Can Sodium Thiosulfate Act as a Reversal Agent for Calcium Hydroxylapatite Filler? Results of a Preclinical Study

Danysz, Wojciech; Nowag, Bartosch; Hengl, Thomas; Kreymerman, Peter; Furne, C; Madeuf, Elise; Höennscheidt, Christoph; Robinson, Deanne Mraz

doi:10.2147/ccid.s271760

Cited by 13 publications

(18 citation statements)

References 14 publications

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“…One study tested topical NTG ointment, and the other four studies tested sodium thiosulfate (STS). The STS study by Robinson [39] additionally investigated the effects of topical sodium metabisulfite (SMB) in combination and in isolation from intralesional STS. Topical SMB was not found to be helpful in CaHA-associated complications.…”

Section: Resultsmentioning

confidence: 99%

“…Results were varied in the four STS studies. One found complete dissolution of CaHA with STS [39] , one found partial reduction [38] , and the remaining two found no evidence indicating STS could dissolve CaHA [40,41] . Of note, the two studies that found no evidence supporting STS were the most recently published in 2020 and 2021, respectively [40,41] .…”

Section: Resultsmentioning

confidence: 99%

“…When SRS is administered via hemodialysis, common adverse effects include nausea, metabolic acidosis, volume overload, and hypocalcemia [54] . Given its calcium-based composition, it has been theorized that STS injections could potentially degrade CaHA into smaller subparts [39] . Four cases of vascular dermal ischemia following CaHA treated with only STS injections in the Netherlands were included in this study [34] .…”

Section: Review Of Post-complication Management Therapiesmentioning

confidence: 99%

“…Unfortunately, individualized results were not reported by the authors, so the estimated efficacy of STS could not be determined from these cases [34] . Four experimental studies addressing the effects of STS on CaHA fillers were also included in this study [38][39][40][41] . Two of these studies were published in 2018 m and both concluded that STS was capable of partially or completely reducing CaHA volume in animal models.…”

Section: Review Of Post-complication Management Therapiesmentioning

confidence: 99%

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Management of vascular complications following calcium hydroxylapatite filler injections: a systemic review of cases and experimental studies

Lindgren¹,

Welsh²

2022

Plast Aesthet Res

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Aim: Dermal fillers are increasingly popular procedures. Inadvertent intraarterial injection of fillers, particularly with calcium hydroxylapatite (CaHA), can result in devastating consequences. A systemic review was performed to summarize management strategies to treat CaHA-associated vascular complications. Methods: The methodology of this review was derived from The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). In addition, this paper presents a previously unreported case of a CaHA-associated vascular complication. Results: There were 32 articles describing 42 cases, plus our case included in this review. There were 15 cases of vision complications, 23 cases of non-vision complications, and 5 experimental studies. The most common injection sites reported were nasal region for vision complications (45%) and nasolabial folds for non-vision complications (40%). Of the 38 human cases, the most prevalent treatment choice was steroids (24 cases, 63%). Complete or near complete improvement was reported in 83% of non-vision complications and 40% of vision complications. There was no noticeable homogeneity in the management strategies and outcomes of the patients. Of the 5 experimental studies, no clear consensus on treatments was found. Conclusion: Vascular complications of CaHA are seemingly uncommon, but it is widely suspected that this is due to underreporting. While best management is prevention, preparation for a potential complication is equally important. Derived from CaHA literature, hyaluronic acid filler complication protocols, findings of this review, and personal experiences, this report proposes management strategies for CaHA-associated vascular complications. We hope these strategies provide a much-needed framework for injectors to refer to and utilize as needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Review Of Post-complication Management Therapiesmentioning

confidence: 99%

Section: Review Of Post-complication Management Therapiesmentioning

confidence: 99%

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Management of vascular complications following calcium hydroxylapatite filler injections: a systemic review of cases and experimental studies

Lindgren¹,

Welsh²

2022

Plast Aesthet Res

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“…Alguns autores estudam um agente de reversão para os casos de redução de nódulo, desvio de material, redução de volume de sobrecorreção e oclusão vascular.. Rullan, et al, (2019) relataram dois casos clínicos de nódulos visíveis de hidroxiapatita de cálcio, cujo tratamento com o tiossulfeto de sódio foi bemsucedido. Entretanto, Danysz, et al, (2020) em seu estudo pré-clinico, concluíram que apesar do tiossulfeto de sódio ter apresentado uma eficácia maior que a solução salina, o uso da solução salina ainda é mais seguro pois o uso do tiossulfeto de sódio apresentou risco de necrose tecidual e hemorragia. Além disso, o mecanismo de ação do tiossulfeto de sódio sugere ser de dispersão e não de degradação, desta forma não ajudaria nos casos de oclusão vascular.…”

Section: Discussionunclassified

Hidroxiapatita de cálcio: uma revisão quanto à eficacia, segurança e imaginologia quando usado como preenchedor e como bioestimulador

Oliveira

Almeida

Martins

et al. 2021

RSD

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Este artigo teve como objetivo apresentar por meio de uma revisão de literatura a eficácia, segurança e satisfação dos pacientes com o uso de hidroxiapatita de cálcio como preenchedor e como bioestimulador de colágeno. Trata-se de uma revisão de literatura realizada por meio de busca ativa dos artigos cientificos na base de dados: U.S. National Library of Medicine (PubMed), utilizando como termo de busca: calcium hydroxylapatite cosmetic. Foram selecionados 69 publicações, no periodo de 2016 à 2021, entretanto à partir dos critérios de inclusão e exclusão foram selecionados 20 artigos. Baseado na revisão de literatura feita neste estudo, a hidroxiapatita de cálcio mostrou-se eficaz como bioestimulador de colágeno e elastina ; como preenchedor apresentou um melhor efeito lift (exceto no caso do lift de sobrancelha) por causa do seu alto módulo de elasticidade, podendo ser usado como suporte para outros preenchedores e fios de sustentação; teve um elevado nivel de satisfação dos pacientes; é considerado um material com um bom perfil de segurança, desde que respeitada a técnica e as indicações ; e pode ser visualizado em radiografias, tomografias e ultrassonografias de alta resolução.

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Radiesse: State of the Art and Dilute Radiesse

Fritsche

Schlesinger³

2023

Dermatological Reviews

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Background Radiesse is a calcium hydroxylapatite (CaHA)‐based filler first FDA‐approved in 2006 for the treatment of human immunodeficiency virus‐associated lipodystrophy and moderate to severe facial wrinkles, particularly the nasolabial folds. It has since expanded into new formulations and has been approved for jawline contouring and treatment of dorsal hand volume loss. CaHAs provide the basis of the filler's appeal, inducing biostimulation of stromal components including collagen, elastin, and vasculature. The carboxymethylcellulose gel carrier gives the filler its notoriously stiff volumizing effects, intended for deeper placement, typically in the subdermal and supraperiosteal planes. Since its inception, innovative efforts have been ongoing to take advantage of the filler's biostimulatory effects without its volumization. Objectives To describe novel uses of dilute, hyperdilute, and HA‐mixed CaHA filler. Methods A review was performed on current available literature and consensus guidelines. Conclusions Diluted and hyperdiluted Radiesse allow for widespread treatment, providing patients the dermal rejuvenation they desire, without the firm volumizing effects seen with undiluted product. This has led to an explosion in off‐label use including treatment of skin laxity of the face, neck and decolletage, arms, abdomen, buttocks, and thighs. Clinicians have also begun combining the CaHA filler with hyaluronic acid‐based fillers to induce skin regeneration while providing a more flexible and softer volume replacement. Radiesse' uses continue to evolve with alterations in the original formula, allowing for increasingly customized product to meet each patient's individual needs.

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Can Sodium Thiosulfate Act as a Reversal Agent for Calcium Hydroxylapatite Filler? Results of a Preclinical Study

Cited by 13 publications

References 14 publications

Management of vascular complications following calcium hydroxylapatite filler injections: a systemic review of cases and experimental studies

Management of vascular complications following calcium hydroxylapatite filler injections: a systemic review of cases and experimental studies

Hidroxiapatita de cálcio: uma revisão quanto à eficacia, segurança e imaginologia quando usado como preenchedor e como bioestimulador

Radiesse: State of the Art and Dilute Radiesse

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