Efficacy of Percutaneous Intraarterial Facial/Supratrochlear Arterial Hyaluronidase Injection for Treatment of Vascular Embolism Resulting From Hyaluronic Acid Filler Cosmetic Injection.

Abstract

BACKGROUND:

Vascular embolism is a serious complication of hyaluronic acid (HA) filler cosmetic injection, and hyaluronidase injection has been proposed as the treatment. Until now, there has been a lack of adequate clinical evidence regarding the benefits of treatment for HA filler-induced vascular embolism by percutaneous facial or supratrochlear arterial hyaluronidase injection.

OBJECTIVES:

The authors sough to evaluate the efficacy of percutaneous facial or supratrochlear arterial hyaluronidase injection as a rescue treatment for HA filler-induced vascular embolism.

METHODS:

We included 17 patients with vascular embolism after facial HA filler injection. Intraarterial injection of 1500 units hyaluronidase was performed via facial artery for 13 cases with skin necrosis and via supratrochlear arterial for 4 cases with severe ptosis and skin necrosis but no visual impairment. Simultaneously, general symptomatic treatment and nutritional therapy were performed.

RESULTS:

After hyaluronidase injection, facial skin necrosis in all cases was restored and ptosis in the 4 cases was also significantly relieved. Patients were subsequently followed-up for 1 month to 1 year. The skin necrosis in 16 patients completely healed, and only 1 patient had small superficial scars.

CONCLUSIONS:

It is effective to alleviate skin necrosis and ptosis resulting from HA filler embolism via percutaneous facial or supratrochlear arterial hyaluronidase injection.

LEVEL OF EVIDENCE: 4:

• Authors: Can Zheng, Qiang Fu, Gui-Wen Zhou, Lin-Ying Lai, Li-Xia Zhang, De-Quan Zhang, Guo-Jie Chen, Li-Ming Liang, Min-Liang Chen
• Journal: Aesthetic surgery journal (Aesthet Surg J) Vol. 42 Issue 6 Pg. 649-655 (05 18 2022) ISSN: 1527-330X [Electronic] England
• PMID: 34958671 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Dermal Fillers
• Hyaluronic Acid
• Hyaluronoglucosaminidase

Topics

• Arteries
• Cosmetic Techniques (adverse effects)
• Dermal Fillers
• Embolism (drug therapy, etiology)
• Humans
• Hyaluronic Acid
• Hyaluronoglucosaminidase
• Injections, Intra-Arterial
• Necrosis