Can fillers cause permanent nerve damage?

Nerve damage during an aesthetic procedure, although very rare, can occur as a result of different causes, such as direct trauma, injection of filler into the nerve, compression of tissue by the product. Nerve injury can be transient and reversible or permanent. As you may already know, dermal fillers are a great way to provide a temporary solution to facial lines and wrinkles. However, recent studies indicate that repeated and prolonged use of deep tissue facial fillers can cause permanent damage or damage to the lymphatic system of the face.

It is important to note that the decision to use fillers should be part of a short-term treatment plan and that long-term use is not recommended. A clear understanding of facial anatomy, the physical characteristics of all fillers used, early recognition and treatment options of complications will ensure optimal results. A team led by Cemile Nurdan Ozturk of the Cleveland Clinic found reports of 61 patients who had serious complications from facial filling procedures, including dead tissue in the nose. What is needed is to be familiar with the physical characteristics of the different fillers, the various injection techniques, the behavior of fillers in the tissues, the responses of the tissues, and a detailed knowledge of the anatomy of the region to be able to adopt a safe and systematic approach to treating complications of fillers.

ASAPS data reveal 1.8 million botulinum toxin procedures and 0.8 million hyaluronic acid (HA) filling procedures performed in the United States alone, making HA fillers the second most popular procedure in the United States. The key to injecting fillers is to inject the right filler at the right level to the right patient and also at the right time. Prevention consists of avoiding filler injection in people who already have malar pockets (pre-existing lymphatic involvement), injection of preperiosteal filler, low G', low hygroscopic and small volume in the infraorbital region. There are seven danger zones for facial nerves that should be avoided when injecting fillers into the face.

NTM infection after filler injections was reported in 2002 following the use of a non-FDA-approved filler. Nodules that occur after HA fillers can be dissolved with hyaluronidase, while those that occur after fillers without HA can be altered by massage after injecting them with saline or lidocaine. Since HA fillers are the most common fillers used in the world today, most complications are observed with them and are treatable most of the time. In different non-surgical facial procedures, fillers are used to inject into the skin layers of the dermis and middle dermis.

In the last decade there has been a sharp increase in indications for the use of injectable fillers in facial aesthetics. A) Malar oedema by injection of 1 ml of HA filler (B) 3D reconstruction of the MRI face showing a large amount of HA filling in the infraorbital region. A better understanding of detailed facial anatomy, evolving filler characteristics and mastery of injection techniques will ensure that most complications can be prevented and their incidence minimized.

Shelly Hongach
Shelly Hongach

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