) experienced complete recovery of vision, whereas 8 cases (16.7%) reported only partial recovery. Management strategies varied greatly and there were no treatments that were shown to be consistently successful. Conclusions Although the risk of blindness from fillers is rare, practitioners who inject filler should have a thorough knowledge of this complication including prevention and management strategies. Level of Evidence: 5

Although the risk of blindness from fillers is rare, it is critical for injecting physicians to have a firm knowledge of the vascular anatomy and to understand key prevention and management strategies.

Although delayed nodules are uncommon from HA-V (0.5%), it is important to be aware of this adverse effect and have a management protocol in place. It is the authors' opinion from the patients' responses and from the literature that these nodules are immune mediated in nature.

_ Die Haut ist bekanntlich der Spiegel der Seele. So gesehen düre es mit dem seelischen Benden in der Bevölkerung sehr schlecht bestellt sein: Gaubt man den Dermatologen, so gibt es kaum noch jemanden, bei dem sich die Seele nicht in Form von Rötungen, Juckreiz, Bläschen oder Flecken an der Haut zumindest ge-legentlich bemerkbar macht. Und manch einer kratzt sich sogar, bevor es juckt. Angesichts dessen hat sich in den letz-ten Jahren in der Dermatologie ein neu-es Teilgebiet etabliert: die Psychoderma-tologie. Doch trotz intensiver Bemühun-gen ist es diesen Spezialisten bisher nicht gelungen, mit Salben oder Lotionen die Seele zu erreichen. Die Flecken sind zwar weg, aber die Seele bleibt krank. Wirksamer in Sachen Seele sind da schon diejenigen Hautärzte, die sich der ästhetischen Dermatologie verschrieben haben. Das Geschä mit den minimal-invasiven Haut-verjüngenden Maßnah-men boomt. Mit der Injektion von Fil-lern oder Botox gelingt es, Menschen nicht nur jünger, sondern sogar freund-licher aussehen zu lassen als sie wirklich sind. Und mit Hilfe der Liposuktion lässt sich das Körpergewicht schneller und leichter reduzieren als mit Sport und Diät. Das macht einfach glücklich. Viele psychische Störungen sind somit eigentlich eine dermato-chirurgischen He-rausforderung. Spielverderber aber sind mal wieder die Krankenkassen. Sie wollen diese innovative Psychotherapie nicht be-zahlen, bevor nicht Studien vorliegen, in denen echte mit Scheineingrien vergli-chen werden. Dabei vergessen sie: Auch der klassischen Psychotherapie mangelt es an einem direkten Vergleich mit einer Schein-behandlung. Manchmal stößt die evidenz-basierte Medizin einfach an ihre Grenzen.

A variety of biodegradable and nonbiodegradable filling agents are available or under investigation in the United States. Choice of product depends on injector preference and the area to be filled. Although permanent agents offer significant clinical benefits, modern biodegradable fillers are durable and often reversible in the event of adverse effects.

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Rosacea is a chronic facial inflammatory dermatosis characterized by background facial erythema and flushing and may be accompanied by inflammatory papules and pustules, cutaneous fibrosis and hyperplasia known as phyma, and ocular involvement. These features can have adverse impact on quality of life, and ocular involvement can lead to visual dysfunction. The past decade has witnessed increased research into pathogenic pathways involved in rosacea and the introduction of novel treatment innovations. The objective of these guidelines is to offer evidence-based recommendations to assist Canadian health care providers in the diagnosis and management of rosacea. These guidelines were developed by an expert panel of Canadian dermatologists taking into consideration the balance of desirable and undesirable outcomes, the quality of supporting evidence, the values and preferences of patients, and the costs of treatment. The 2015 Cochrane review "Interventions in Rosacea" was used as a source of clinical trial evidence on which to base the recommendations.

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