Filler-induced complications of the lips: 10 years experience with intralesional laser treatment and refinements

Aesthetic Surgical Pathway in Permanent Facial Filler Removal

“…complications, as systemic antibiotic therapy, intra-lesional injections of corticosteroid and/or 5fluorouracil, needle aspiration, surgical drainage and laser therapy [7][8][9][10][11] ,although none of those techniques is able to totally remove previously injected permanent fillers. he mainstay for a proper preoperative filler-removal evaluation is represented by the Magnetic Resonance Imaging (MRI) 13 .Ultrasonographic evaluation may give infos related to the facial location of the filler and regarding the type of filler injected, although only the MRI let the surgeon to clearly evaluate the relationship between the fillers and the surrounding tissues such as muscles, fat compartments and fascia layers 13,14 .A careful preoperative evaluation is mandatory to reduce the risk of facial nerve damaging, a main issue why surgeons usually refuse to perform these surgical procedures.Although non-surgical procedures may solve and/or mitigate permanent fillers complications, the only way to remove the filler previously injected is represented by surgical excision [15][16][17][18][19][20] .…”

“…For the same reason,also a permanent filler injected with transitory good result, years after implantation may induce a worsening of facial appearance during the aging process,creating a drooping/bulging effect 5,6 . In addition to the aging process of facial structures, permanent fillers may also develop delayed complications such as migration,granuloma, lumps and/or abscesses 3,5 .For these reasons, many patients are not satisfied with the long-term results following non-resorbable filler injections and years after implantation request removal of the products 3,5,[7][8][9][10][11] .The use of permanent fillers is totally or partially forbidden in some European countries such as Netherland and Poland, especially for the challenge to face their surgical removal 12 .Several non-surgical managements have been introduced to treat permanent filler…”

“…3,5 For these reasons, many patients are not satisfied with the long-term results following nonresorbable filler injections and years after implantation request removal of the products. 3,5,[7][8][9][10][11] The use of permanent fillers is totally or partially forbidden in some European countries such as the Netherland and Poland, especially for the challenge to face their surgical removal. 12 Several nonsurgical managements have been introduced to treat permanent filler complications, as systemic antibiotic therapy, intralesional injections of corticosteroid, and/or 5-fluorouracil, needle aspiration, surgical drainage, and laser therapy, [7][8][9][10][11] although none of those techniques is able to totally remove previously injected permanent fillers.…”

“…3,5,[7][8][9][10][11] The use of permanent fillers is totally or partially forbidden in some European countries such as the Netherland and Poland, especially for the challenge to face their surgical removal. 12 Several nonsurgical managements have been introduced to treat permanent filler complications, as systemic antibiotic therapy, intralesional injections of corticosteroid, and/or 5-fluorouracil, needle aspiration, surgical drainage, and laser therapy, [7][8][9][10][11] although none of those techniques is able to totally remove previously injected permanent fillers. The mainstay for a proper preoperative filler-removal evaluation is magnetic resonance imaging (MRI).…”