Summary: All fillers are associated with the risk of both early and late complications. Early side effects such as swelling, redness, and bruising occur after intradermal or subdermal injections. The patient has to be aware of and accept these risks. Adverse events that last longer than 2 weeks can be attributable to technical shortcomings (e.g., too superficial an implantation of a long-lasting filler substance). Such adverse events can be treated with intradermal 5-fluorouracil, steroid injections, vascular lasers, or intense pulsed light, and later with dermabrasion or shaving. Late adverse events also include immunologic phenomena such as late-onset allergy and nonallergic foreign body granuloma. Both react well to intralesional steroid injections, which often have to be repeated to establish the right dose. Surgical excisions shall remain the last option and are indicated for hard lumps in the lips and visible hard nodules or hard granuloma in the subcutaneous fat. (Plast. Reconstr. Surg. 118 (Suppl.): 92S, 2006.)
The aesthetic benefit the patient achieves with temporary fillers is 90 percent technique and 10 percent substance. With permanent fillers, it's 99 percent technique.Jean Carruthers 1 A ll injectable dermal fillers can cause complications. Late side effects can be divided into those caused by insufficient training or technical errors during injection and those caused by immunologic (allergic and nonallergic) reactions to the injected substance. In the case of late, nonallergic reactions, the pathologic substratum differs from injectable to injectable but can always be classified into one of three distinct forms of foreign body granuloma.2 The histologic reaction is always similar, 3 and the trigger for this sudden stimulation of macrophages might be a systemic infection of the patient.