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Retrospective Study of Vascular Complications Caused by Hyaluronic Acid Injection

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Abstract

Background

Complications from intravascular embolization of hyaluronic acid (HA) are not only no longer uncommon but also devastating. This study aimed to examine clinical aspects of patients referred to our hospital for care following complications from intravascular filler embolization.

Methods

We retrospectively reviewed data from all patients referred to our medical center for the management of complications associated with intravascular embolization of HA fillers including demographics, medical history, clinical features, and treatment between November 2013 and June 2022.

Results

A total of 116 patients with vascular complications (27 cases with vision loss and 89 cases with skin necrosis) were assessed. The highest risk injection sites for skin necrosis included the nasal region (58/115, 50.4%), temple (16/115, 13.9%), and forehead (11/115, 9.6%) and for vision loss included the nasal region (18/30, 60.0%) and forehead (7/30, 23.3%). In skin necrosis cases, a needle (60/89, 67.4%) carried a higher risk than that of a cannula (29/89, 32.6%), whereas in vision loss cases, nasal dorsum injections using a cannula (16/27, 59.3%) carried a higher risk than that observed using a needle (11/27, 40.7%). No treatment was completely successful in reversing these complications.

Conclusion

Intravascular embolization of HA filler is a serious complication. Although some combination treatments have been proposed, there is no standard protocol for treating severe complications.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.

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Acknowledgements

We would like to thank Editage for their linguistic assistance during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou, 510317, Guangdong Province, China

    You-Liang Zhang, Yin Chen, Zhong-Sheng Sun & Sheng-Kang Luo

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  1. You-Liang Zhang
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  2. Yin Chen
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Correspondence to Sheng-Kang Luo.

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Zhang, YL., Chen, Y., Sun, ZS. et al. Retrospective Study of Vascular Complications Caused by Hyaluronic Acid Injection. Aesth Plast Surg 47, 2745–2753 (2023). https://doi.org/10.1007/s00266-023-03522-9

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  • DOI: https://doi.org/10.1007/s00266-023-03522-9

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