Such cool, but not always safe fillers: complications that may arise

Under the eyes

Hyaluronic acid is often injected under the eyes to achieve the following goals:

• Improve skin condition.
• Get rid of wrinkles.
• Increase skin elasticity.
• Remove dark spots under the eyes.

The last reason is the most popular. But the skin in this area is very thin. Because of this, when hyaluronic acid is injected into this area, the likelihood of any side effects occurring is highest. The skin is very sensitive, so the cosmetologist administers an anesthetic half an hour before the procedure.

Next, the area under the eyes is treated with an antiseptic. The injection is administered according to a special scheme for the eye area to avoid mistakes. The insertion site is sealed with a special plaster to prevent infections.

To prevent various complications, it is recommended to apply ice to the area where the gel is introduced; this will also help reduce swelling. Swelling most often occurs within 2-7 days. But to determine its nature, you need to re-visit an aesthetic medicine specialist after 1-2 days.

Is it possible to remove creases in the nasolabial area using other methods? Yes, but such methods also have their own characteristics.

• Hardware procedures. Hardware cosmetology effectively fights shallow wrinkles by stimulating collagen production. It is carried out in a course of 5–6 procedures. Does not eliminate deep creases.
• Dysport and Botox injections. The technique involves introducing a toxin that blocks brain signals entering the desired muscle area, as a result of which they relax and fine wrinkles are smoothed out. The procedure is effective for eliminating shallow creases that are visible during facial expressions and invisible in a relaxed state.
• Mesothreads. During correction, special threads are introduced into the subcutaneous layers to form a strong frame. As a result of such manipulations, the muscles are tightened - a lifting effect is created. Often this procedure is supplemented with fillers to add volume to the nasolabial area.
• Mesotherapy. Like fillers, mesotherapy is injected and has a rejuvenating effect. The fillers are ready-made cocktails or those prepared by a cosmetologist. The technique is used to eliminate shallow wrinkles and prevent dermal aging.
• Plasmolifting. During the procedure, plasmafillers are used - drugs that are created from the patient’s own blood, and therefore do not cause side effects or rejection. The technique is aimed at launching the natural processes of skin rejuvenation. The effect of such fillers lasts from 3 weeks to 2 months.
• Lipofilling. A similar procedure, but the filler is the patient’s adipose tissue. The drug is not completely eliminated from the body. Filler migration, asymmetry after correction, and even infection are possible.

Despite the fact that biorevitalization, mesotherapy or any other procedures aimed at improving both the condition of the skin and the appearance in general have long been worked out by many (almost all) cosmetologists, the possibility of any unpleasant manifestations is still possible. and sometimes even dangerous side effects after the injection of a specialized product.

There are situations when it is simply necessary to remove filler from under the skin, especially when it comes to the area under the eyes. The extremely thin and sensitive skin is very susceptible to various types of complications after a procedure aimed at improving appearance. Among the “symptoms” when you should not waste a minute, the following stand out:

• The first signs of necrosis, expressed in blanching of the area where the product was administered, numbness and pain, especially acutely felt during touching. Necrosis is the death of cells, and in the most advanced situations, of tissues as a whole. Despite the fact that such a side effect is considered extremely rare, it is still better to know about it so as not to miss the moment when help can still be provided.
• Insufficient depth of filler injection. If the cosmetologist who performed the procedure incorrectly calculated how much inside the needle of the syringe with the drug should be inserted, the Tyndall effect may occur, which manifests itself as a slight blue discoloration of the areas where the drug was introduced.
• Formation of granulomas. This phenomenon is caused by the fact that the body was unable to recognize hyaluronic acid as an assistant and began to produce “response actions” aimed at protecting its safety.

Granulomas
Physically safe, but unpleasant consequences of the correction procedure include the following:

• Aesthetic deterioration of the face. In fact, there are often situations when the client does not like the result that appeared after the procedure: lips that seemed attractively plump actually became “ducky” and completely unsuitable for a particular patient, and an inadequate immune response to a foreign substance turned barely noticeable wrinkles under the eyes into real swelling bags.
• Physical discomfort. Actually, they do not cause pain or any symptoms of dangerous consequences, however, if after the administration of the drug it becomes uncomfortable and unpleasant, then you can and should seek the help of a cosmetologist who will “extract” the cocktail.

In addition to hyaluronidase, there are several other procedures to neutralize the consequences of improper administration of a cocktail based on hyaluronic acid. You can remove fillers under the eyes using:

• Surgical method. This approach is used if the correction was carried out with an old-generation product that cannot be dissolved with hyaluronidase.

Such cocktails are distinguished by the fact that they can “grow” into the tissue, so it is impossible to completely remove them in any way, even with the help of surgery. Remains of the composition can cause inflammation at any time and even turn into an abscess.

• Darsonvalization, laser or microcurrent therapy. These three procedures are absolutely identical to the procedure for introducing hyaluronidase, however, their effect appears much slower and less pronounced than the injection of the substance. Alternatives are used if there are any contraindications to the introduction of the enzyme itself.

On the lips

Recently, an increasing number of girls are turning to cosmetologists to increase their lip size. Some guys also follow this fashion. To increase the volume of the lips, the doctor injects hyaluronic acid with a needle.

If immediately after the injection or after some time swelling, facial asymmetry begins to appear, and the lips in some places become blue-black or gray, then these signs indicate the Tyndall effect. This side effect on the lips can be accompanied by pain and discomfort while eating.

Sometimes swelling goes away after a few days without medical intervention.

This is due to the high sensitivity of the skin of the lips. Typically, subcutaneous tubercles have an oval shape. It is impossible to completely hide the manifestations with decorative cosmetics, even if you use matte lipstick. When the Tyndall effect occurs in the lip area, it usually resolves within 2 months.

READ ALSO: How you can remove nasolabial folds using salon procedures, special exercises, folk and cosmetic products

Some girls expect the side effect to disappear on its own. But you can contact a specialist to quickly remove excess filler using hyaluronidase. At the first symptoms, you should in any case consult a doctor so that an infection does not spread in the tissues, which can lead to necrosis.

Fibrosis after hyaluronic acid

Any cosmetic and especially plastic manipulations can be accompanied by general reactions of the body, which depend on individual sensitivity. When injecting fillers, you have to deal with many similar complications; salons and companies are often silent about them.

Local anesthesia is always used during filler injection. But despite this, a certain degree of discomfort arises. This is due to the following:

• The diameter of the needle for introducing filler is sometimes quite large. Many solutions (including hyaluronic acid) cannot technically be passed through a small and thin needle.
• Most fillers are quite dense in nature. They roughly “pull apart” the tissue as the specialist injects the solution subcutaneously. This causes discomfort.
• Fan-shaped movements of the needle are often used during filler injection. This causes irritation of more nerve endings, which is accompanied by noticeable pain.

Many filler manufacturers, taking into account this pain aspect, produce a ready-made solution with the addition of an anesthetic, most often lidocaine.

Fillers can be injected into several areas at once, or in individual places. Each area on the face hides its own dangers and the most common complications.

Hematomas of various sizes often appear in the upper third of the nasolabial fold. This is due to the intensive blood supply to these areas. There is also an increased risk of recurrent herpes infection. Therefore, anyone who is prone to the appearance of these rashes is recommended to take a course of antiviral drugs before and after the injection of filler.

Skin necrosis in the area of ​​the nasolabial fold often occurs, which is complicated by the addition of a secondary bacterial infection.

Under the eyes

This area is one of the most sensitive to all kinds of influences. Even minor trauma leads to hematomas that “blur” up to 3-4 cm. It takes up to several weeks for them to completely disappear.

When fillers are injected into the area under the eyes, tissue swelling almost always occurs. To prevent this complication, it is recommended to apply ice to the gel injection area.

Filler injections are most often performed in this area. The following complications are possible:

• Swelling for 10 days or more.
• Formation of hematomas due to good blood supply to the lips.
• Recurrence of herpetic infection.
• Formation of knots both outside and inside the lips. The location of the seals on the side of the oral cavity can interfere with chewing and bring a feeling of constant discomfort when speaking. They can be removed surgically, as well as conservatively using physiotherapy, injections of enzyme preparations, etc.

Inflammatory nodule of the left lower lip after injection of hyaluronic acid

If your face hurts after fillers, this does not mean the development of pathology or a serious complication. Doctors consider this sensation as a side effect that does not require medical intervention or the use of any medications, and ceases to bother you 2-4 days after the procedure. Why does facial pain occur?

• the skin is injured during the injection of fillers, punctures are made in the deep layers of the dermis - pain is a natural reaction of nerve endings;
• fillers fill the voids, after which the soft tissues stretch and take a new position - pain means adaptation of the dermis to new conditions;
• human skin is too sensitive and reacts inadequately to any impact.

If the face does not begin to hurt immediately, but 5 or more days after the manipulation, then this may mean infection in the punctures, the development of inflammation - the help of a doctor will be required.

If the recovery period after filler injections is accompanied by the formation of atypical lumps, then this is called facial fibrosis. If this happens during the first 24 hours and persists for another 72 hours, then there is no need to seek medical help - the phenomenon is natural and does not pose a danger to the general health of the patient.

But if the seals persist for a longer time, you must undergo an examination by a cosmetologist.

Causes of the problem:

• inadequate reaction of the body to the injection of filler - tissue rejects it as a foreign body;
• low quality hyaluronic acid;
• moving the filler under the skin;
• there is an increased production of fibroblasts, which causes intensive growth of connective tissue;
• superficial injection of filler;
• incorrect calculation of the drug dose.

These fillers are considered one of the safest and most biocompatible. Hyaluronic gel attracts liquid, so there is always tissue swelling at the injection sites. This filler often migrates from the injection area. Over time, it resolves and the procedure has to be repeated.

Women often complain of a “hollow” under the eyes due to the presence of wrinkles in the area of ​​the nasolacrimal groove. The defect can be easily corrected with fillers. But you need to be prepared for tissue swelling and infraorbital hematomas.

Such materials are practically never used. Non-absorbable gels always shift over time, distorting the shape of the face. They can also compress important venous and arterial vessels, disrupting the nutrition of the tissues of the area.

Chronic inflammation is always present at the injection site of such gels, which leads to excessive growth of connective tissue and rejection of the filler.

If after injection of filler an infection has entered the dermis, the following symptoms will indicate this:

• pain in the area of ​​the pathological focus is constantly present, has a pulling/aching nature, and can spread to the entire face;
• body temperature rises to low-grade levels;
• the skin at the site of development of the pathological process is very hot to the touch, “burning”;
• the face turns bright red.

Additionally, swelling, the formation of compactions, and tubercles with visually detectable purulent contents are noted.

Fibrosis is a thickening of connective tissue that forms after the introduction of hyaluronic acid. It can form as a complication of contouring or as a consequence of the body’s individual reaction to the injected substance. The main causes of fibrosis are:

• development of the inflammatory process at injection sites;
• violation of manipulation technique;
• rejection of a foreign substance by the body;
• movement of injected hyaluronic acid under the skin;
• vascular damage (puncture);
• violation of the rules of the rehabilitation period by the patient.

Pronounced symptoms of fibrosis are:

• the appearance of hard, dense formations at injection sites;
• the formation of a clearly defined tumor that does not move with intense palpation;
• mild discomfort in areas of fibrosis formation.

This complication after the introduction of hyaluronic acid is severe and late, occurring on the 3-5th day of the recovery period. With multiple compactions that are determined visually, doctors talk about granuloma - most often it occurs during manipulation of the lips.

The first symptoms of fibrosis of facial tissues after filler appear on days 4-6 of the recovery period. Most often present during anti-aging procedures on the lips, but can begin to develop anywhere. Treatment of fibrosis involves the use of the following:

• steroid hormonal drugs - injected directly into the changed areas of facial tissue, helps only in case of immune rejection of hyaluronic acid;
• cryodestruction and electrocoagulation procedures are effective only against superficial seals;
• laser and radio wave therapy - at least 5 procedures will be required and no doctor will guarantee a positive result.

Laser therapy

If signs of fibrosis appear in the nasolabial lips after fillers, then the only radical solution to the problem is to receive injections of hyralunidase: an enzyme that dissolves hyaluronic acid and ensures its rapid removal. No amount of physiotherapeutic procedures will help solve the problem.

If the patient does not consult a doctor in time about fibrous formations in the nasolabial lips, then a full-fledged surgical intervention will be necessary to correct the situation. It can lead to additional complications:

• wound infection;
• bleeding;
• tissue necrosis.

Fibrosis

Rehabilitation after fillers requires the patient to follow certain rules:

• avoid exposure to heat, refuse to visit the bathhouse, sauna and take a hot bath for 1-2 weeks;
• exclude excessive physical activity for 10 days, but moderate exercise is completely acceptable;
• for the first 2 days do not use decorative cosmetics;
• any care after fillers should be carried out by professional, high-quality cosmetics;
• For 2 weeks, touch the injection site of hyaluronic acid as little as possible, do not put pressure on it, and refuse massage.

You should give up decorative cosmetics

Inflammation cannot be considered a side effect. Despite the complete biological compatibility of non-sulfonated glycosaminoglycan, immediately after its administration, the internal organs activate their classic protective mechanism against “external irritants”. After a few days, all biological processes are normalized, and inflammation quickly disappears. If this doesn't happen:

• During the puncture, an infection entered the body. This does not mean that the cosmetologist did something wrong; maybe the injections only “activated” the viruses that had entered the tissue a few days before the injections;
• The woman was diagnosed with autoimmune diseases, which, in response to the absorption of the cocktail, began to inflame the treated area.

These two points are diametrically opposed. In the first case, the woman must take pharmacological agents, in the second - steroids, which dampens the effect of the local immune reaction. If steroids are injected into an area with a bacterial infection, the situation will only worsen, with the likely formation of massive suppurations and further scarring. Therefore, it is extremely dangerous to self-medicate; you need to urgently make an appointment with a specialist for qualified advice.

Leading cosmetology companies claim that fillers do not harm the body; unscrupulous clinics are to blame. It is not true. Despite the frequent use of anesthetic gel, the sensations from the procedure can be unpleasant.

How to treat complications

If any complications occur, you should contact a specialist and follow his recommendations. Self-medication and illiterate actions can only aggravate the situation.

If an infection occurs

In this case, it is imperative to undergo a course of treatment with antibacterial drugs. This can prevent the spread of infection and reduce the likelihood of noticeable scar formation in the future.

In case of insufficient correction with fillers

This is one of the least dangerous complications. Usually, for a complete correction, you simply need to perform the procedure again after a certain period of time.

Edema

This complication can be dealt with in different ways depending on the location. The following are highlighted:

• Manual massage. Especially useful for lips.
• Compliance with some nutritional rules. You should temporarily limit the consumption of alcohol, table salt, smoked and salty foods - everything that can provoke fluid retention in the body.
• It is helpful to apply cold compresses to areas of swelling.

Hematomas

Large bruises sometimes have to be opened and the contents removed. Small ones are easier to deal with; it is enough to lubricate the hematoma with heparin-based ointment. This will help the bruise “bloom” faster.

Fibrosis after fillers: what to do

Here's what to do if fibrosis develops after injection of fillers:

• administer specific drugs for resorption and removal of hyaluronic acid (hormonal steroids, hyaluronidase);
• undergo a course of laser and radio wave therapy;
• use cryodestruction - cold treatment.

Cryotherapy
If conservative methods do not give a positive result, then surgical excision of the nodes is prescribed. It is also indicated for deep fibrous formations.

Allergy

To eliminate allergic reactions, various hormonal ointments are used. But with pronounced changes, sometimes you have to remove the filler.

How to get rid of infiltration

An infiltrate (a compaction with clearly defined boundaries) can also form in the late rehabilitation period, and you can get rid of it as follows:

• undergo ultrasound diagnostics - determine the exact location of the problem, the boundaries of the capsule and the quality of its contents (there may well be pus there);
• introduce Lidaza into the problem area - a drug based on hyaluronidase, an enzyme that breaks down hyaluronic acid into water and carbon dioxide and quickly removes decay products;
• undergo a short course of anti-inflammatory therapy - you can use Ibuprofen, which will additionally have an analgesic effect.

Massages help get rid of the infiltrate only for a short time - the capsule simply “hides” in deeper tissues.

To learn how lip filler is removed using hyaluronidase, watch this video:

Gel migration

In most cases, you need to remove the filler from the place where it has moved. For example, to eliminate hyaluronic acid, the enzyme hyaluronidase is used to dissolve it. If the defect is not very large, you can wait until the gel itself dissolves in the tissues.

Seals

Various nodules can be removed surgically, and you can also try to treat them conservatively. Physiotherapy (electrophoresis and others) helps well in this regard.

Is it possible to remove it with Lidaza?

Lidase is a pharmaceutical preparation that includes a substance such as hyaluronidase. This medication is designed specifically to relieve the client from errors caused by incorrect injection of filler for correction.

Hyaluronidase is an enzyme that promotes the rapid breakdown of hyaluronic acid and the removal of residues from the skin after an unsuccessful procedure. This substance is obtained from the testes of pigs, sheep or often cattle. Despite all the rejection that this information could cause, it should be remembered that it is also produced by the human body and effectively fights not only the consequences of incorrect correction, but even cellulite fibrosis.

Mechanism of action of hyaluronidase

Lidaza is considered the most popular drug in Russia, as it has been used for quite a long time in various fields of medicine, for example, cosmetology, gynecology and surgery. This product, produced in Russia, is much more effective than expensive European analogues, which is why cosmetologists of the Russian Federation love this medicine so much.

The drug will bear fruit if you need:

• Eliminate excess hyaluronic acid. Injecting too much filler defies the “more is better” rule. On the contrary, the main substance of the “filler” can negatively affect the condition of facial features and facial expressions. There were situations when the excess volume of the drug “moved” to other, nearby places.
• Remove swelling. The area under the eyes is especially sensitive, which is why it is more susceptible to various changes, for example, the appearance of wrinkles, bags or bruises. Preparations based on hyaluronic acid, aimed at combating these unpleasant phenomena, often cause not a slight swelling at the injection site, but very painful swelling that requires immediate medical attention. Lidaza can just help eliminate the consequences.

Before and after filler removal

• Prevent necrosis. Necrosis is the death of tissue and at the same time the most serious side effect that can occur after correction. If too much of the drug is administered, the drug can compress the blood vessels, as a result of which sufficient blood flow to the area is prevented and disturbances in the functioning of cells occur.
• Neutralize blueness and bumpiness. A phenomenon called the Tyndall Effect occurs when the filler shows through or produces bumps from the filler when an excessive amount of the product is injected. The area under the eyes is especially susceptible to this consequence, since the skin there is particularly tender and thin.

• Cure granulomas. Granuloma is a tumor-like formation that occurs as a result of a protective reaction of the body that perceives hyaluronic acid as a harmful object. Hyaluronidase is able to “break” the chain of filler structure and, accordingly, remove the immune system from a state of mobilization.

How to avoid complications

In order to minimize the risk of unpleasant consequences after the injection of fillers, it is useful to follow the recommendations:

• Choose only a trusted clinic and specialist. Never fall for the “at-home beauty” tricks.
• On the eve of the procedure, you must tell the doctor about all previous similar manipulations. Some fillers are incompatible with each other, so they should not be applied to the same area, even over time.
• It is advisable to introduce filler gradually, in small doses. It is better to make a correction later than to remove excess gel.
• Do not use substances that constrict blood vessels at the injection site, such as epinephrine. This way you can miss a terrible complication - thrombosis of a vein or artery.
• It is better to use fillers, the excess of which can be easily removed. For example, hyaluronic gel easily disappears with the introduction of hyaluronidase.
• Perform an aspiration test during injection. It helps determine whether the needle has entered the vessel.

Side effects after a few years

When injecting fillers, consequences can occur even after many years:

1. 
   Fibrosis is a strong proliferation of connective tissue, but it is worth noting that the appearance of fibrosis is a normal phenomenon, this is how the body responds to the appearance of a foreign body in the body - filler. But if this process becomes uncontrollable, then as a consequence, after a few years, seals appear that are not only palpable, but also protrude above the surface of the skin, stretching it.

2. Scarring - this pathology occurs only in those patients who have a tendency to form keloid and peripheral scars on the skin. In this case, the wounds from the injections do not heal, but begin to turn into scars. This happens because the direct contraindication to the “beauty injection” was ignored.

Some women refuse the injection of fillers because they believe that it can stretch the skin, and after resorption it will become even more wrinkled - this is a myth.

Hyaluronic acid, which is part of the filler, tightens the skin, as it stimulates the production of its own elastin and collagen, the face becomes natural with the natural elasticity of the skin.

When the gel is introduced, the subcutaneous layer is filled with the required amount of filler, as a result of which the wrinkle is smoothed out, volume is restored, tissue is strengthened and the skin becomes more elastic. In addition, modern fillers for nasolabial folds do not just create a visual rejuvenating effect. They improve cell synthesis and stimulate the production of collagen and elastin, which are an important part of the young dermis.

The duration of positive changes from “beauty injections” is influenced by the patient’s age, skin condition, and facial activity of his face. But the durability of the effect also depends on the type of filler chosen. Each type of filler has its own duration of action.

Fillers based on calcium hydroxyapatite and polylactic acid are more durable; their effect lasts up to two years. But this positive characteristic has an important drawback: if the patient is dissatisfied with the changes made, it will be difficult to return everything to its original state, and you will have to put up with such a persistent effect.

If the problem occurs despite taking all necessary precautions, it can be corrected using the following methods:

• Massage. The treated areas should be massaged to gently distribute the drug. This method is effective only if it is performed directly during the procedure.
• Excision of the injection. The method involves removing excess material using a needle.
• Aspiration. An incision is made in the damaged area, after which the filler is sucked out using a needle and syringe.
• Hyaluronidase. This is an enzyme that dissolves hyaluronic acid and is used to correct any unsatisfactory results with its use.

FAQ

How long does swelling last after filler injection?

Swelling at the filler injection sites for 3-5 days is considered normal; in some people it can persist for 7-10 days - for example, if the skin is overly sensitive.

How long after hyaluronidase can filler be injected?

Doctors recommend reintroducing fillers 3-4 weeks after using hyaluronidase.

Is it possible to do a facial massage after fillers?

Restrictions on facial massage are placed for 2 weeks after the introduction of fillers, but only if both the procedure itself and rehabilitation proceed without complications. Otherwise, massage is contraindicated until complete recovery (at least 4 weeks).

We recommend reading about why bruises appear after lip augmentation. From the article you will learn about the causes of bruises, their healing process, methods to speed up healing, and prevent complications. And here is more information about the appearance of seals on the lips after the injection of hyaluronic acid.

Fillers are widely used in facial contouring. Extensive experience in their use allows today to carry out these procedures with minimal complications. But before you decide on contour plastic surgery, you should weigh the pros and cons, become familiar with the contraindications and possible consequences.