ABSTRACT
An ever-increasing interest in perioral rejuvenation with dermal fillers reflects
the aesthetic importance of this region. However, filler injections in the lips and
perioral area have been associated with various complications. Such complications
are classified according to severity (mild, moderate, severe) or by the time of onset:
immediate (within 24 hours after injection), early (24 hours to 4 weeks post-procedure), and late or delayed (>4 weeks after injection).
While most complications are mild and manageable, vascular compromise, infections,
and the development of delayed-onset nodules may significantly undermine the ultimate
aesthetic outcome and cause substantial morbidity. These more serious complications
often require more invasive treatment modalities. This article details the prevention
and management of such adverse events and discusses safe filler injection principles,
including safety recommendations for the lips. Lastly, we highlight the use of ultrasound
guidance in complication prevention (vascular mapping, filler identification, location,
and extent), assessment (identification of intra-vascular embolus or external vascular
compression by the filler implant), and management (real-time imaging of hyaluronidase
or other drug injection in the affected area). Aesthetic practitioners should be versed
in injection anatomy and the prevention, recognition, and management of filler complications
in the perioral area.
Keywords
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Article info
Publication history
Accepted:
January 29,
2023
Received:
July 26,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Precision diagnosis and treatment of vaso-occlusive complications from injectable dermal fillers: Evolving role for ultrasound guidanceJournal of Plastic, Reconstructive & Aesthetic Surgery
- PreviewInjectable dermal fillers, fat injection, and neurotoxins play an ever-greater role in plastic surgery, as growing numbers of patients seek minimally invasive options to address facial aging, acquired deformities, and reconstructive needs.1–5 Despite the appeal of injectables as well-tolerated, low-risk interventions with negligible downtime, there is potential for rare, but significant complications. Among the most concerning complications of injectable dermal fillers are vaso-occlusive events and necrosis.
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- Re: Complications of Fillers in the Lips and Perioral area: Prevention, Assessment, and Management Focusing on Ultrasound GuidanceJournal of Plastic, Reconstructive & Aesthetic Surgery
