Watch out for scars- Vascular complication due to hyaluronic acid dermal filler

Vascular complication due to fillers

Abstract

Introduction: The frequency of cosmetic application and the possibility of complications are increasing day by day all over the world. It can be said that the most important complication that can be seen after cross-linked hyaluronic acid filler applications is vascular complications, because there may be results such as tissue loss and vision loss. Case: A fourty six year old female patient was consulted from the plastic surgery clinic with complaints of purple discoloration and pain on her forehead. In the anamnesis,it was learned that the patient's wrinkle in the frontal region was filled with filler 4 days ago. A bluish-purple area in a reticular pattern that does not disappear with pressing was observed,starting from the glabellar area and progressing towards the frontal hairline. Vascular complication due filler material and ischemia was considered in the patient and treatment was started immediately. Totally 300 U of hyaluronidase was injected intra and subdermally. It was recommended to mix  of topical betamethasone valerate and fusidic acid three times a day and apply topically to the complained area, and apply hot compress 4 times a day for 4 minutes. The patient was referred for hyperbaric oxygen therapy for an average of 2-2.5 hours per day for 2 consecutive days. On the 7th day after the first hyaluronidase administration, the patient's physical examination revealed no signs of significant ischemia and vascular occlusion. Discussion: Our aim in sharing this case was to state that although the risk of vascular complications in filler applications is related to the amount of filling, there is a risk of vascular complications even in very-very small filling applications. In addition, if there is a previous surgical, traumatic or burn scar tissue in an area, we think it would be beneficial to think twice before applying.