The use of injectable dermal fillers like hyaluronic acid carries some risks. Some of them are general to deraml fillers and concern every injectable material and some are specialized in hyaluronic acid. As with any injection, antiseptic measures should be taken. It is reasonable that if we pierce the skin with a needle without first wiping the area with antiseptic, a skin germ can be inoculated. In most cases it is inoculated but takes over our immune system and neutralizes bacteria.But sometimes when our body is vulnerable our immune system does not do so well. Then it is possible to create a micro-abscess which causes problems if appropriate measures are not taken.
Specific complications of hyaluronic acid include the failure of the desired aesthetic effect, the formation of granuloma, ischemia and necrosis of soft tissue from excessive injection with consequent pressure of the material on the soft tissue and the intravascular infusion of hyaluronic acid. The latter case is frightening when we inject the material in the area of the nasopharyngeal groove, nose and middle eyebrow. This area carries vessels that communicate with the artery of the eye. So, I would say it is obvious that hyaluronic acid should always be used by a specialist plastic surgeon as he is the only doctor well trained in the material but also in human anatomy. About 300 cases of injectable hyaluronic acid blindness have been recorded in the world literature. The number is certainly small compared to the millions of treatments that are done every year but this should not reassure us and turn to unskilled doctors. The immediate action of the doctor can save the patient’s vision. It requires direct injection of hyaluronidase behind the eye as close as possible to the ocular artery and additionally to the area where the material was injected. All other complications from the use of injectable hyaluronic acid are reversible either by the use of hyaluronidase or by other measures.
- Hyaluronic acid