Understanding How to Prevent and Treat Adverse Events of Fillers and Neuromodulators

Glynis Ablon, MD, FAAD

Disclosures

Plast Reconstr Surg Glob Open. 2016;4(12S):e1154 

In This Article

Abstract and Introduction

Abstract

Experience teaches cosmetic surgeons to become good, but avoiding and treating adverse events make them great. In no area is this more true than in cosmetic procedures involving fillers and neuromodulators. By utilizing knowledge of materials and anatomy involved, specialists seek to avoid complications. A well-trained physician is able to reduce the sequelae from an adverse event by acting promptly using algorithms and a methodical approach to treatments. In this article I discuss the difference between perceived and true complications from fillers and neuromodulators, how to avoid, what to look for and how to treat to provide patients with the best possible outcomes, and make the physicians life less stressful.

Introduction

Experience teaches cosmetic surgeons to become good, but avoiding and treating adverse events make them great. In no area is this more true than in cosmetic procedures involving fillers and neuromodulators. By utilizing knowledge of the materials and anatomy involved, specialists seek to avoid complications. A well-trained physician is able to reduce the sequelae from an adverse event by acting promptly using algorithms and a methodical approach to treatments. In many instances, dealing with complications may be iterative because no 2 complications are exactly the same. However, by understanding the etiology and using an algorithm, it is possible to have a solid foundation.

When injecting fillers and toxins, it is imperative to differentiate between real and imagined complications. Each injection entails some degree of risk, and all of the potential complications should be in the informed consent signed by the patient. In addition, the most frequent and significant adverse events should be discussed before the procedure. Common treatment-related adverse events may be perceived by patients as complications if they do not expect to encounter them. For instance, bruising, pain, edema, erythema, needle marks, and asymmetry are all events that are common with any type of procedure involving an injection. However, true complications are the ones we are primarily concerned about. These include scars, infections, granulomas, persistent lumps, droops and ptosis, visible palsy, and vascular occlusion. By understanding the anatomy and the materials being injected, it is possible to decrease the probability of a complication and to mitigate the outcome should one occur.

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