I am indebted to Park et al. for continuing to share their experience treating complications of fillers.
1
The article did not mention where the initial treatment was rendered. In their facial filler article, Park et al. wrote that all of those patients had their initial injections elsewhere.2
I assume that some, if not all, of their hand patients were initially treated elsewhere as opposed to having been treated at Park et al.'s institutions where the prior records should have been readily available. It is well known that there can be marked differences between what a patient believes was injected and what was indeed injected.3
, 4
The authors presented a treatment algorithm that is based upon what filler was injected. They wrote:
“For CaHA fillers, our clinical experience suggests that treatment with intralesional steroids or hyaluronidase injection is not appropriate.”1
Thus, it is important for readers to know that the authors had first hand knowledge of what fillers were injected as the algorithm recommended different treatments for hyaluronic acid, calcium hydroxyapatite (CaHA) and other fillers.
Could the authors please explain how they knew what fillers had been injected before instituting treatment?
- •Did they solely rely upon the patient's history?
- •Did they review prior medical records?
- •Did they find certain characteristics for different fillers on physical examination and imaging studies? If so, what were these characteristics?
- •Did they perform preliminary biopsies that were subjected to chemical analysis?
Funding
None.
Conflict of interest
None.
References
- Clinical experience with complications of hand rejuvenation.J Plast Reconstr Aesthet Surg. 2012; 65: 1627-1631
- Clinical experience with hyaluronic acid-filler complications.J Plast Reconstr Aesthet Surg. 2011; 64: 892e7
- Facts not fiction: Fake Botox®, Omega-3 fatty acids are good for you and the “Toxic Tush” Syndrome.J Plast Reconstr Aesthet Surg. 2012; 65: 1138-1140
- The use of NMR spectroscopy for identifying unknown foreign materials after aesthetic procedures.J Plast Reconstr Aesthet Surg. 2012; 65 ([Epub 2011 Oct 28]): 692-694
Article info
Publication history
Published online: August 06, 2012
Received:
July 4,
2012
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
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- Reply to ‘Comment: Clinical experience with complications of hand rejuvenation’Journal of Plastic, Reconstructive & Aesthetic SurgeryVol. 65Issue 12
- PreviewWe would like to thank Dr. Freshwater for his comments regarding our article “Clinical Experience with Complications of Hand Rejuvenation.” As with our previous publications,1–4 most patients in our present work were referred to our institution from other hospitals.5 We totally agree with Dr. Freshwater that knowing the exact fillers injected is important to give patients proper treatments. As a tertiary medical center in our country, we received a letter of medical request without exceptions. Among those patients, 15 patients treated at our institution with prior medical records including proven injected materials were selected in this work.
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