Injection Necrosis of the Glabella: Protocol for Prevention and Treatment After Use of Dermal Fillers

Glaich, Adrienne S.; Cohen, Joel L.; Goldberg, Leonard Harry

doi:10.1111/j.1524-4725.2006.32052.x

Cited by 131 publications

(132 citation statements)

References 14 publications

(41 reference statements)

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“…However, the greatest shortcoming of these synthetic fillers is that they are recognized as a foreign substance by the body, which can cause immune rejection or a granulomatous response. Several studies have reported that these fillers were biocompatible, but other studies have shown a risk of adverse reactions [3][4][5][6]. Moreover, when the area to be corrected is wider, a large amount of filler is required, and this presents limitations due to cost.…”

Section: Discussionmentioning

confidence: 99%

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The Feasibility of Platelet-Rich Fibrin Matrix Filler in a Nude Mouse Model

Jeon

Kim

Lee

et al. 2017

Arch Aesthetic Plast Surg

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Background In contrast to fillers made from artificial substances, platelet-rich fibrin matrix (PRFM) filler does not cause hypersensitivity reactions or foreign body reactions. PRFM is also highly accessible in terms of cost. Hence, in this study, the efficacy of PRFM for soft tissue augmentation and volume maintenance was evaluated in an animal experiment. Methods Twenty nude mice were injected with hyaluronic acid filler, fibrin glue, PRFM filler, and normal saline (control). The remaining volume was measured 4 times over the course of 8 weeks using the volumetric taping bowl method and magnetic resonance imaging. Results All nude mice survived and showed no signs of infection, such as erythema or edematous changes, during the study period. Migration of the injected substance was not detected at 2, 4, or 8 weeks after the procedure. The remaining volumes of normal saline at 2, 4, and 8 weeks were 10.50%, 2.00%, and 0.00%; fibrin glue, 20.50%, 9.00%, and 2.50%; hyaluronic acid filler, 82.00%, 35.00%, and 17.33%; and PRFM filler, 70.31%, 26.75%, and 14.37%, respectively. Conclusions PRFM filler had a high soft-tissue filling capacity compared with the control. It also showed a similar effect to hyaluronic acid filler. Thus, PRFM filler could be a good alternative for correcting soft-tissue deficits.

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Section: Discussionmentioning

confidence: 99%

“…NUMBER 3. OCTOBER 2017 ing, encapsulation, and granuloma formation, as well as chronic or delayed infections [3][4][5][6]. For this reason, doctors have been searching for autologous sources for soft tissue augmentation.…”

Section: Introductionmentioning

confidence: 99%

The Feasibility of Platelet-Rich Fibrin Matrix Filler in a Nude Mouse Model

Jeon

Kim

Lee

et al. 2017

Arch Aesthetic Plast Surg

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“…Hyaluronidase, by quickly breaking down the hyaluronic acid polymer, is able to reduce the risk of skin necrosis secondary to vascular compression if injected early, according to the medical literature [6][7][8]. Unfortunately, injection after 24 hours has been shown to be rather inefficient.…”

Section: Vascular Compression and Occlusion And The Risk Of Necrosismentioning

confidence: 99%

The Use of Hyaluronidase to Treat the Excess of Cross-Linked Hyaluronic Acid Following Aesthetic Medicine Procedures: A Practical Point of View

Ranneva¹

2017

Emerg Med

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Polymers formed by hyaluronic acid are generally catalyzed by Hyaluronidase and the product contains oligomers. Hydrolysis of the bond present in between the N-acetyl-Dglucosamine and D-glucuronic acid is responsible for such chemical process. Huge literature support is present supporting the application of this process for reducing cellulitis fibrosis. In the recent times, potential granulomatous reactions are being treated through this process as well as aiding in dissolving excess hyaluronic acid filler. Implication of hyaluronidase includes simple jabbing of hyaluronidase enzyme prepared with sterile solution. Generally, the solution consist sterile lyophilized hyaluronidase preparation with sterile saline medium. After conducting the allergy testing direct injection can be given to the problem area for treatment. Assessment of allergy is mandatory as the enzyme hyaluronidase protein may invoke sensitization in the patient. The expected outcome is mostly rapid and definitive.

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“…Collagen, HA and poly-L-lactic acid can induce granulomatous response, which in some cases can be asymptomatic or manifest as erythema, swelling or nodule formation [10,11,12]. Circulation impairment caused by vascular compression and leading to necrosis or vision loss results from filler administration in the problematic regions or "danger zones" like glabella area, cheeks, nasal ala, peri-oral or temporal area [13,14,15].…”

Section: Artificial Fillers and The Adverse Events Of Their Usementioning

confidence: 99%

Fat graft – the natural choice for reconstructive, regenerative and aesthetic surgery

Ibrahim¹,

Rybacka-Mossakowska²,

Michalak³

2017

Advances in Cell Biology

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The search for appropriate filler, which can be used for aesthetic and reconstructive operations is currently one of challenges for plastic surgery. The application of absorbable and permanent artificial fillers may cause adverse events. Thus, autologous fat grafting can be a safe alternative. Moreover, fat tissue is rich in adipose-derived stem cells (ASC), which can be successfully used for regenerative procedures. The paper reviews reports on fat grafting procedures, which indicate risks and their possible prophylactic. Adipose tissue is a much more prolific source of ASCs than bone marrow. Basically, ASC are characterized by a spectrum of markers: CD11b-CD45-CD13+CD73+CD90+, which can be widened by CD36+CD-106-CD10+CD26+CD49d+CD49e+CD3-D49f -PODXL-to improve phenotyping. It is suggested to use at least two negative markers and two positive markers during the same phenotyping analysis. Fat transfer requires appropriate approach, planning and technique to make it clinically successful. Fat grafting fulfills the expectations for ideal injectable agent, which can be used for aesthetic and reconstructive surgery. To improve the survival of fat graft, careful decisions on donor site, local anesthetic administration, liposuction method, processing and placement methods need to be made. Moreover, fat is the source of adipose-derived stem cells which can be used for regenerative procedures. A proper transformation and identification of those cells is required to improve clinical effects.Running title: Fat graft -The natural choice for plastic surgery

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Injection Necrosis of the Glabella: Protocol for Prevention and Treatment After Use of Dermal Fillers

Abstract: Injection necrosis in the glabellar region may be prevented by knowledge of the local anatomy and an understanding of its pathophysiology and treated by a suggested protocol.

Cited by 131 publications

References 14 publications

The Feasibility of Platelet-Rich Fibrin Matrix Filler in a Nude Mouse Model

The Feasibility of Platelet-Rich Fibrin Matrix Filler in a Nude Mouse Model

The Use of Hyaluronidase to Treat the Excess of Cross-Linked Hyaluronic Acid Following Aesthetic Medicine Procedures: A Practical Point of View

Fat graft – the natural choice for reconstructive, regenerative and aesthetic surgery

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