Complications of minimally invasive cosmetic procedures: Prevention and management

Abstract

Over the past decade, facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular. Office-based, minimally invasive procedures can promote a youthful appearance with minimal downtime and low risk of complications. Injectable botulinum toxin (BoNT), soft-tissue fillers, and chemical peels are among the most popular non-invasive rejuvenation procedures, and each has unique applications for improving facial aesthetics. Despite the simplicity and reliability of office-based procedures, complications can occur even with an astute and experienced injector. The goal of any procedure is to perform it properly and safely; thus, early recognition of complications when they do occur is paramount in dictating prevention of long-term sequelae. The most common complications from BoNT and soft-tissue filler injection are bruising, erythema and pain. With chemical peels, it is not uncommon to have erythema, irritation and burning. Fortunately, these side effects are normally transient and have simple remedies. More serious complications include muscle paralysis from BoNT, granuloma formation from soft-tissue filler placement and scarring from chemical peels. Thankfully, these complications are rare and can be avoided with excellent procedure technique, knowledge of facial anatomy, proper patient selection, and appropriate pre- and post-skin care. This article reviews complications of office-based, minimally invasive procedures, with emphasis on prevention and management. Practitioners providing these treatments should be well versed in this subject matter in order to deliver the highest quality care.

Patient factors influencing dermal filler complications: prevention, assessment, and treatment

“…Patients should be advised to stop anti-inflammatory and antiplatelet agents a week prior to treatment (if medically appropriate) to minimize bruising, and they may benefit from a list of foodstuffs, herbal supplements, and over-the-counter medications to avoid. 14 – 16 …”

“…29 , 30 Avoiding anesthesia with epinephrine (adrenalin) close to a vascular bundle to prevent vasospasm and tenting the skin to avoid the vascular supply are also appropriate recommendations. 16 …”

Bromelain: an overview of industrial application and purification strategies

“…These enzymes gently digest the protein of dead cells in the upper layer of the skin, resulting in their replacement by younger skin cells from lower layers (Ozlen and Chatsworth 1995). Bromelain can also reduce bruising and swelling of skin after cosmetic injection treatments (Levy and Emer 2012).…”

Specificity of using botulinic toxin type A for blepharospasm treatment

“…Для безопасности инъекций БТА необходимо строго соблюдать рекомендованные дозы [17], технику и предписанные сроки инъекций, а также учитывать общие противопоказания к методу боту линотерапии (возраст до 18 лет, воспалительный процесс в месте инъекции, острая фаза инфекционных или неинфекционных заболеваний, в том числе с гипертермией, повышенная чувствительность к компонентам препарата, беременность и грудное вскармливание) и специальные противопоказания (медицинские ограничения) при лечении БС (выраженный гравитационный птоз мягких тканей лица, выраженные грыжи в области верхнего и нижнего века, период до 3 мес после хирургической операции на лице) [18,19].…”