Treatment Protocol for Acute Arterial Occlusion Secondary to Facial Revolumization Procedures

Dominguez, Steven; Moshrefi, Shawn; Dobke, Marek

doi:10.12788/emed.2017.0030

Cited by 6 publications

(6 citation statements)

References 21 publications

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“…These options include topical nitroglycerin, hyperbaric oxygen, phosphodiesterase inhibitors, and anticoagulants [12]. If a patient is seen immediately after or during a procedure in which occlusion is suspected, hyaluronidase can be used to degrade the remaining HA [13]. Alternatively, anticoagulation with a phosphodiesterase inhibitor or low molecular weight heparin can be used [12,14].…”

Section: Discussionmentioning

confidence: 99%

“…Massaging and warming the area are also recommended, as is applying topical nitroglycerin to the area [13,14]. Finally, patients are typically transitioned to anti-platelet therapy with 81mg…”

Section: Discussionmentioning

confidence: 99%

“…Dermatology Online Journal || Photo Vignette aspirin [13], until resolution or satisfactory improvement. In our case, the patient presented three days after the incident and was therefore no longer a candidate for hyaluronidase treatment.…”

Section: Discussionmentioning

confidence: 99%

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Livedo racemosa secondary to hyaluronic acid injection

Toussi¹,

Ma²,

Tartar³

2020

DOJ

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Livedo racemosa secondary to hyaluronic acid injection

Toussi¹,

Ma²,

Tartar³

2020

DOJ

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“… 6 A comprehensive treatment approach may include hyaluronidase (if a hyaluronic acid filler), topical nitroglycerin paste, warm compresses, steroids, aspirin or low molecular weight heparin, phosphodiesterase inhibitor, HBO2, consideration of prophylactic antibiotic and antiviral therapy, and plastic surgery, ophthalmology, and neurology consultation. 7 …”

Section: Discussionmentioning

confidence: 99%

Hyperbaric Oxygen for Ischemia due to Injection of Cosmetic Fillers: Case Report and Issues

Henderson

Reilly

Cooper

2018

Plastic and Reconstructive Surgery - Global Open

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Summary:Natural and synthetic fillers have revolutionized aesthetic facial rejuvenation and soft-tissue augmentation. We present a case highlighting the dangers of filler self-injection. A 37-year-old woman self-injected a dermal filler around both temples. She immediately experienced left--side hearing loss, blanching over the left face, and pain. Prompt treatment with hyaluronidase, topical nitro paste, and warm compresses ensued. An emergency computed tomography angiogram showed occlusion of a superficial temporal artery branch. We treated her with enoxaparin, aspirin, dexamethasone, piperacillin-tazobactam, and intradermal lidocaine. After 6 hyperbaric oxygen therapy (HBO2) treatments in 3 days, the patient showed improvement in appearance with markedly decreased ischemic discoloration and her hearing returned to baseline. Algorithms for treating such injuries generally neglect HBO2. HBO2 is thought to be efficacious in these situations by a variety of mechanisms: oxygenation of ischemic tissues, reduction of edema, amelioration of ischemic/reperfusion injury, promotion of angiogenesis and collagen maturation. Her resolved hearing highlights the utility of HBO2 in sudden hearing loss as well. Injectors should have guidelines for using product, not only on patients but staff as well. Filler courses should include handling complications and include HBO2 in their guidelines. Clinicians should remind patients to seek treatment from qualified clinicians. The goal of a bargain price using self-injection may quickly become expensive and disfiguring.

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“…Serious complications are rare and include delayed onset nodules and/or vascular compromise/occlusion that can lead to tissue necrosis, stroke, and permanent visual impairment. 19,21-30 These can be prevented and minimised with comprehensive knowledge of the relevant anatomy, pharmacology, and physiology, together with the use of a correct injection technique.…”

Section: Introductionmentioning

confidence: 99%

Complications of toxins and fillers in facial aesthetics

Samizadeh,

De Boulle

2023

Prim Dent J

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Dermal filler and botulinum toxin injections are among the most performed non-invasive procedures for rejuvenation and contouring, internationally. Although most dermal fillers and approved botulinum toxins are well tolerated with a high safety profile, adverse events and/or complications can happen. Injection-related sequelae and side effects are usually rare, mild, transient, and self-limiting in nature. However, devastating and life-changing complications, such as intravascular occlusion, skin necrosis, permanent visual impairment, and stroke, have been reported. Risk reduction measures include an in-depth knowledge of anatomy, physiology, and pharmacology, correct patient selection, correct identification of clinical indications, and, fundamentally, the importance of appropriate skill and training. In this paper, some of the complications are discussed and advice on how to minimise adverse events and complications from these injectables is provided.

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Treatment Protocol for Acute Arterial Occlusion Secondary to Facial Revolumization Procedures

Cited by 6 publications

References 21 publications

Livedo racemosa secondary to hyaluronic acid injection

Livedo racemosa secondary to hyaluronic acid injection

Hyperbaric Oxygen for Ischemia due to Injection of Cosmetic Fillers: Case Report and Issues

Complications of toxins and fillers in facial aesthetics

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