Nerve damage during an aesthetic procedure is rare, but it can occur due to various causes such as direct trauma, injection of filler into the nerve, or compression of tissue by the product. The damage can be either transient and reversible or permanent. Dermal fillers are a great way to provide a temporary solution to facial lines and wrinkles. However, recent studies suggest 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 fillers should be used as part of a short-term treatment plan and long-term use is not recommended. 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. To ensure optimal results, it is essential to be familiar with the physical characteristics of different fillers, injection techniques, behavior of fillers in tissues, responses of tissues, and detailed knowledge of anatomy of the region. ASAPS data reveals 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 successful filler injections is to inject the right filler at the right level to the right patient 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 recent years, there has been a sharp increase in indications for using injectable fillers in facial aesthetics. Malar oedema can be caused by injecting 1 ml of HA filler and 3D reconstruction of MRI face shows a large amount of HA filling in the infraorbital region.
To minimize complications, it is important to have a better understanding of detailed facial anatomy, evolving filler characteristics and mastery of injection techniques.
