Complications of fillers in the lips and perioral area: Prevention, assessment, and management focusing on ultrasound guidance

Kroumpouzos, George; Harris, Steven; Bhargava, Shashank; Wortsman, Ximena

doi:10.1016/j.bjps.2023.01.048

Cited by 15 publications

(11 citation statements)

References 61 publications

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“…However, with the increasing popularity of these procedures, there has also been a corresponding rise in awareness of potential side effects, with bruising being one of the most common concerns. 17 The anatomy of the human lip is a study in complexity and function, seamlessly integrating diverse structures that cater to sensitivity, expression, and survival. [18][19][20] The superior and inferior labial arteries are significant blood vessels that provide vascular supply to the upper and lower lips, respectively.…”

Section: Discussionmentioning

confidence: 99%

Achieving Bratz Doll Look with Lip Fillers: A Prospective Observational Study on Blunt Cannula Techniques

Alhallak,

Omran,

Tomi

2024

Plastic and Reconstructive Surgery - Global Open

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Background: This study aims to evaluate the efficacy and safety of a blunt cannula technique using hyaluronic acid fillers for achieving the Bratz doll lip aesthetic, characterized by enhanced volume and sharp definition. Methods: Thirty volunteers, 22–40 years of age, were selected based on specific inclusion criteria at Albany Cosmetic and Laser Center for 6 months. The technique involved precise filler injections using a Steriglide blunt cannula. Pre- and postprocedure measurements of lip dimensions and angular changes were meticulously documented and analyzed using IBM SPSS Statistics software. Results: The procedure significantly increased the average height of both the upper and lower vermilion zones, with notable changes in angular measurements and the distance between the midline and oral commissure, aligning with the Bratz doll aesthetic. Importantly, none of the participants experienced bruising, a common side effect in traditional needle-based methods. The overall satisfaction rate was high, with an average score of 8.5 out of 10, reflecting the procedure’s success in meeting aesthetic goals and ensuring participant comfort. Conclusions: The blunt cannula technique for lip augmentation presents a safe and effective alternative to traditional needle-based methods. The absence of bruising and high satisfaction rates underscore the technique’s precision and alignment with patient safety and comfort. This study contributes to the field of cosmetic lip enhancement, offering a novel approach that balances aesthetic aspirations with health considerations, potentially influencing future practices in cosmetic procedures.

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Section: Discussionmentioning

confidence: 99%

Achieving Bratz Doll Look with Lip Fillers: A Prospective Observational Study on Blunt Cannula Techniques

Alhallak,

Omran,

Tomi

2024

Plastic and Reconstructive Surgery - Global Open

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“…Several therapies, including oral antibiotics and oral or intralesional corticosteroids, can effectively treat DIRs. 4 , 14 Oral antibiotics are typically tried first when the DIR is inflammatory and/or suspected of infection (abscess formation). Intralesional steroids can be tried in such cases if the DIR shows a suboptimal response to antibiotics.…”

Section: Discussionmentioning

confidence: 99%

“… 3 DIRs can cause significant discomfort and aesthetic and functional repercussions to the patients. 4 Treatment of DIRs is challenging, and repetitive courses of systemic corticosteroids are sometimes required for years. 5 …”

mentioning

confidence: 99%

Oral Methotrexate Treatment of Delayed-Onset Inflammatory Reactions to Dermal Fillers

Landau,

Silikovich,

Fida

et al. 2024

Aesthetic Surgery Journal Open Forum

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Background In aesthetic practice, delayed onset (late) inflammatory reactions (DIRs) to dermal fillers are encountered. The treatment of DIRS can be challenging, with a response to established therapies, including oral antibiotics, intralesional and oral steroids, and hyaluronidase injection, occasionally reported as unsatisfactory. Objectives Evaluate the efficacy of low-dose oral methotrexate (MTX) therapy in treating recalcitrant DIRs. Methods We retrospectively reviewed cases of recalcitrant DIRs treated with oral MTX. Data collected included individuals’ gender and age, medical history, filler type, facial area(s) injected, previous treatments attempted to dissolve the DIR, MTX treatment dosage and duration, and outcome. Adverse events were monitored throughout the treatment. Results Thirteen women with a mean age 52.6 years (range, 31-67 years) that developed recalcitrant DIRs to dermal filler injection are included. Nine reactions were triggered by injection of hyaluronic acid (HA) fillers, 3 by liquid silicone (LIS), and 1 by polymethyl-methacrylate (PMMA). The average starting dosage of MTX was 12.1 mg/week (range, 7.5-12.5 mg/week). Patients were treated for 2-3 months in most cases. The average follow-up post-MTX therapy was 11.8 months (range, 2-36 months). Complete response to MTX treatment was observed in10 patients (6 HA and 4 LIS cases), partial response in 1 (HA case), and unsatisfactory response in 2 (HA and PMMA cases). Treatment was tolerated well. Conclusions A short course of low-dose oral MTX is a possible treatment of DIRs that have not responded to established therapies. The promising results of this report require validation by powered studies.

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“…Because I focus on structure, I have taken advantage of the idea that filler follows the route of least resistance, and projection and support are more easily achieved with a "tent with poles" like effect from the needle on bone. 1 Two landmark articles have emerged in recent years which gave me pause. The first authored by Pavicic et al regarding arterial wall penetration indicated that 25-gauge cannulas were likely safest, of course there were limitations to this study, but I suspect it created a change in the young injector long-term approach.…”

Section: Expert's Perspective: Treatment Approach; a Comment On Cannu...mentioning

confidence: 99%

From Nasolabial Folds to Pan-facial Rejuvenation—The Evolution of Fillers in my Career

Grunebaum,

Eitan,

Cave

2023

Facial Plast Surg

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Complications of fillers in the lips and perioral area: Prevention, assessment, and management focusing on ultrasound guidance

Cited by 15 publications

References 61 publications

Achieving Bratz Doll Look with Lip Fillers: A Prospective Observational Study on Blunt Cannula Techniques

Achieving Bratz Doll Look with Lip Fillers: A Prospective Observational Study on Blunt Cannula Techniques

Oral Methotrexate Treatment of Delayed-Onset Inflammatory Reactions to Dermal Fillers

From Nasolabial Folds to Pan-facial Rejuvenation—The Evolution of Fillers in my Career

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